F.11 Harmful use A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected psychoactive substances) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol).

F.12 Dependence syndrome A cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance and sometimes a physical withdrawal state.

The dependence syndrome may be present for a specific psychoactive substance (e.g. tobacco, alcohol or diazepam), for a class of substances (e.g. opioid drugs) or for a wider range of pharmacologically different psychoactive substances.

• Chronic alcoholism
• Dipsomania
• Drug addiction

Both of these definitions have subgroups, of which the following were included:

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Mental and behavioural disorders due to use of opioids

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Mental and behavioural disorders due to use of cocaine

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Mental and behavioural disorders due to use of hallucinogens

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Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances

This category should be used when two or more psychoactive substances are known to be involved, but it is impossible to assess which substance is contributing most to the disorders. It should also be used when the exact identity of some or even all the psychoactive substances being used is uncertain or unknown, since many multiple drug users themselves often do not know the details of what they are taking.

Includes: misuse of drugs NOS [not otherwise specified]