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Co-Occurring Schizophrenia and Substance Dependence/Abuse

Substance Dependence

Substance Dependence
Substance Abuse
Assessment of Co-occurring Disorders
Motivational Interviewing
Applying MI: Express Empathy
Applying MI: Develop Discrepancy
Applying MI: Avoid Argument
Applying MI: Roll With Resistance
Applying MI: Support Self-Efficacy
Evidence Based for Motivational Interviewing
Future Research and Barriers to Service
Web sites of Interest

Substance Dependence Criteria

A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:


1. Tolerance, as defined by either of the following:

  •  A need for markedly increased amounts of the substance to achieve Intoxication or desired effect
  •  Markedly diminished effect with continued use of the same amount of the substance


2. Withdrawal, as manifested by either of the following:

  •  The characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
  •  The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms


3. The substance is often taken in larger amounts or over a longer period than was intended


4. There is a persistent desire or unsuccessful efforts to cut down or control substance use


5. A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects


6. Important social, occupational, or recreational activities are given up or reduced because of substance use


7. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)


Specify if:


With Physiological Dependence: evidence of tolerance or withdrawal (i.e., either Item 1 or 2 is present)

Without Physiological Dependence: no evidence of tolerance or withdrawal (i.e., neither Item 1 nor 2 is present)






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Nicole & Colleen