HAMS: Harm Reduction for Alcohol

DSM-IV-TR Criteria for Alcohol Dependence

Alcohol Dependence - Diagnostic Code 303.90

A maladaptive pattern of alcohol 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) a need for markedly increased amounts of alcohol to achieve Intoxication or desired effect

(b) markedly diminished effect with continued use of the same amount of alcohol

(2) Withdrawal, as manifested by either of the following:

(a) the characteristic withdrawal syndrome for alcohol (refer to Criteria A and B of the criteria sets for Withdrawal from alcohol)

(b) alcohol (or a closely related drug such as valium) is used to relieve or avoid withdrawal symptoms

(3) alcohol is often used 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 alcohol use

(5) a great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects

(6) important social, occupational, or recreational activities are given up or reduced because of alcohol use

(7) alcohol 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 alcohol (e.g. continued drinking despite recognition that an ulcer was made worse by alcohol consumption)


  • 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)

Course specifiers

  • Early Full Remission
  • Early Partial Remission
  • Sustained Full Remission
  • Sustained Partial Remission
  • On Agonist Therapy
  • In a Controlled Environment

(Note--a diagnosis of Alcohol Dependence can never be changed to a diagnosis of Alcohol Abuse. The DSM also states that "The differentiation of Sustained Full Remission from recovered (no current Substance Abuse Disorder) requires consideration of the length of time since the last period of disturbance, the total duration of the disturbance, and the need for continued evaluation.")

from DSM-IV-TR

Please also visit our web page DSM-IV-TR Alcohol Related Disorders

Online Support
Chat Room
Live Meetings
17 Elements
Sample Plans
Recommended Reading
Online Store
About HAMS
Evidence For HR
Contact Us

HAMS is a 501(c)3 not-for-profit incorporated in the state of New York


The HAMS Harm Reduction Network, Inc.
P. O. Box 498
New York, NY 10012
Tel: 347-678-5671
Email: hams@hamshrn.org

HAMS: Where Better is Better!

© 2009 The HAMS Harm Reduction Network, Inc.
Under 21? Please visit AHRCS