Alcohol dependence criteria

According to the ICD 10, a definite diagnosis is made when three or more of the key features of dependence have been present at the same time during the previous year:

• a strong desire or sense of compulsion to drink alcohol
• difficulties in controlling drinking behaviour in terms of its onset, termination, or levels of consumption
• a physiological withdrawal state when drinking has stopped or been reduced, as evidenced by the characteristic alcohol withdrawal syndrome (tremor, sweating, anxiety, nausea and vomiting, agitation, insomnia) or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms—for example, benzodiazepines
• evidence of tolerance, such that increased quantities of alcohol are required to achieve the effects originally produced by lesser amounts
• progressive neglect of alternative pleasures or interests because of alcohol consumption, increased amount of time necessary to obtain or drink alcohol or to recover from its effects (1);

According to the DSM-IV criteria for alcohol dependence, at least three out of seven of the following criteria with respect to alcohol use must be manifest during a 12 month period:

• tolerance
• withdrawal symptoms or clinically defined alcohol withdrawal syndrome
• use in larger amounts or for longer periods than intended
• persistent desire or unsuccessful efforts to cut down on alcohol use
• time is spent obtaining alcohol or recovering from effects
• social, occupational and recreational pursuits are given up or reduced because of alcohol use
• use is continued despite knowledge of alcohol-related harm (physical or psychological)

Reference:

• (1) Day E, Copello A, Hull M. Assessment and management of alcohol use disorders. BMJ. 2015;350:h715
• (2) NICE (February 2011). Alcohol-use disorders - Diagnosis, assessment and management of harmful drinking and alcohol dependence