Substance Dependence (SD) is a maladaptive pattern of substance use, producing significant impairment or distress. It is a more serious substance use disorder than Substance Abuse (broadly defined as problem use). A diagnosis of SD requires at least three of the following symptoms: 1) tolerance to the substance's effects; 2) withdrawal symptoms when not using; 3) using more than intended; 4) persistent desire and unsuccessful efforts to reduce or control use; 5) much time spent getting, using, or recovering from the substance; 6) other activities given up because of substance use; and 7) continued use despite causing physical or psychological problems.

Antisocial Substance Dependence refers to SD with co-occurring antisocial behavior or conduct disorder (CD). CD is a persistent pattern of behavior, beginning in childhood or early adolescence, in which the basic rights of others or societal norms are violated. It can include behaviors ranging from lying and running away, serious violations of curfews and truancy, fighting, physical cruelty to people or animals, intentional fire-setting and deliberate destruction of property, to burglary, robbery and forced sexual activity. Evidence suggests that early-onset Antisocial Substance Dependence (SD + CD) may be more strongly influenced by heritable risk factors than other substance use disorders.


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Division of Substance Dependence