1. ICD-10 classification of substance-use disorders MRCPsych addiction psychiatry seminars Dr Stuart Mclaren 2nd March 2012

2. Block F10-F19 Mental and behavioural disorders due to: F10alcoholF17tobacco F11opioidsF18volatile solvent F12cannabinoidsF19multiple and F13sedativesother F14cocaine F15stimulants F16hallucinogens

3. 1. Clinical conditions resulting from substance use F1x.0acute intoxication F1x.1harmful use F1x.2dependence syndrome F1x.3withdrawal state F1x.4withdrawal state with delirium

4. 2. Clinical conditions resulting from substance use F1x.5psychotic disorder F1x.6amnesic disorder F1x.7residual and late-onset psychotic disorder F1x.8other mental or behavioural disorders F1x.9unspecified mental and behavioural disorder

5. ICD-10 Dependence syndrome 3 or more evident some time in the previous year: Desire or compulsion to use the substance Difficulties in controlling use behaviour Withdrawal states Tolerance Neglect of other pleasures or interests ‘salience’ Persistent use despite harm

6. Classification of dependence syndrome F1x.20currently abstinent F1x.21currently abstinent, but in protected environment F1x.22on clinically supervised maintenance F1x.23currently abstinent on aversive drug F1x.24currently using the substance F1x.25continuous use F1x.26episodic use

7. Residual and late-onset psychotic disorder F1x.7 F1x.70flashbacks F1x.71personality or behavioural disorder F1x.72residual affective disorder F1x.73dementia F1x.74other persisting cognitive impairment F1x.75late-onset psychotic disorder

8. Problem of the majority or minority? CigarettesSex AlcoholExercise Illicit drug useWork EatingShopping Gambling Internet Love

9. Definitions of addiction ‘ Addiction is not an elephant!’ From ‘Theory of addiction’ by Robert West (2006)