Diagnostic Criteria

A. Cessation of (or reduction in) use of a substance that has been heavy and prolonged.

B. The development of a substance-specific syndrome shortly after the cessation of (or reduction in) substance use.

C. The substance-specific syndrome causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including withdrawal from another substance.

E. The substance involved cannot be classified under any of the other substance categories (alcohol; caffeine; cannabis; opioids; sedatives, hypnotics, or anxiolytics; stimulants; or tobacco) or is unknown.

Note: It is not permissible to code a comorbid mild other (or unknown) substance use disorder with other (or unknown) substance withdrawal.

Differential Diagnosis

Dose reduction after extended dosing, but not meeting the criteria for other (or unknown) substance withdrawal

The individual used other (or unknown) substances, but the dose that was used was insufficient to produce symptoms that meet the criteria required for the diagnosis.

Substance withdrawal or other substance/medication-induced disorders

Familiar substances may be sold in the black market as novel products, and individuals may experience withdrawal with discontinuing those substances. History, toxicology screens, or chemical testing of the substance itself may help to identify it.

Different types of other (or unknown) substance-related disorders

Episodes of other (or unknown) substance withdrawal may occur during, but are distinct from, other (or unknown) substance use disorder, unspecified other (or unknown) substance-related disorder, and unspecified other (or unknown) substance-induced disorders.

Other toxic, metabolic, traumatic, neoplastic, vascular, or infectious disorders that impair brain function and cognition

Numerous neurological and other medical conditions may produce rapid onset of signs and symptoms mimicking those of withdrawals. Paradoxically, drug intoxication also must be ruled out, because, for example, lethargy may indicate withdrawal from one drug or intoxication with another drug.

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