• Important social, occupational, or recreational activities are given up or reduced because of alcohol use. • Recurrent alcohol use in situations in which it is physically hazardous. • 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. • Tolerance, as defined by either of the following: o A need for markedly increased amounts of alcohol to achieve intoxication or desired effect. o A markedly diminished effect with continued use of the same amount of alcohol. • Withdrawal, as manifested by either of the following: o The characteristic withdrawal syndrome for alcohol. o Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms. Stimulant use disorder A pattern of amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period: • The stimulant is often taken in larger amounts or over a longer period than was intended. • There is a persistent desire or unsuccessful efforts to cut down or control stimulant use. • A great amount of time is spent in activities necessary to obtain the stimulant, use the stimulant, or recover from its effects. • Craving, or a strong desire or urge to use the stimulant. • Recurrent stimulant use resulting in a failure to fulfill major role obligations at work, school, or home. • Continued stimulant use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the stimulant. • Important social, occupational, or recreational activities are given up or reduced because of stimulant use. • Recurrent stimulant use in situations in which it is physically hazardous.
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