Epidemiology ofDSM-5Drug Use Disorder

Abstract

Drug use disorders (DUDs) are associated with substantial burden through impairment in major life roles and increased risk for suicidality, neuropsychological deficits, diminished quality of life, and infectious disease (eg, human immunodeficiency virus and hepatitis).^1-7 Drug use disorders also confer substantial burden on families, social networks, and society as a whole through violent and property crime, incarceration, poverty, and homelessness.^4,8 Changing societal factors in the last 15 years suggest changes in the distribution of DUDs in the general US adult population. These include public attitudes that have become increasingly permissive toward some types of drug use and legalization.^9-12 Also, prescriptions for opioid analgesics and other psychoactive medications with addiction potential have increased greatly, with consequences such as drug overdoses.^13-15 In addition, obtaining secure employment has become more difficult for many; unemployment is robustly associated with increased risk for DUDs.¹⁶ Using DSM-IV definitions of DUDs, national survey data indicate that prevalence may have increased. Comparisons of 12-month and lifetime DSM-IV DUD prevalence in the general adult population in 2001-2002 (2.0% and 10.3%, respectively)¹⁷ and 2012-2013 (4.1% and 15.6%, respectively)^18,19 indicate that rates of 12-month DUDs more than doubled, while rates of lifetime DUDs increased by 50%. With a wider segment of the population now affected by DUDs, up-to-date information is needed on other aspects of DUDs distribution in the general population, including sociodemographic correlates, associated comorbidity and disability, and treatment use.