Document ID: chunk:federal_register_of_legislation:F2018C00653:reg:7:p1
Version: federal_register_of_legislation:F2018C00653
Segment Type: reg
Provision Reference: reg 7 (pt 1/2)
Character Range: 3752–7041

7               Kind of injury, disease or death to which this Statement of Principles relates
(1)          This Statement of Principles is about substance use disorder and death from substance use disorder.
Meaning of substance use disorder
(2)          For the purposes of this Statement of Principles, substance use disorder means a disorder of mental health that meets the following diagnostic criteria (derived from DSM-5):

          A problematic pattern of substance use leading to clinically significant impairment or distress, as manifested by at least four of the following criteria, occurring within a 12-month period:

              1. Substances are often taken in larger amounts or over a longer period than was intended.

              2. There is a persistent desire or unsuccessful efforts to cut down or control substance use.

              3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.

              4. Craving, or a strong desire or urge to use substances.

             5. Recurrent substance use resulting in a failure to fulfil major role obligations at work, school, or home.

             6. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substances.

              7. Important social, occupational, or recreational activities are given up or reduced because of substance use.

              8. Recurrent substance use in situations in which it is physically hazardous.

             9. Continued substance use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

            10. Tolerance, as defined by either of the following:

                (i)            a need for markedly increased amounts of substances to achieve intoxication or desired effect; or
                (ii)         a markedly diminished effect with continued use of the same amount of a substance.

             Note:  This criterion is not considered to be met for those individuals taking substances solely under appropriate medical supervision.

            K.        For substances other than hallucinogens or inhalants, withdrawal, as manifested by either of the following:

                (i)            the characteristic substance withdrawal syndrome; or
                (ii)         substances (or a closely related substance) are taken to relieve or avoid withdrawal symptoms.

             Note:  This criterion is not considered to be met for those individuals taking substances solely under appropriate medical supervision.
             Note:  The definition of substance use disorder excludes alcohol use disorder and acute substance intoxication in the absence of substance use disorder.
             Note:  DSM-5 and substance are defined in the Schedule 1 - Dictionary.
Death from substance use disorder
(3)          For the purposes of this Statement of Principles, substance use disorder, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's substance use disorder.
            Note: terminal event is defined in the Schedule 1