The world has changed a lot in the past 16 years, and our views on addiction have changed with it. On February 10, the American Psychiatric Association (APA) shared with the world their updated take on addiction and related topics with the release of draft diagnostic criteria for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). An APA publication, the DSM is widely used as the basis for mental health diagnoses in the United States and is considered by many to be the “Bible” on mental health topics. Although the DSM has undergone several revisions since its initial publication in 1952, including a slight update in 2000, the version currently in use has seen no significant changes since 1994. The DSM-5, scheduled for release in final form in May 2013, will reflect the tremendous advances in medical and psychological science that have occurred in the last decade.

Some of the most significant changes in the draft version of the DSM-5 are related to addiction and substance abuse. Most notably, the work group responsible for reviewing the Substance-Related Disorders category of the DSM-IV has proposed that the categories of substance abuse and dependence be renamed Addiction and Related Disorders. This change is meant to help differentiate between the compulsive drug-seeking behavior that defines addiction and the tolerance and withdrawal that can be seen even with appropriate use of prescribed drugs.

The category of Addiction and Related Disorders will also expand to include non-substance related addictions. So far pathological gambling is the only disorder with sufficient research to be recommended for inclusion in the DSM-5 under behavioral addictions, although Internet addiction was considered. Additions to the behavioral addiction category are expected in the future, as scientists begin conducting more studies on the topic. They have a lot of work to do to catch up with pop culture, which has introduced addictions to things like shopping, video games, Facebook, work, and obesity—not to mention the prominent spot in the headlines given to sex addiction, thanks to celebrities like Tiger Woods and David Duchovny.

The proposed draft of the DSM-5 is available for review at www.dsm5.org, and readers can submit comments until April 20, 2010.