Aligning the ICD-11 classification of disorders due to substance use with global service needs
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The use of psychoactive, potentially dependence-producing substances is highly prevalent around the world, and contributes substantially to global disease burden. There is a major gap between the need for treatment for substance use disorders. Changes proposed for the classification of substance use disorders in the Eleventh Revision of the International Classification of Diseases and Related Health Problems, based on a public health approach, have important implications for the conceptualisation, structure and availability of services. These include: (1) an updated and expanded range of substance classes; (2) greater specification of different harmful patterns of substance use, which may be continuous or episodic and recurrent; (3) a new category to denote single episodes of harmful use; (4) a category describing hazardous use of substances; and (5) simplification of diagnostic guidelines for substance dependence. This paper describes these changes and the opportunities they present for improved prevention, treatment, monitoring and health policy.
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Separate categories for Harmful Substance Use and Substance Dependence are intended to facilitate early recognition and intervention for substance use problems, helping to distinguish between patterns that may respond to brief psychological interventions and those needing more substantial treatment.
“Separate categories for Harmful Substance Use and Substance Dependence are intended to facilitate early recognition and intervention for substance use problems, helping to distinguish between patterns of substance use behaviour that may respond to brief psychological interventions such as motivational interviewing and those needing more substantial treatment that may include detoxification or”
From An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in <scp>ICD</scp> ‐11 and <scp>DSM</scp> ‐5 (2021) · cites this paper as [74]
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Forouzanfar, M. H., Afshin, A., Alexander, L. T., Anderson, H. R., Bhutta, Z. A., Biryukov, S., Brauer, M., Burnett, R., Cercy, K., Charlson, F. J., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31679-8 · Cited by 7,698 · see citing works
Neurobiology of addiction: a neurocircuitry analysis
Koob, G. F., & Volkow, N. D. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)00104-8 · Cited by 3,698 · see citing works
Drug Dependence, a Chronic Medical Illness
McLellan, A. T., Lewis, D. C., O'Brien, C. P., & Kleber, H. D. (2000) · JAMA · doi:10.1001/jama.284.13.1689 · Cited by 2,622 · see citing works
Wang, P. S., Aguilar-Gaxiola, S., Alonso, J., Angermeyer, M. C., Borges, G., Bromet, E. J., Bruffaerts, R., de Girolamo, G., de Graaf, R., Gureje, O., et al. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61414-7 · Cited by 1,655 · see citing works
Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol
Anderson, P., Chisholm, D., & Fuhr, D. C. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60744-3 · Cited by 1,102 · see citing works
Tackling Harmful Alcohol Use: Economics and Public Health Policy
OECD (2015) · doi:10.1787/9789264181069-en · Cited by 991 · see citing works
The Untilled Fields of Public Health
Winslow, C. ‐. A. (1920) · Science · doi:10.1126/science.51.1306.23 · Cited by 716 · see citing works
Lopez‐Quintero, C., Cobos, J. P. D. L., Hasin, D. S., Okuda, M., Wang, S., Grant, B. F., & Blanco, C. (2010) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2010.11.004 · Cited by 702 · see citing works
‘Vaping’ profiles and preferences: an online survey of electronic cigarette users
Dawkins, L., Turner, J. J., Roberts, A. D. L., & Soar, K. (2013) · Addiction · doi:10.1111/add.12150 · Cited by 461 · see citing works
Neuroscience of Psychoactive Substance Use and Dependence
Mann, K. F. (2004) · Addiction · doi:10.1111/j.1360-0443.2004.00906.x · Cited by 300 · see citing works
International Advisory Group for the Revision of ICD‐10 Mental and Behavioural Disorders (2011) · World Psychiatry · doi:10.1002/j.2051-5545.2011.tb00022.x · Cited by 300 · see citing works
Drug policy and the public good: evidence for effective interventions
Strang, J., Babor, T. F., Caulkins, J. P., Fischer, B., FOXCROFT, D. R., & Humphreys, K. N. (2012) · The Lancet · doi:10.1016/s0140-6736(11)61674-7 · Cited by 267 · see citing works
Drug policy and the public good
Babor, T. F., Caulkins, J. P., Edwards, G., Fischer, B., Foxcroft, D., Humphreys, K. N., Obot, I. S., Rehm, J. T., Reuter, P., Room, R., et al. (2010) · Choice Reviews Online · doi:10.5860/choice.48-0303 · Cited by 218 · see citing works
Keeley, J. W., Reed, G. M., Roberts, M. C., Evans, S. C., Medina-Mora, M. E., Robles, R., Rebello, T., Sharan, P., Gureje, O., First, M. B., et al. (2016) · American Psychologist · doi:10.1037/a0039972 · Cited by 173 · cited 1× · see citing works
“For example, Koob & Volkow (2016) have described three phases in the development of dependence in a ‘ cycle that goes from repetition (pursuit of pleasure), to maladaptation (negative emotions and withdrawal), to an increasingly severe dependence (loss of control), which denote repeated failures in…”
BackgroundSelf-citationDrug Policy and the Public Good
Babor, T. F., Caulkins, J. P., Edwards, G., Fischer, B., FOXCROFT, D. R., Humphreys, K. N., Obot, I. S., Rehm, J. T., Reuter, P., Room, R., et al. (2009) · doi:10.1093/acprof:oso/9780199557127.001.0001 · Cited by 169 · see citing works
Online survey characterizing vaporizer use among cannabis users
Lee, D. C., Crosier, B. S., Borodovsky, J. T., Sargent, J. D., & Budney, A. J. (2015) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2015.12.020 · Cited by 140 · see citing works
Shidhaye, R., Lund, C., & Chisholm, D. (2015) · International Journal of Mental Health Systems · doi:10.1186/s13033-015-0031-9 · Cited by 125 · see citing works
Reduced-risk drinking as a viable treatment goal in problematic alcohol use and alcohol dependence
van Amsterdam, J., & van den Brink, W. (2013) · Journal of Psychopharmacology · doi:10.1177/0269881113495320 · Cited by 109 · see citing works
Chisholm, D., & Saxena, S. (2012) · BMJ · doi:10.1136/bmj.e609 · Cited by 100 · see citing works
Wegman, M. P., Altice, F. L., Kaur, S., Rajandaran, V., Osornprasop, S., Wilson, D., Wilson, D. P., & Kamarulzaman, A. (2017) · The Lancet Global Health · doi:10.1016/s2214-109x(16)30303-5 · Cited by 87 · see citing works
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Advances in the science and treatment of alcohol use disorder
Witkiewitz, K. A., Litten, R. Z., & Leggio, L. (2019) · Science Advances · doi:10.1126/sciadv.aax4043 · Cited by 599 · see citing works
First, M. B., Gaebel, W., Maj, M., Stein, D. J., Kogan, C. S., Saunders, J. B., Poznyak, V. B., Gureje, O., Lewis‐Fernández, R., Maercker, A., et al. (2021) · World Psychiatry · doi:10.1002/wps.20825 · Cited by 236 · see citing works
Self-citationAlcohol Use Disorders in ICD‐11: Past, Present, and Future
Saunders, J. B., Degenhardt, L., Reed, G. M., & Poznyak, V. (2019) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.14128 · Cited by 135 · see citing works
Self-citationMarsden, J., Tai, B., Ali, R. L., Hu, L., Rush, A. J., & Volkow, N. D. (2019) · Addiction · doi:10.1111/add.14546 · Cited by 80 · see citing works
Personality disorder and substance use disorder – An update
Köck, P., & Walter, M. (2018) · Mental Health & Prevention · doi:10.1016/j.mhp.2018.10.003 · Cited by 52 · see citing works
Corkery, J., Schifano, F., & Martinotti, G. (2019) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.14183 · Cited by 38 · see citing works
Estimating the economic consequences of substance use and substance use disorders
Manthey, J., Hassan, S. A., Carr, S., Kilian, C., Kuitunen‐Paul, S., & Rehm, J. T. (2021) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1080/14737167.2021.1916470 · Cited by 37 · see citing works
Störungen durch Substanzgebrauch und abhängige Verhaltensweisen in der ICD-11
Arnaud, N., & Thomasius, R. (2020) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000748 · Cited by 19 · see citing works
A Bibliometric Analysis of the Development of ICD-11 in Medical Informatics
Chen, D., Zhang, R.-T., Zhao, H., & Feng, J. (2019) · Journal of Healthcare Engineering · doi:10.1155/2019/1649363 · Cited by 18 · see citing works
Matone, A., Gandin, C., Ghirini, S., & Scafato, E. (2022) · Clinical Psychology in Europe · doi:10.32872/cpe.9539 · Cited by 16 · see citing works
ICD ‐11 for Alcohol Use Disorders: Not a Convincing Answer to the Challenges
Rehm, J. T., Heilig, M. A., & Gual, A. (2019) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14182 · Cited by 17 · see citing works
Psychische Störungen in der ICD-11
Walter, H., Husemann, R., & Hölzel, L. P. (2024) · Nervenheilkunde · doi:10.1055/a-2216-7277 · Cited by 14 · see citing works
Yen, J., Chou, W., Liao, H.-Y., & Ko, C. (2022) · Current Addiction Reports · doi:10.1007/s40429-022-00459-y · Cited by 14 · see citing works
Diagnostic Definitions and Classification of Substance Use Disorders
Saunders, J. B., & Latt, N. C. (2020) · Springer eBooks · doi:10.1007/978-3-030-36391-8_8 · Cited by 12 · see citing works
Schüler-Springorum, M., Unseld, M., & Wolf, T. (2024) · Forensische Psychiatrie Psychologie Kriminologie · doi:10.1007/s11757-023-00817-0 · Cited by 12 · see citing works
Yen, J., Király, O., Griffiths, M. D., Demetrovics, Z., & Ko, C. (2024) · Journal of Behavioral Addictions · doi:10.1556/2006.2024.00066 · Cited by 11 · see citing works
Lundin, A., Wærn, M., Löve, J., Lövestad, S., Hensing, G. K. E., & Danielsson, A. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108925 · Cited by 11 · see citing works
Mallah, N., Rodríguez‐Cano, R., Figueiras, A., & Takkouche, B. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108730 · Cited by 10 · see citing works
Reed, G. M., First, M. B., Kogan, C. S., Hyman, S. E., Gureje, O., Gaebel, W., Maj, M., Stein, D. J., Maercker, A., Tyrer, P., et al. (2019) · World Psychiatry · doi:10.1002/wps.20611 · Cited by 765 · see citing works
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Cherpitel, C. J., Ye, Y., & Poznyak, V. (2018) · Bulletin of the World Health Organization · doi:10.2471/blt.17.202093 · Cited by 8 · see citing works
Self-citationSevigny, E. L., & Caces, M. F. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.07.043 · Cited by 8 · see citing works
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Chen, D., Zhang, R., & Zhu, X. (2018) · Entropy · doi:10.3390/e20100769 · Cited by 6 · see citing works
Bishop, L., & Almquist, Y. B. (2020) · Addiction · doi:10.1111/add.15174 · Cited by 6 · see citing works
Bobes-Bascarán, T., Flórez, G., Seijo, P., & Bobes, J. (2019) · Adicciones · doi:10.20882/adicciones.1368 · Cited by 6 · see citing works
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Modrzyński, R. (2023) · Psychiatria i Psychologia Kliniczna · doi:10.15557/pipk.2022.0031 · Cited by 5 · see citing works
Smoking cessation among people with mental illness: A South African perspective
Morar, T., & Robertson, L. J. (2022) · South African Family Practice · doi:10.4102/safp.v64i1.5489 · Cited by 4 · see citing works
Terminology and Conceptualization of Opioid Use Disorder and Implications for Treatment
Saitz, R. (2019) · Current clinical psychiatry · doi:10.1007/978-3-030-16257-3_4 · Cited by 4 · see citing works
A Brief History of Opioids and the Evolution of Concepts Associated with Substance Use Disorders
Cruz, S. L., & Rafful, C. M. (2022) · Springer eBooks · doi:10.1007/978-3-031-09936-6_1 · Cited by 3 · see citing works
Reed, G. M. (2023) · Cambridge University Press eBooks · doi:10.1017/9781009182232.002 · Cited by 3 · see citing works
Self-citationReal, T., Cruz, S. L., Medina‐Mora, M. E., Robles, R., & González, H. (2020) · Springer eBooks · doi:10.1007/978-3-030-36391-8_20 · Cited by 3 · see citing works
Self-citationICD-11 chapter on mental and behavioural disorders: heralding new ways of seeing old problems
Gureje, O. (2018) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796018000033 · Cited by 3 · see citing works
Laslett, A., & Room, R. (2021) · Addiction · doi:10.1111/add.15436 · Cited by 3 · see citing works
The correlation between strength and range of motion of the neck muscles and opium smoking in Iran
Massah, O., Arab, A. M., Farhoudian, A., Noroozi, M., & Hashemirad, F. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1200091 · Cited by 2 · see citing works
Reed, G. M. (2023) · Cambridge University Press eBooks · doi:10.1017/9781009182232 · Cited by 2 · see citing works
Self-citationSubstance use disorders: a call for a staging paradigm
Bachi, K., Hurd, Y. L., & Salsitz, E. A. (2025) · Translational Psychiatry · doi:10.1038/s41398-025-03484-3 · Cited by 2 · see citing works
Massah, O., Arab, A. M., Farhoudian, A., Noroozi, M., & Hashemirad, F. (2023) · Brain Sciences · doi:10.3390/brainsci13091281 · Cited by 2 · see citing works
Disorders Due to Substance Use
Saunders, J. B. (2023) · Cambridge University Press eBooks · doi:10.1017/9781009182232.007 · Cited by 1 · see citing works
CIM-11 (OMS) : nouvelle révision et impact de la classification onusienne en psychiatrie
Chessa, A., & Sentissi, O. (2023) · L Encéphale · doi:10.1016/j.encep.2023.10.003 · Cited by 1 · see citing works
How the ICD ‐11 and the CDDR address the public health dimensions of substance use
Medina‐Mora, M. E., & Robles, R. (2024) · World Psychiatry · doi:10.1002/wps.21252 · Cited by 1 · see citing works
Self-citationRathod, H. K. (2023) · Healthline · doi:10.51957/healthline_533_2023 · Cited by 1 · see citing works
Development and Current Status of ICD-11 Mental, Behavioral, or Neurodevelopmental Disorders
Gäebel, W., Salveridou‐Hof, E., Kresse, A., Kadakia, R. F., & Reed, G. M. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009067287.018 · Cited by 1 · see citing works
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Abdulrahim, D., & Bowden‐Jones, O. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818788-3.00005-x · Cited by 1 · see citing works
Massah, O., Arab, A. M., Farhoudian, A., Noroozi, M., & Hashemirad, F. (2024) · Preprints.org · doi:10.20944/preprints202401.1163.v1 · Cited by 1 · see citing works
Abhängigkeitserkrankungen – eine Volkskrankheit?
Lesch, O., & Walter, H. (2020) · Springer eBooks · doi:10.1007/978-3-662-60284-3_2
Haley, S. J., Vargens, R. W., Sudré, A. A. D. S., Ferreira, F., Alves, K., de Carvalho, V. A. L., Puig, D. S. N., Athié, K., & Fortes, S. (2021) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00648-2
Addiction: A Short Overview of a Widespread Disease
Lesch, O., Walter, H., Wetschka, C., Hesselbrock, M. N., HESSELBROCK, V. M., & Pombo›, S. (2020) · Springer eBooks · doi:10.1007/978-3-030-41941-7_2
The Hazardous Use Scale of psychoactive substances. A pilot study
Modrzyński, R., Pisarska, A., & Mańkowska, A. (2022) · Alcoholism and Drug Addiction · doi:10.5114/ain.2022.125279
Schieber, L. Z., Lopes-Cardozo, B., & Guy, G. P. (2023) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2023.2116
Ware, O. D., & Dunn, K. E. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197618431.013.3
Association Between Opium Smoking and Neck and Upper Spine Posture Disorders
Massah, O., Arab, A. M., Farhoudian, A., Noroozi, M., & Hashemirad, F. (2023) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs-138142
Laurenz, L. J., & Thomasius, R. (2023) · Springer eBooks · doi:10.1007/978-3-662-65267-1_25
Ahmadi, S., Basharpoor, S., Atadokht, A., Narimani, M., & Hasani, F. (2022) · Journal of Health and Care · doi:10.61186/jhc.24.3.193
Crespi, G., Giglio, E., Galimberti, G. L., & Lucchini, A. (2024) · MISSION · doi:10.3280/mis65-66-2024oa18112
Amiola, A., Sahadevan, S., Rafiq, S. B., & Alexander, R. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009430715.015
Matevosyan, S. N., Soghoyan, A. F., & Tataryan, K. (2024) · ARMENIAN JOURNAL OF MENTAL HEALTH · doi:10.55436/1829202x-2024.15.2-3
Devgun, P., Nagpal, M., Bajwa, D. S., Ghara, H. K., Gupta, R., Kaur, A., Kaur, B., Kaur, S., Kalkat, I. S., Khanna, P., et al. (2025) · Healthline · doi:10.51957/healthline_735_2025
Linkes, C. D., & Vives, M. (2025) · The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society · doi:10.1002/9781118410868.wbehibs167.pub2
Linkes, C. D., & Vives, M. (2025) · The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society · doi:10.1002/9781118410868.wbehibs1046
Substance Use Disorders and Suicide
Abou‐Saleh, M. T. (2025) · Cambridge University Press eBooks · doi:10.1017/9781108963763.012
Heckel, N., Nordt, C., Engeli, E., Duerler, P., & Herdener, M. (2026) · Advances in Drug and Alcohol Research · doi:10.3389/adar.2026.16094
McKeegan, G. F. (2026) · Evidence-based practices in behavioral health · doi:10.1007/978-3-032-18372-9_12
Reilly, J., Lam, M., Sara, G. E., & Heffernan, E. (2026) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674261470582
- Authors
- Poznyak, V., Reed, G. M., & Medina-Mora, M. E.
- Affiliations
- World Health Organization (CH)
- Columbia University Irving Medical Center (US)
- Corresponding author
- Poznyak, V.
- Venue
- Epidemiology and Psychiatric Sciences
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-12-04
- Volume
- 27
- Issue
- 3
- Pages
- 212-218
- ISSN
- 2045-7960 (ISSN-L)
- 2045-7979
- PMC
- PMC6998967
- OpenAlex
- W2771559873
- Cited by
- 62
- References
- 20
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 9 · 2023: 12 · 2022: 6 · 2021: 7 · 2020: 6 · 2019: 9 · 2018: 5
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Epidemiology and Psychiatric Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- ICD-11, substance use disorders, substance dependence, diagnostic classification, global health policy, substance use prevention, health planning
- MeSH terms
- Humans, Public Health, Substance-Related Disorders, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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