DSM-V could turn 40 per cent of college kids into ‘alcoholics’

I’ve written a blog post in the Telegraph about the unintended consequences of DSM-V’s decision to scrap the abuse/dependence distinction and replace it with varying degrees of “addiction”.

Up to 40 per cent of student drinkers could be classified as alcoholics, according to the revised “bible” of psychiatry, scheduled for publication next May.

I know what you’re thinking: only 40 per cent? Have these guys been anywhere near a college pub crawl?

But, actually, the new criteria set out by the American diagnostic manual DSM-V could end up doing something really stupid: that is, persuading four out of ten student drinkers that they are suffering from a “disease”, which is how most addiction specialists in the America and Britain (heavily influenced by Alcoholics Anonymous) regard addiction.

Here’s the problem: earlier DSM volumes distinguished between “abuse” of drugs and “dependence” on them. The first term is now regarded as too judgmental (of course) and the second is regarded as unscientific, because dependence on something isn’t the same thing as addiction. Are diabetics addicted to insulin, for example?

As this article from Time explains, DSM-V “will have just one diagnosis for addiction problems, though it will be characterised as either mild, moderate or severe”. So student boozers who get wasted once a week could be labelled as “mildly” addicted. And the result? As Time points out, since the name for alcohol addiction is alcoholism, the new manual “will also tremendously elevate the number of people considered alcoholics. One Australian study suggested that using DSM-V definitions will increase the number of people diagnosed with alcoholism by a stunning 60 per cent.”

As I stress in The Fix, there is a continuum between university binge drinking and alcoholism – I found myself sliding along it. I have no idea at which point I became an alcoholic. How long is a piece of string? “Addiction” is a complex phenomenon. On the one hand, if DSM-V recognises the existence of that continuum, that’s a good thing. But if it means shoehorning mildly or potentially addicted youngsters into the disease model, enabling 12-step groups to diagnose them with a lifelong, incurable illness, then the reform will achieve nothing and probably make matters worse.