I.   Diagnostic Criteria for Psychoactive Substance Abuse

     A.   A maladaptive pattern of psychoactive substance use indicated by at
          least one of the following:

          1.   Continued use despite knowledge of having a persistent or
               recurrent social, occupational, psychological, or physical
               problem that is caused or exacerbated by use of the psychoactive
               substance

          2.   Recurrent use in situations in which use is physically hazardous

     B.   Some symptoms of the disturbance have persisted for at least one
          month, or have occurred repeatedly over a longer period of time

     C.   Never met the criteria for Psychoactive Substance Dependence for this
          substance

II. Diagnostic Criteria for Psychoactive Substance Dependence

     A.   At least three of the following:

          1.   Substance often taken in larger amounts or over a longer period
               than the person intended

          2.   Persistent desire or one or more unsuccessful efforts to cut
               down or control substance use

          3.   A great deal of time spent in activities necessary to get the
               substance (e.g., theft), taking the substance (e.g., chain
               smoking), or recovering from its effects

          4.   Frequent intoxication or withdrawal symptoms when expected to
               fulfill major role obligations at work, school, or home (e.g.,
               does not go to work because hung over, goes to school or work

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

          6.   Continued substance use despite knowledge of having a persistent
               or recurrent social, psychological, or physical problem that is
               caused or exacerbated by the use of the substance (e.g., keeps
               using heroin despite family arguments about it, cocaine-induced
               depression, or having an ulcer made worse by drinking)

          7.   Marked tolerance: need for markedly increased amounts of the
               substance (i.e., at least a 50% increase) in order to achieve
               intoxication or desired effect, or markedly diminished effect
               with continued use of the same amount

Note: The following items may not apply to cannabis,

hallucinogens, or phencyclidine (PCP)

          8.   Characteristic withdrawal symptoms (see specific withdrawal
               syndromes under Psychoactive Substance-induced Organic Mental
               Disorders)

          9.   Substance often taken to relieve or avoid withdrawal symptoms

     B.   Some symptoms of the disturbance have persisted for at least one
          month, or have occurred repeatedly over a longer period of time.

III. Criteria for Severity of Psychoactive Substance Dependence:

     A.   Mild: Few, if any, symptoms in excess of those required to make the
          diagnosis, and the symptoms result in no more than mild impairment in
          occupational functioning or in usual social activities or
          relationships with others.

     B.   Moderate: Symptoms or functional impairment between "mild" and

     C.   Severe: Many symptoms in excess of those required to make the
          diagnosis, and the symptoms markedly interfere with occupational
          functioning or with usual social activities or relationships with
          others.

     D.   In Partial Remission: During the past six months, some use of the
          substance and some symptoms of dependence.

     E.   In Full Remission: During the past six months, either no use of the
          substance, or use of the substance and no symptoms of dependence.

Because of the availability of cigarettes and other nicotine-containing substances and the absence of a clinically significant nicotine intoxication syndrome, impairment in occupational or social functioning is not necessary for a rating of severe nicotine dependence.