Psychiatrists and mental health specialists who are revising the manual used to diagnose mental disorders have just agreed to revise the definition of addiction. According to The New York Times, this decision could mean that millions more people will be diagnosed as addicted. The impact will affect health insurers, taxpayers and families of patients across the nation.
The manual, known as the DSM (for Diagnostic and Statistical Manual of Mental Disorders), is currently undergoing its fifth revision and is scheduled to be finalized by the end of the year and released in May 2013. The manual is used to by insurance companies to determine coverage, by courts to determine the mental fitness of defendants and by a host of other government agencies and private organizations. The American Psychiatric Association is responsible for the content of the DSM-5.
The new definition of addiction that has been approved for DSM-5 includes an expanded list of symptoms for drug and alcohol addiction. At the same time, the number of symptoms required for a diagnosis of addiction is being reduced. For example, people who frequently drink too much and crave alcohol can be diagnosed as addicted under the new definition even if their use of alcohol has not seriously disrupted their life.
According to Dr. Charles O’Brien, head of the group of researchers who came up with the new addiction standards for DSM-5, the new definition will allow substance abusers to receive treatment sooner and avoid serious complications that can occur with chronic addiction.
In addition to revising the definition of drug and alcohol addiction, gambling will be included as an addiction disorder for the first time. The panel of doctors working on DSM-5. is also considering adding “behavioral addiction” as a new catchall diagnosis that could include addiction to sex, shopping, the Internet or video games.
Dr. Keith Humphreys, a Stanford psychology professor and former White House drug policy advisor, predicts that as many as 20 million substance abusers could suddenly be categorized as addicts. This could lead to an unprecedented expansion in addiction treatment. According to The New York Times, some economists believe that many health insurers will react to DSM-5 changes by limiting coverage of addiction treatment.
The DSM revision process, which involves the work of 162 specialists, has been controversial. The panel is said to have received 25,000 comments on its proposed changes from researchers, treatment centers, government agencies and patient advocate groups. None of these comments have been made public.