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If use and abuse: assign only abuse If use, abuse, and dependence: assign only dependence DSM-V Diagnostic Criteria Criterion (1-4): Impaired Control Over Substance Use Taken in larger amounts or over a longer period than was intended Persistent desire or unsuccessful efforts to cut down or control substance use A great deal of time is spent in activities necessary to obtain and use the substance, or recover from it Craving, or a strong desire or urge to use substance Criterion (5-7): Social Impairment Recurrent substance use resulting in a failure to fulfill major obligations at work, school, or home Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of substance Important social, occupational, or recreational activities are given up or reduced because of use Criterion (8-9): Risky Use of Substance Recurrent opioid use in situations in which it is physically hazardous Continued opioid use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance Criterion (10-11): Pharmacological Criteria* Tolerance, as defined by either of the following: A need for markedly increased amounts of substance to achieve intoxication or desired effect A markedly diminished effect with continued use of the same amount of a substance Withdrawal, as manifested by either: Characteristics of substance withdrawal syndrome Substances are taken to relieve or avoid withdrawal symptoms RESOURCES: ICD-10-CM Guidelines

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In contrast, East Asia experienced the most significant declines in ASDR and age-standardized DALYs, with EAPCs of 1.72 (95% CI: [1.88]- [1.56]) and 1.79 (95% CI: [1.96] - [1.62])