ICD Body System
Mental disorders [290 - 319]
Date amended:
External
Statements of Principles
Current RMA Instruments

Reasonable Hypothesis SOP

50 of 2026

Balance of Probabilities SOP

51 of 2026
Changes from previous Instruments

 

ICD Coding
  • ICD-10-AM Codes:  F11.1, F11.2,  F11.1, F12.2,  F13.1, F13.2,  F14.1, F14.2,  F15.1, F15.2,  F16.1, F16.2,  F17.1, F17.2, F18.1, F18.2,  F19.1, F19.2
Brief description

Substance use disorder is a mental health disorder characterised by a problematic pattern of substance use resulting in clinically significant impairment or distress. Under DSM-5-TR, the diagnosis requires at least two diagnostic criteria to be present within a 12-month period. The disorder encompasses a spectrum of severity, replacing the previous DSM-IV categories of substance abuse and substance dependence. 

Confirming the diagnosis

This diagnosis needs to be confirmed by a psychiatrist who needs to assess whether the DSM-5-TR diagnostic criteria for substance use disorder have been met. 

Additional diagnoses covered by SOP

Substance use disorder involving:

  • Cannabis
  • Cocaine
  • Hallucinogens
  • Inhalants (hydrocarbon based)
  • Multiple substances or other psychoactive substances 
  • Opioids
  • Other stimulants (including amphetamines)
  • Prescription drugs (sedatives, hypnotics, anxiolytics, tranquillisers)
  • Sedatives, hypnotics or anxiolytics
  • Tobacco
Conditions not covered by SOP
  • Alcohol use disorder *
  • Caffeine- related disorders #
  • Chronic solvent encephalopathy *
  • Substance intoxication #
  • Substance withdrawal #
  • Substance- induced mental disorders (unless occurring in the presence of substance use disorder) #

* another SOP applies

# Non-SOP condition

Clinical onset

Clinical onset is the earliest point at which the DSM-5-TR diagnostic criteria for substance use disorder are first met. This requires at least two diagnostic criteria to have occurred within a 12- month period. Clinical onset is not the date the substance was first used or when occasional or recreational use commenced.

Clinical worsening

Clinical worsening may be demonstrated by progression in the severity of substance use disorder, including the development of additional DSM-5-TR diagnostic criteria, increasing functional impairment or distress, or escalation in the frequency or severity of problematic substance use. As substance use disorders often fluctuate over time, establishing permanent clinical worsening requires consideration of the overall clinical course rather than temporary exacerbations.