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Substance Use Disorder E026

Last amended 
31 October 2017
Current RMA Instruments
Reasonable Hypothesis SOP
59 of 2017
Balance of Probabilities SOP
60 of 2017
Changes from previous Instruments

SOP Bulletin 199

ICD Coding
  • ICD-9-CM Codes: 304, 305.2-305.8
  • ICD-10-AM Codes: F11.2, F12.2, F13.2, F14.2, F15.2, F16.2, F17.2, F19.2, F55.0
Brief description

Substance use disorder is a DSM-5 diagnosis that replaced the DSM-IV categories of drug dependence and drug abuse.  The condition involves clinically significant psychosocial impairment and problematic behaviors related to obtaining, using, or recovering from a substance.

Confirming the diagnosis

A report from a specialist psychiatrist that conforms with the Repatriation Commission Guidelines for Psychiatric Compensation Claims is required for diagnosis.

Additional diagnoses covered by SOP

Substance use disorder involving:

  • Amphetamines
  • Cannabis
  • Cocaine
  • Hallucinogens
  • Inhalants (hydrocarbon based)
  • Opioids
  • Prescription drugs (sedatives, hypnotics, anxiolytics, tranquillisers)
  • Tobacco
Conditions not covered by SOP
  • Alcohol use disorder*
  • Caffeine-related disorders
  • Chronic solvent encephalopathy*
  • Substance intoxication
  • Substance-induced mental disorders

* another SOP applies

Clinical onset

Clinical onset is when the the diagnostic criteria can first be said (by a medical practitioner) to have been fulfulled. It will not be when the substance was first used.

Clinical worsening

Evidence of worsening of the condition may be shown by an increase in the number of symptoms/diagnostic criteria or a more severe pattern of symptoms or problems resulting from substance use.  Establishing that any worsening represents a permanent clincial worsening will be more difficult, as there may be fluctuations in the pattern of substance use over time.