Wednesday, June 11, 2014

New Diagnosis Alcohol Use Disorder Goes Mainstream in New York

New York City Port Authority Sign
Taken by moi on my most recent field trip

Two years ago I discussed the re-vamping of the DSM (diagnostic and statistical manual of mental disorders) aka the manual aka the bible of mental disorders to it's newest, greatest, and latest edition V.

While Number 5 is still gaining ground it is still not quite mainstream IMHO. Most (the vast majority and everyone I know) of the therapists, evaluators, OASAS assessors, doctors, and clinical social workers are still stuck on the older DSM edition IV, and it's commensurate antiquated verbiage.

see my blog post on the new DSM-V here:

Not the Age of Aquarius but One of ADDICTION

We are, face it still living in the age of "addiction." The terms abuse and dependency are still on every evaluator and therapist lips, so I was surprised two weeks ago at what I saw posted up at the New York Port Authority Terminal. A large poster of a child, and the words "7.5 million children in the U.S. live with a parent with an alcohol use disorder"

It finally happened, not dependency, not addiction but the first use publicly of the catch-all term:


The fear has begun, and I am here to say, no I am here to state, that the use of these new terms is scary. Because the new terms are vast, vague, and so all encompassing. There are in fact:

alcohol use disorder
substance use disorder
marijuana use disorder
etc. use disorder

and the treatment called for is ,,,

you name it depending on how the evaluator feels about the severity of the use disorder and it's context.
Is this

Diagnoses that are non-specific

Vague definitions give clinicians great leeway. BUT they can lead to everything from non invasive to fully invasive methods and treatment. These can give the therapists and evaluators IMO too much control based merely on an opinion and too much subjectivity to make a diagnosis let alone formulate a proper and appropriate treatment protocol.

Are we moving forward or backwards? Hard to say at this time. Harder still will be getting judges, prosecutors, and probation officers to understand all these new terms and definitions.

The New DSM V is Not Bad "per se"

I used the book (the old DSMs) in college and in my practice for many years. Even physical diagnoses as a Chiropractic Physician sometimes had a mental overlay. Treatment of a whole person required understanding mind and body. Untreated mental issues prolonged physical ones. Anxiety and stress, and manic-depressive (bi-polar) conditions are all too common within our population. Proper and appropriate diagnostic work ups and treatment need to be part and parcel of the management of any disease including those involving drugs and/or alcohol.

Always consult with an attorney about any criminal or non-criminal charges you have pending to discuss your options and/or defenses.

I am certified in Field Sobriety and Breath Alcohol Testing, and an active member of the National College of DUI Defense (NCDD). My online materials include over 500 blog posts, dozens of articles, and over 500 informative videos on my youtube channel.

I have co-authored Strategies for Defending DWI Cases in New York, in both 2011 and 2013. These are West Thomson legal manuals on New York State DWI defense, and focus on the best practices for other lawyers handling a New York DWI case. I was selected by Super Lawyers as a Upstate New York 2013 Rising Star in DWI/DUI Defense based on my experience, contributions, and professional standing.