SHOULD TOLERANCE AND WITHDRAWAL BE REQUIRED FOR SUBSTANCE DEPENDENCE DISORDERS

Despite the historical importance of tolerance and withdrawal in the s ubstance abuse nomenclature, empirical evaluations of tolerance and wi thdrawal relative to other, non-physical, dependence criteria have bee n infrequent. Based on data from 521 subjects rom a newly completed su rvey evaluating proposed options for DSM-IV substance use disorders, w e found, first, across classes of drugs, requiring tolerance or withdr awal had little effect on rates of dependence, as most subjects who me t dependence criteria for each drug class also reported tolerance. Sec ond, tolerance and withdrawal did not emerge as superior to the other dependence criteria on several indicators of concurrent and predictive validity, including severity.