From:  Theodora Binion, Director
Division of Alcoholism and Substance Abuse

DSM-5 IMPLEMENTATION FOR DASA TREATMENT AND INTERVENTION PROVIDERS

The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013. As with previous editions, this latest DSM contains the most current and best available descriptions of how mental disorders are expressed and recognized by trained clinicians. Implementing the DSM-5 will assist individual clinicians to more accurately diagnose Substance Use Disorders as well as help substance abuse treatment providers better integrate into the larger medical and behavioral health treatment systems. For these reasons, DASA will require licensed substance abuse treatment and intervention providers begin using the DSM-5 on January 1, 2016. Since the current Administrative Rule Part 2060 mandates use of DSM-IV, this change will be implemented by policy directive and codified upon the next Part 2060 rule revision.

For DASA treatment providers, the most noteworthy DSM-5 change is the elimination of the separate Substance Abuse and Substance Dependence diagnostic categories. The two categories are being combined into one Substance Use Spectrum Disorder with varying levels of severity based on the number of symptoms identified. Under the newly combined disorder, 2-3 symptoms will result in a Mild Substance Use Disorder, 4-5 symptoms a Moderate Substance Use Disorder, and 6 or more symptoms a Severe Substance Use Disorder.

Implementation of the DSM-5 will also impact licensed Illinois DUI Evaluators. Currently, risk level classifications for DUI offenders may be determined by the presence of Substance Abuse or Substance Dependence symptoms as defined in the DSM-IV. One of four abuse symptoms or any dependence symptom results in the assignment of Significant Risk. Three of seven dependence symptoms results in the assignment of High Risk. Under newly established DSM-5 spectrum disorders, one symptom of a Substance Use Disorder will result in a Moderate Risk classification, 2-3 symptoms in a Significant Risk classification, and four or more in a High Risk classification. Starting January 1, 2016, an updated DUI Services Reporting System (eDSRS) reflecting these changes will be implemented.

In the coming months, DASA providers are encouraged to review their clinical processes and documentation procedures to ensure timely and accurate implementation of the DSM-5. DASA will be providing a series of webinars in the late fall of 2015 outlining the DSM-5 changes as they relate to DUI evaluation services and use of the updated eDSRS. Information regarding these webinars will be announced soon.

Thank you in advance for your cooperation and assistance. As always, contact DASA Help at DHS.DASAHELP@ILLINOIS.GOV with questions.