1Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland
The World Health Organization (WHO) is currently working on the development of the eleventh revision of the International Classification of Diseases (ICD), and the draft ICD-11 is currently at the final stage of development for subsequent field testing. There are several innovations in suggested nomenclature and taxonomy of disorders due to substance use and related health conditions. In the draft ICD-11, disorders due to substance use are merged with recognized “behavioural addictions” in the section “Disorders due to substance use and addictive behaviors”. The draft ICD-11 maintains the diagnostic categories of substance dependence and harmful substance use (“harmful pattern of use” in the draft ICD-11) as separate diagnostic entities. The diagnostic guidelines for dependence are revised and simplified by grouping 6 diagnostic features from ICD-10 into three: (i) impaired control over substance use; (ii) increasing priority in life (salience) and (iii) physiological features. Severity qualifiers are suggested for alcohol intoxication. A new diagnostic category has been introduced in the draft ICD-11, that has no equivalents in ICD-10 or DSM-5 – “single episode of harmful use”. Classes of psychoactive substances have been revised with an opportunity to code health conditions, due to use of the most prevalent “new psychoactive substances”– synthetic cannabinoids and synthetic cathinones. However the term “NPS” is deliberately avoided in the draft ICD-11. The methodology and implementation of the planned ICD-11 field testing will be described.