The Diagnostic and Statistical Manual of Mental Disorders (DSM) is one of the most commonly referred to manuals on mental health disorder diagnosis and treatment. Updated regularly, the fifth version of the manual will be released in May, and it is expected to have a few changes that may be significant for patients who are struggling with alcohol abuse and addiction.
Formerly, a patient could be diagnosed with either problem drinking (e.g., alcohol abuse) or alcohol addiction (e.g., alcoholism). In the new DSM-V, however, these disorders will be combined into a single diagnosis: alcohol use disorder.
How will this affect treatment and care for patients who need their health insurance company to cover part of the cost of treatment?
Insurance Coverage and the DSM
Insurance companies often base their decision on what treatment services will and will not be covered under a given policy based upon the diagnosis received by the patient and the therapies that have been proven to be effective in its care. In some cases, changes to the DSM can impact this significantly. If, for example, a disorder is removed from the manual altogether or is separated out of a spectrum disorder, the change to the criteria required for a diagnosis may mean that someone who has formerly been receiving health insurance coverage for treatment of that disorder will no longer qualify.
In the case of the combined alcohol use disorder, this likely will be a non-issue, according to a report on Time.com.
Will People Lose Their Alcohol-Related Diagnosis Due to DSM Changes?
A study published in the journal Alcoholism: Clinical & Experimental Research investigated whether or not the new diagnostic definition of alcohol abuse and use would change the diagnosis of participants currently struggling with an alcohol problem. They looked at 7,000 sets of twins to cull their data and found that the change was not likely to cause a less accurate diagnosis than the current criteria but that it doesn’t necessarily improve the diagnostic criteria currently in use.
Right now, there is a separate diagnosis for alcohol abuse, which implies either a short-term alcohol problem or a binge drinking issue, and for alcoholism, which requires long-term and chronic physical and psychological dependence upon alcohol. The new “alcohol use disorder” will include patients who currently fall into both categories. Essentially, those who are new to alcohol abuse and long-term alcoholics could end up with the diagnosis. Though patients’ access to treatment will likely be unaffected, it could have a negative impact on the patient who, for example, may struggle with binge drinking during college and seek help but otherwise have no issue with alcohol.
Alexis Edwards, PhD, was a researcher for the study. In a news release, he said: “(I)t is not clear that the proposed diagnostic changes will result in a more accurate diagnosis. (A)t best, one group of low severity cases will be replaced by another; at worst a group of individuals who exhibit more severe problems will be excluded from the DSM-5 diagnosis, while less severely affected individuals will meet diagnostic criteria.”
Learn More About Alcohol Rehabilitation at Alta Mira
If someone you love is struggling with alcohol abuse or addiction, don’t wait to get them the treatment they need to heal. Though changes to the DSM shouldn’t affect their access to appropriate medical care, every day they continue with an active alcohol abuse problem could be damaging to their physical and mental health and wellness. Contact us at Alta Mira today to speak to a counselor about effective alcohol rehab and treatment.