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Continued drinking despite adverse consequences constitutes an alcohol-usedisorder4 (Table 1). The Diagnostic and Statistical Manual of Mental Disorders, fourthedition, text revision (DSM-IV-TR), differentiates abuse from dependence,4 but recentresearch suggests that they represent one disorder, which the proposed taxonomyfor the DSM-5 would consolidate into a single spectrum.9 At the severe endof the spectrum, chronic, severe dependence is a recurring brain disorder characterizedby loss of control over drinking, drinking despite harm, daily or neardailydrinking, a compulsion to drink (“craving”), tolerance, withdrawal, andsubstantial disability.
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