The DSM-5 Craving Criterion Was Validated for Cannabis and Five Other Substances, With Moderate Craving More Predictive Than Severe

Across all six substances, craving was associated with most baseline validators. Moderate craving was more strongly associated with validators than severe craving and improved predictive validity for daily substance use. Including craving improved the validity and clinical relevance of DSM-5 SUD diagnoses across all substances.

Validation study of 588 adults who engaged in binge drinking or illicit drug use and endorsed at least one DSM-5 SUD criterion. Assessed craving across 6 substances. Logistic regression estimated associations with validators. Electronic daily assessment tracked use for 90 days.

The DSM-5 added craving as a new diagnostic criterion for substance use disorders but it had not been systematically validated across substances. This study confirms it belongs in the diagnosis and works consistently across different drugs including cannabis.

For cannabis specifically, validating the craving criterion matters because some have questioned whether cannabis produces "real" cravings comparable to harder drugs. This study shows the craving criterion works just as well for cannabis as for heroin or cocaine.

Sample required at least one SUD criterion, so results may not generalize to casual users. Self-reported craving may be interpreted differently across individuals. 90-day follow-up captures a limited window. Cannot determine whether craving causes continued use or vice versa.