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The 11 DSM-5 diagnostic criteria for stimulant use disorder are: Taking stimulants in larger amounts or for longer than intended A persistent desire or unsuccessful efforts to reduce or control stimulant use Spending a great deal of time obtaining, using, or recovering from stimulants Strong craving or urge to use stimulants Failing to fulfill major obligations at work, school, or home because of stimulant use Continuing use despite persistent or recurring interpersonal or social problems caused by stimulants Giving up or reducing important social, work, or recreational activities because of stimulant use Repeatedly using stimulants in physically hazardous situations Continuing use despite knowing stimulants are worsening a physical or psychological condition Tolerance: needing significantly more of the drug to achieve the same effect Withdrawal: experiencing characteristic withdrawal symptoms when reducing or stopping use Severity is classified by the number of criteria met: Mild: 2 to 3 criteria Moderate: 4 to 5 criteria Severe: 6 or more criteria It is important to note that developing tolerance or experiencing withdrawal during prescribed, closely supervised medical use does not automatically constitute a use disorder

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None of the policies we reviewed had clauses that preempt lower jurisdictions from enacting stronger policies, but neither did any include explicit antipreemption language

"It appears that smokers have an altered opioid flow all the time, when compared with non-smokers, and that smoking a cigarette further alters that flow by 20 to 30 percent in regions of the brain important to emotions and craving," said David Scott, a graduate student in the University of Michigan Neuroscience Program