{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T21:26:30Z","timestamp":1793568390765,"version":"4.5.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Australian Government Research Training Program Scholarship","award":["DOI: https:\/\/doi.org\/10.82133\/C42F-K220"],"award-info":[{"award-number":["DOI: https:\/\/doi.org\/10.82133\/C42F-K220"]}],"id":[{"id":"https:\/\/ror.org\/0314h5y94","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Aust N Z J Psychiatry"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Effective treatment and care of substance use disorders requires reliable and valid diagnosis. Their diagnosis in mental health services reportedly remains inconsistent despite their prevalence and associated harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study examines routine substance use disorder diagnosis across public adult mental health services to identify patterns. Care recorded in the statewide electronic health record of 58,724 adults over 4\u2009years was analysed. Substance use disorder diagnosis, specified and aggregated by substance class and clinical state, was compared across gender, age, substance class and diagnostic groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Substance use disorder was present in 34.4% of patients. Common specific substance classes were nicotine, cannabinoids, alcohol and stimulants (excluding cocaine). The most common class at 14.1% was multiple and other drug use. Of those with any substance use disorder, 45.3% had multiple and other drug use or other residual use disorders and 21.3% had substance-induced psychosis. People with schizophrenia had higher proportions of substance use disorders than the entire cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Substance use disorder diagnostic practice lacks specificity and consistency with diagnostic classification guidance. Disorders requiring combined consideration of aetiology and comorbidity, including \u2018multiple and other drug use\u2019 disorders and substance-induced psychosis, may be over-diagnosed. Nicotine use disorder is likely under-diagnosed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Improving diagnostic specificity is central to effectively treating substance use disorders. Non-specific substance use disorder diagnoses, including \u2018multiple and other drug\u2019 use, should be avoided unless necessary. Specific substances should be named. Consistent use of diagnostic classifications and ongoing diagnostic review are vital for diagnostic clarification and specific treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00048674261470582","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:33:31Z","timestamp":1785490411000},"page":"1053-1062","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Substance use disorders diagnostic practice in Australia: A study of Queensland\u2019s adult mental health services"],"prefix":"10.1177","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5065-772X","authenticated-orcid":false,"given":"John","family":"Reilly","sequence":"first","affiliation":[{"name":"Mental Health Alcohol and Other Drugs Branch, Clinical Excellence Queensland, Queensland Health, Brisbane, Australia"},{"name":"School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lam","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia"},{"name":"Forensic Mental Health Group, Queensland Centre for Mental Health Research, Queensland Health, West Moreton Hospital and Health Service, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3762-1711","authenticated-orcid":false,"given":"Grant","family":"Sara","sequence":"additional","affiliation":[{"name":"Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia"},{"name":"Faculty of Medicine and Health, University of New South Wales, Sydney, Australia"},{"name":"System Information and Analytics Branch, NSW Ministry of Health, St Leonards, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ed","family":"Heffernan","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia"},{"name":"Forensic Mental Health Group, Queensland Centre for Mental Health Research, Queensland Health, West Moreton Hospital and Health Service, Brisbane, Australia"},{"name":"Queensland Forensic Mental Health Service, Metro North Hospital and Health Service, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"e_1_3_3_2_1","volume-title":"Implementing the Comprehensive Care Standard: Clinical Assessment and Diagnosis","author":"Australian Commission on Safety and Quality in Health Care (ACSQHC)","year":"2020","unstructured":"Australian Commission on Safety and Quality in Health Care (ACSQHC) (2020) Implementing the Comprehensive Care Standard: Clinical Assessment and Diagnosis. 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