Multiple specified psychoactive substance dependência is a transtorno of regulation of uso of multiple specified substances arising from repeated or continuous uso of the specified substances. The characteristic feature is a strong internal drive to uso the specified substances, which is manifested by impaired ability to control uso, increasing priority given to uso over other activities and persistence of uso despite harm or negative consequences. These experiences are often accompanied by a subjective sensation of urge or craving to uso the specified substances. Physiological features of dependência may also be present, including tolerance to the effects of the specified substances, abstinência symptoms following cessation or reduction in uso of the specified substances, or repeated uso of the specified substances or pharmacologically similar substances to prevent or alleviate abstinência symptoms. The features of dependência are usually evident over a period of at least 12 months but the diagnosis may be made if uso of the specified substances is continuous (daily or almost daily) for at least 3 months.