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Cottler and Grant et al raise 2 concerns regarding the estimates of alcohol and illicit drug dependence in the NCS-R: (1) that the algorithm required respondents to endorse at least 1 lifetime abuse symptom for a diagnosis of dependence, yielding an underestimate of DSM-IV1 dependence; and (2) that our approach of aggregate assessment of drug dependence rather than separate assessment of individual classes of illicit drugs is inconsistent with the fact that DSM-IV does not have a category of generic drug dependence.
Kessler RC, Merikangas KR. Drug Use Disorders in the National Comorbidity Survey: Have We Come a Long Way?—Reply. Arch Gen Psychiatry. 2007;64(3):381-382. doi:10.1001/archpsyc.64.3.381