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Expansion of the classes of psychoactive substances: The number of psychoactive substance classes has increased from 9 in ICD-10 to 14 in ICD-11, according to a 2022 article by Matone et al., published in the journal Clinical Psychology in Europe , titled Alcohol and Substance Use Disorders Diagnostic Criteria Changes and Innovations in ICD-11: An Overview . The additional substance classes include cannabis, nicotine, caffeine, synthetic cathinones, and MDMA (Methylenedioxymethamphetamine) or related drugs including MDA (3,4-Methylenedioxyamphetamine)