Circular 14/2026/TT-BYT Regulating Diagnostic Criteria and Professional Procedures for Determining the State of Drug Dependence

 

CIRCULAR

Regulating diagnostic criteria and professional procedures

for determining the state of drug dependence

MINISTER OF HEALTH

 

Based on the Narcotics Control Law No. 120/2025/QH15;

Based on the Medical Examination, Treatment Law No. 15/2023/QH15;

Based on Decree No. 42/2025/NĐ-CP regulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

Based on Decree No. 166/2026/NĐ-CP regulating the dossier, procedures, and formalities for determining the state of drug dependence;

Considering the proposals by the Director of the Department of Disease Prevention and the Director of the Department of Medical Examination and Treatment;

The Minister of Health promulgates this Circular to regulate diagnostic criteria and professional procedures for determining the state of drug dependence.

 

Article 1. Scope of Application

This Circular regulates diagnostic criteria and professional procedures for determining the state of drug dependence for individuals specified in paragraph 1, Article 31 of the Narcotics Control Law No. 2025.

Article 2. Diagnostic Criteria for Drug Dependence

1. A person is diagnosed as having a drug dependence when at least three out of six criteria specified herein occur simultaneously within at least one month, or if they occur in a shorter period than one month, then repeatedly over the course of twelve months. The diagnostic criteria for the state of drug dependence include the following six criteria:

a) Criterion 1: Strong desire or feeling compelled to use drugs;

b) Criterion 2: Difficulty controlling behaviors related to drug use in terms of timing, duration, or dosage;

c) Criterion 3: Evidence of tolerance to the drug;

d) Criterion 4: Increasing apathy towards other pleasures or hobbies due to drug use;

e) Criterion 5: Continued use of drugs despite knowledge of their harmful effects;

f) Criterion 6: Presence of withdrawal state (withdrawal syndrome) when discontinuing or reducing drug use.

2. The determination of criteria 2, 3, 4, 5, and 6 for diagnosing drug dependence is carried out according to the guidelines specified in Appendix I attached hereto. The determination of characteristic withdrawal states from drugs is conducted according to the guidelines for determining characteristic withdrawal states from drugs specified in Appendix II attached hereto.

3. The determination of diagnostic criteria for drug dependence is based on clinical follow-up results, information obtained from the individual requiring diagnosis or their companion (if any), and records provided by the local police authority or a specialized agency responsible for narcotics control and crime prevention (hereinafter referred to as the requesting authority).

Article 3. Professional Procedures for Determining Drug Dependence

1. Step 1: Receive individuals requiring determination of drug dependence and the request dossier from the requesting authority in accordance with the provisions of Paragraph 3, Article 3 of Decree No. 166/2026/NĐ-CP dated May 15, 2026, issued by the Government regulating the dossier, procedures, and formalities for determining drug dependence..

2. Step 2: Conduct medical examination, clinical follow-up, update information in the patient's medical record, and complete the Comprehensive Follow-Up Form as specified in Appendix III attached hereto to determine the state of drug dependence.

3. Step 3: Record conclusions:

a) In cases where only one or two criteria of drug dependence are present, including Criterion 6, conclude "not dependent on drugs" and provide the result of determining drug dependence according to the provisions of Article 4 of this Circular.

b) In cases where at least three criteria of drug dependence as specified in Paragraph 1, Article 2 of this Circular are present, conclude "dependent on drugs" and provide the result of determining drug dependence according to the provisions of Article 4 of this Circular.

c) In cases where two criteria of drug dependence are present, including Criterion 6 or where signs according to the diagnostic criteria for drug dependence are not clear, follow the provisions of Paragraph 4 of this article.

4. Step 4: Conduct medical examination and clinical follow-up, update information, record in the patient's medical file, and complete relevant follow-up forms in cases specified in point c of paragraph 3 of this article:

a) Immediately conduct medical examination and clinical follow-up to determine the state of drug dependence;

b) Conduct medical examination and update the medical record;

c) Monitor and complete the Comprehensive Follow-Up Form for determining the state of drug dependence and relevant follow-up forms for determining withdrawal states from each type of drug, including: Follow-Up Form for Determining Withdrawal States from Opium-like Drugs as specified in Appendix III; Follow-Up Form for Determining Withdrawal States from Stimulants (amphetamine, cocaine or other stimulants) as specified in Appendix III; and Follow-Up Form for Determining Withdrawal States from Cannabis as specified in Appendix III attached hereto;

d) Record "withdrawal state present" or "no withdrawal state present" in the relevant follow-up forms for determining withdrawal states from each type of drug. The conclusion on withdrawal states is summarized in the Comprehensive Follow-Up Form for determining the state of drug dependence;

e) Record the state of drug dependence in the Comprehensive Follow-Up Form for determining the state of drug dependence and update the medical record. In cases where at least three out of six criteria of drug dependence as specified in Paragraph 1, Article 2 of this Circular are present, conclude "dependent on drugs". If there are not enough three criteria of drug dependence or if the diagnostic criteria have not been fully met due to insufficient time, conclude "not dependent on drugs". Provide the result of determining drug dependence according to the provisions of Article 4 of this Circular.

5. During the process of determining the state of drug addiction, individuals who need to be determined as having a state of drug addiction and who exhibit withdrawal symptoms, mental disorders, or accompanying illnesses shall be examined and treated in accordance with the provisions of the law on medical examination and treatment. In cases where expertise exceeds the capabilities of the relevant professionals, transfer to healthcare facilities equipped for such treatment shall be carried out.

1. Record the results in accordance with the conclusion regarding the state of drug addiction on the Comprehensive Follow-up Registration Form and enter it into the Drug Addiction Status Determination Result Form as per Model No. 04 specified in the Annex to Decree No. 166/2026/NĐ-CP.

2. The Drug Addiction Status Determination Result Form shall be transmitted in accordance with Point d, Clause 2 of Article 4; Point c, Clause 2 of Article 5 and Clause 3 of Article 6 of Decree No. 166/2026/NĐ-CP.

Article 5. Implementation

1. The Department of Disease Prevention shall be responsible for coordinating the implementation, guidance, and inspection of this Circular.

2. The Department of Medical Examination and Treatment shall cooperate with the Department of Disease Prevention in implementing and inspecting the execution of the provisions of this Circular according to their assigned functions and responsibilities.

3. Health authorities under the Ministry of Public Security and the Ministry of Defense within their jurisdiction shall be responsible for coordinating, cooperating with relevant agencies and units in implementing this Circular.

4. People's Committees at provincial and municipal levels shall be responsible for:

b) Direct training institutions under its jurisdiction to organize continuous training on diagnosing and determining drug dependence for healthcare facilities and doctors, medical officers to determine drug dependence according to the provisions of Circular No. 22/2013/TT-BYT dated August 9, 2013 by the Minister of Health guiding continuous training for health personnel, amended and supplemented by Circular No. 26/2020/TT-BYT.

c) Entrust people's committee at the commune level to direct healthcare facilities under its jurisdiction to implement this circular and regularly report quarterly, annually or on an urgent basis on activities related to determining drug dependence in their administrative areas and send reports to specialized health agencies under the provincial people's committee according to regulations.

5. The person determined to be dependent on drugs or his/her parents, guardians, or legal representatives have the responsibility:

a) To comply with the rules and regulations of the healthcare facility during the process of determining drug dependence;

b) To provide truthful information about their history of using drugs, signs of drug use, and other relevant professional information during the process of determining drug dependence.

Article 6. Enforceability

1. This Circular shall come into force on July 1, 2026.

2. The Circular No. 18/2021/TT-BYT dated November 16, 2021, issued by the Minister of Health, which stipulates the diagnostic criteria and professional procedures to determine the state of drug dependence, shall cease to have effect from the date this Circular comes into force.

Article 7. Cross-Reference

In case there are changes, supplements, or replacements in laws and regulations cited in this Circular, such provisions shall be applied according to the new legal document.

Article 8. Implementation Responsibility

The Director of the Office of the Ministry, Director of the Department of Disease Prevention, Director of the Department of Medical Examination and Treatment, Heads of Departments and Bureaus under the Ministry of Health, Heads of Subordinate Organs and Units under the Ministry of Public Security and Ministry of Defense, Chairmen of People's Committees of Provinces and Municipalities, and other relevant organs and organizations shall be responsible for implementing this Circular.

In case of difficulties or obstacles during implementation, entities, organizations, and individuals are to report to the Ministry of Health (through the Department of Disease Prevention) for guidance and resolution./.

 

 

 

Appendix I

GUIDELINES FOR DETERMINING CRITERIA 2, 3, 4, 5 AND 6

FOR DIAGNOSIS OF DRUG DEPENDENCE

(Issued with Circular No. …./2026/TT-BYT dated [date] of 2026 by the Minister of Health)

1. Criterion 2. Difficulties in controlling drug use behaviors, including at least one of the following:

a) Using drugs with larger quantities and for longer durations than intended;

b) Persistent desire or efforts to reduce or control drug use that are unsuccessful.

2. Criterion 3. Evidence of tolerance to drugs, including at least one of the following:

a) Increased need for significant amounts of drugs to achieve desired effects or intoxication;

b) Reduced effectiveness with continued use of the same quantity of drugs.

3. Criterion 4. Increasing indifference towards other pleasures or interests due to drug use, including at least one of the following:

a) Significant changes in interests or concerns that are abandoned or reduced due to drug use;

b) Most of the time spent seeking or using drugs or recovering from their effects.

4. Criterion 5. Continued drug use despite knowledge of harmful effects, including:

a) Physical: contracting sexually transmitted infections, HIV/AIDS, hepatitis B, hepatitis C, or other complications such as intoxication and overdose;

b) Psychological and behavioral: depression, anxiety, cognitive impairment, emotional instability, etc.;

c) Family consequences: economic depletion, family breakdown, loss of trust in the user.

5. Criterion 6. Evidence of withdrawal syndrome (drug withdrawal symptoms) when stopping or reducing drug use, including at least one of the following:

a) Typical withdrawal state: signs of withdrawal from opiate drugs; stimulants (amphetamine-like substances, cocaine, or other stimulants), and cannabis. Guidelines for determining typical withdrawal states of drugs are provided in Appendix II attached to this Circular;

b) Using the same type of drug or similar substances to alleviate or avoid withdrawal symptoms.

Appendix II

GUIDELINES FOR DETERMINING

TYPICAL WITHDRAWAL STATES OF DRUGS

(Issued with Circular No. …./2026/TT-BYT dated [date] of 2026 by the Minister of Health)

1. Signs to determine opiate withdrawal state:

a) Evidence of recent cessation or reduction in use of opiate drugs after repeated use over a long period;

b) At least three out of twelve withdrawal symptoms listed below appear within several minutes to several days following the sign at point (a):

- Desire for drug use;

- Nasal congestion or sneezing;

- Watery eyes;

- Muscle pain or cramps;

- Abdominal cramping;

- Nausea or vomiting;

- Diarrhea;

- Pupillary dilation;

- Goosebumps or chills;

- Increased heart rate or blood pressure;

- Yawning;

- Insomnia.

c) These withdrawal symptoms are not related to internal medicine conditions, psychiatric disorders, or other behavioral disorders.

2. Signs to determine stimulant (amphetamine-like substances, cocaine, or other stimulants) withdrawal state:

a) Evidence of recent cessation or reduction in use of stimulants after repeated use over a long period;

b) Mood disorder (depression or loss of pleasure);

c) At least two out of six withdrawal symptoms listed below appear within several hours to several days following the sign at point (a):

- Drowsiness or fatigue;

- Sluggishness or mental agitation;

- Desire for stimulants;

- Increased appetite;

- Insomnia or excessive sleep;

- Strange and difficult-to-understand dreams.

d) These withdrawal symptoms are not related to internal medicine conditions, psychiatric disorders, or other behavioral disorders.

3. Signs to determine cannabis withdrawal state:

a) Evidence of recent cessation or reduction in use of cannabis after repeated use over a long period.

3. Signs to determine withdrawal from cannabis:

a) Evidence of having recently stopped or reduced cannabis use after long-term repeated use of cannabis.

b) At least three of the seven withdrawal symptoms listed below appear within a maximum of five days after the signs specified in point a of this section:

- Irritability, anger, or provocation;

- Stress or anxiety;

- Sleep disturbance (insomnia or nightmares);

- Loss of appetite or weight loss;

- Restlessness;

- Diminished appearance;

- At least one of the following symptoms: abdominal pain, tremors, sweating, fever, chills, headache.

c) These withdrawal symptoms are not related to an internal disease, mental disorder, or another behavioral disorder.

Appendix III

MODEL FORM FOR DETERMINING THE STATUS OF DRUG DEPENDENCE

(Issued in conjunction with Decree No. …./2026/TT-BYT dated [date] 2026

by the Minister of Health)

 

Model Number 01. Combined follow-up form to determine the status of drug dependence

 

I. Personal Information

II. Follow-up results to determine the status of drug dependence

1. Drug of concern for determining the status of drug dependence (if applicable): …

2. Follow-up results regarding diagnostic criteria for determining the status of drug dependence:

Note:

- (*) The criterion occurs simultaneously within at least one month, or if it exists for a shorter period than one month, it must recur simultaneously within twelve months.

- Drug dependence is determined when there are at least three out of six diagnostic criteria for drug dependence.

III. Conclusion on the status of drug dependence:

……………………………………………()…………………………………….……..….………….……………………………………………………………………

 

Model Number 02. Follow-up form to determine the state of withdrawal from opiate drugs

I. Personal Information

1. Full Name: (...)

2. Date, month, year of birth: …/… /……

3. Gender:  Male  Female

II. Follow-up results to determine the state of withdrawal from opiate drugs

Determination of withdrawal status when any of the following signs are present:

1. Evidence of recent cessation or reduction in use of opiate drugs after prolonged repeated use:  Yes  No

2. At least three out of twelve withdrawal symptoms listed below appear within a few minutes to several days after sign 1:  Yes  No

Restless sleepNote:

: The maximum follow-up period to determine the state of withdrawal from opiate drugs is three days.

………………………………………………()………………………………………………….…………………………………………………………………………

 

(Sign, write full name)

 

(amphetamine, cocaine or other stimulants)

I. Personal Information

1. Full Name: (...)

2. Date, month, year of birth: …/… /……

3. Gender:  Male  Female

II. Follow-up results to determine the state of withdrawal from stimulants

Determination of withdrawal status when any of the following signs are present:

1. Evidence of recent cessation or reduction in use of stimulants after prolonged repeated use:  Yes  No

Insomnia or excessive sleepStrange and difficult to understand dreams

Note:

………………………………………………………()…………………………………………...………………………………………………………………………

 

 

 

 

 

 

 

 

 

 

 

Determination of drug dependence status

FOLLOW-UP FORM

TO DETERMINE THE STATE OF WITHDRAWAL FROM CANNABIS

I. Personal Information

1. Full Name: (...)

2. Date, month, year of birth: …/… /……

1. There is evidence of having recently ceased or reduced the use of cannabis after a long history of repeated use:  Yes  No

2. At least three out of seven withdrawal symptoms listed below have appeared within five days following symptom 1 above:  Yes  No

These withdrawal symptoms are not related to internal medicine diseases, mental disorders, or another behavioral disorder:  Yes  No

Notes: The observation period to determine the cannabis withdrawal state: a maximum of five days.

III. Conclusion on Cannabis Withdrawal State:

………………………………………………()…………………………………………

…………………………………………………………………………………………...