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The DSM-5 does not classify any substance as a gateway drug. The DSM-5 recognizes 10 substance classes and diagnoses substance use disorder across mild (2 to 3 criteria), moderate (4 to 5 criteria), and severe (6 or more criteria) severity levels based on 11 standardized criteria, with no reference to sequential initiation patterns

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They are then sent to a de-trimming center, called a "despalillo", to be stripped of their central vein