Understanding addiction requires understanding a complex interplay of factors, such as the nature of addictive substances, biology, emotional disposition and personal history of trauma and abuse. Terms like "addict" and "alcoholic" are not actually clinical definitions but are terms used frequently to describe people who have lost control of their use of a substance. Clinically, we use the terms abuse and dependence to categorize problems with addictive substances. According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Forth Edition) substance abuse and dependence are defined as follows:
Substance Abuse: A pattern of maladaptive use of a substance that results in clinically significant impairment over a 12 month period, marked by one or more of the following:
Substance Dependence: A pattern of maladaptive use of a substance that results in clinically significant impairment over a 12 month period, marked by three or more of the following:
Substance Abuse: A pattern of maladaptive use of a substance that results in clinically significant impairment over a 12 month period, marked by one or more of the following:
- Failure to fulfill major role obligations (i.e. at work, school, home).
- Recurrent substance use in situations where it is physically hazardous.
- Recurrent substance related legal problems.
- Continued use despite persistent personal or social problems.
Substance Dependence: A pattern of maladaptive use of a substance that results in clinically significant impairment over a 12 month period, marked by three or more of the following:
- Tolerance (needing to take more of the substance to achieve a desired effect, or diminished effect with continued use of the same substance).
- Withdrawal (as marked by the characteristic withdrawal symptoms for the particular substance, or using the substance to avoid withdrawal symptoms).
- Taking the substance in larger amounts than planned.
- Repeated unsuccessful attempts to cut down or quit using the substance.