Addiction has been defined as "a chronically relapsing disorder," characterized by (1) compulsion to seek and take the
drug, (2) loss of control in limiting intake, and (3) emergence of a negative emotional state (eg, dysphoria,
anxiety, irritability) reflecting a motivational
withdrawal syndrome when access to the drug is prevented." It is a disease of the brain, several genetic factors have been identified which predispose an individual to developing addiction should an initial "event" (ie. drug use) take place.
An addict is someone who is addicted to a substance (or behavior), which is the case when three symptoms emerge: (1)
continued use despite negative consequences (ie. damage to health, financial loss, relational problems) (2)
loss of control (ie. in limiting intake, use of more than planned, use when inappropriate) (3) preoccupation/obsession (ie. thinking about the drug throughout the day, obsession around acquiring and using the drug).
The terms addiction and
dependence are no longer used to describe substance related disorders by the American Psychiatric Association. Instead all substance disorders are called "Substance Abuse Disorders". The disorders are differentiated according to the type of substance as follows:
A)
Alcohol
B)
Cannabis (including
marijuana,
hash, wax)
C)
Caffeine
D)
Hallucinogens (including
Phencyclidine,
Lysergic acid diethylamide,
Ecstasy, mushrooms, club, rave drugs)
E)
Inhalants
F)
Opioids (including
opiates,
heroin,
morphine,
methadone,
narcotics)
G)
Sedatives (muscle relaxers, barbiturates),
Hypnotics (sleeping pills),
anxiolytics (
benzodiazepines)
H)
Stimulants (including
cocaine,
crack,
amphetamines,
methamphetamine)
Diagnosis is made according to the following:
Thinking back, is there a 12-month period of time where you could answer YES to any of these questions?
1. Do you find that you use more often, or for a longer time, than you planned for?
2. Do you want to cut back or stop; or have you ever tried and failed to cut back or stop your use?
3. Do you spend a great deal of your time obtaining, taking, or recovering from your use?
4. Do you experience strong desires or cravings to use?
5. Have you repeatedly failed to fulfill major obligations at work, at home, or at school because of your use?
6. Do you continue to use even though you suspect, or even know, that it creates or worsens interpersonal or social problems?
7. Have you given up or reduced important social, occupational, or recreational activities because of your use?
8. Do you repeatedly use in situations in which it is physically hazardous to yourself or others, such as smoking in bed, driving a car, operating a machine, or being at work while intoxicated, impaired, or under the influence?
9. Do you continue to use, even though you suspect, or even know, that it creates or worsens problems with your mind and body?
10. Do you find that you need to use more than in the past in order to achieve the same desired effect, or that you feel less of an effect from the same amount than in the past?
11.*Do you find when you stop or reduce your use, that you experience any withdrawal symptoms, or have you ever taken another substance to prevent or reduce withdrawal symptoms?”
2-3 yes responses indicates a mild disorder.
4-5 yes responses indicates a moderate disorder.
6 or more yes responses indicates a severe disorder.