Question: What Constitutes an Addiction?
The Diagnostic and Statistical Manual of Mental Disorders, (Fourth Edition) Text Revision, which is the current official text on which diagnoses are based, and contains the criteria for addiction and other mental health problems. However, the DSM does not define addictionspecifically. Rather, problems which fall under the umbrella of addiction are dispersed throughout the manual.
Alcohol and Drug Addictions
The criteria for addiction to alcohol and drugs are typically diagnosed using the criteria for substance dependence. There are seven criteria for substance dependence. To be diagnosed, the person would have to have at least three of the criteria within the same year.
The first two criteria, tolerance and withdrawal, are central to “physiological dependence” on a drug. A person can be diagnosed with substance dependence either with or without the “physiological dependence,” although a person is at greater risk of medical problems and relapse if he does not have “physiological dependence.”
The seven criteria for substance dependence are:
(1) Tolerance, as defined by either of the following:
(a) A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
(b) Markedly diminished effect with continued use of the same amount of the substance.
(2) Withdrawal, as manifested by either of the following: (a) The characteristic withdrawal syndrome for the substance (refer to Criteria A or B of the criteria sets for Withdrawal from specific substances). (b) The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms.
(3) The substance is often taken in larger amounts or over a longer period than was intended.
(4) There is a persistent desire or unsuccessful efforts to cut down or control substance use.
(5) A great deal of time is spent in activities necessary to obtain the substance (such as visiting multiple doctors or driving long distances), use the substance (such as chain smoking) or recover from its effects.
(6) Important social, occupational, or recreational activities are given up or reduced because of substance use.
(7) The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
Diagnostic and Statistical Manual of Mental Disorders, Text Revision, Fourth Edition, (Copyright 2000). American Psychiatric Association.