The Medical Definition of Addiction
The medical definition of addiction has seven criteria. This definition is based on the criteria of American Psychiatric Association (DSM-IV) and the World Health Organization (ICD-10).(1)
An addiction is any behavior that meets at least three of the seven criteria during the same 12-month period.
- Tolerance. You can use more and more over time.
- Withdrawal. When you stop using, you experience at least one of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting.
- Difficulty controlling your use. Sometimes you use more or for a longer time than you'd like.
- Negative consequences. You continue to use even though there are negative consequences to your mood, self-esteem, health, job, or family.
- Significant time or emotional energy spent. You spend a significant amount of time or thought obtaining, using, concealing, planning, or recovering from your use.
- Put off or neglected activities. You have given up or reduced social, recreational, work, or household activities because of your use.
- Desire to cut down. You have repeatedly thought about cutting down or controlling your use, or you have made unsuccessful attempts to cut down or control your use.
What Addiction is Not
You don't have to use every day. There is nothing in the definition about how often you use. You could use once a month, but if when you use you sometimes have difficulty controlling how much you use, or you have negative consequences, then you have an addiction.
You don't have to crave drugs or alcohol. You can go for a whole month without thinking about using or craving, but if you break down and have difficulty controlling your use, or have negative consequences because of your use, you still have an addiction.
You don't have to go through withdrawal. Every person is different when it comes to withdrawal. Some people experience significant withdrawal, and others very little. There's little correlation between how much withdrawal you experience and the extent of your addiction.
You don't have to suffer major losses. If you've suffered major losses, then you already have a major addiction. If your family members have ever commented on your use, then you've already suffered significant losses. It takes all of their courage in the beginning to make even the smallest comment about your use. The look of disappointment in their eyes is a loss. Bigger losses are harder to repair.
You don't need a fancy definition to tell you if you have an addiction. There is a simple test. If you think you might have a problem, then you probably do.
Terms
The terms alcohol addiction, alcoholism, and alcohol dependence all mean the same thing. No one term is more serious than the other. Different terms have evolved over the years to overcome the negative stigma of addiction, and to make it easier for people to reach out and ask for help.
The same is true for the terms drug addiction and drug dependence.
The Definition of Substance Abuse
Some people aren't addicted to drugs or alcohol, but abuse them. The American Psychiatric Association (DSM-IV) definition of substance abuse is at least one of the following four criteria.
- Continued use despite social or interpersonal problems.
- Repeated use resulting in failure to fulfill obligations at work, school, or home.
- Repeated use resulting in physically hazardous situations.
- Use resulting in legal problems.
Created: March 11, 2007, Last Modified: February 15, 2008