How is Addiction Diagnosed?

Addiction often escapes diagnosis for a number of reasons. First, the addict (whether addicted to drugs, alcohol, or some activity such as sex or work) is reticent to admit to a problem. They are very likely going to see their addiction as the one thing getting them through life as opposed to the thing that is working against them and contributing to all their other problems. Second, they are not very likely to seek treatment. Addictions are often diagnosed when an addict seeks treatment for some other form of emotional disorder such as depression, whether that emotional disorder is real or imagined. The addict might think they are “depressed” when, in fact, they are experiencing emotional problems as a result of their addiction.

The DSM IV, the diagnostic criteria manual published by the American Psychiatric Association, states that there are four criteria for substance abuse:

  • Failure to fulfill major obligations
  • Use when physically hazardous
  • Recurrent legal problems
  • Recurrent social or interpersonal problems

Substance abuse is the first escalation toward full-blown addiction. An individual may use a substance socially, meaning that their use is purely recreational and occasional. Then they may begin using more heavily, which is considered substance abuse. If substance abuse is left unchecked, they may become addicted. The DSM IV lists these criteria as indicators of addiction:

  • Tolerance, meaning that more of the substance must be used to produce a high
  • Withdrawal, meaning that serious physical symptoms appear when use is discontinued
  • Use of large amounts of the substance over long periods of time or frequent binging
  • Unsuccessful attempts to cut down
  • Time spent obtaining the substance replaces social, occupational, or recreational activities
  • Continued use despite adverse consequences

The main overriding symptom of addiction is loss of control. If someone repeatedly tries to stop using the substance and cannot successfully cut down or quit on their own, they would be diagnosed as addicted. The “Big Book” of Alcoholics Anonymous, which is the text used to work the 12 steps, suggests that anyone who questions whether or not they are an alcoholic should try some “controlled drinking.” If they find that they cannot control how much they drink when they drink, or they cannot control when and where they drink, they might be an alcoholic.

If you can relate to any of these symptoms, a visit with a counselor specializing in addiction treatment or a meeting of a 12 step group such as Alcoholics Anonymous, Narcotics Anonymous, or Overeaters Anonymous should help you decide for sure. Only you can decide whether or not you’re an addict. While a counselor, psychiatrist or psychologist may diagnose an addiction problem, treatment is much more successful if you come to believe that the diagnosis is true.


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