The Problem

What is Substance Abuse?

DSM 5 categorizes Substance Use Disorders using 11 different criteria by severity depending on how many symptoms are present in an individual over the period of 12 months.

2-3: mild substance use disorder
4-5 moderate
6+ symptoms indicate severe substance use disorder.

The symptoms are as follows:

Taking the substance in larger amounts or for longer than you’re meant to.
Wanting to cut down or stop using the substance but not managing to.
Spending a lot of time getting, using, or recovering from the use of the substance.
Cravings and urges to use the substance.
Not managing to do what you should at work, home, or school because of substance use.
Continuing to use, even when it causes problems in relationships.
Giving up important social, occupational, or recreational activities because of substance use.
Using substances again and again, even when it puts you in danger.
Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
Needing more of the substance to get the effect you want (tolerance)
Development of withdrawal symptoms, which can be relieved by taking more of the substance.

What is Addiction?

Addiction is defined differently. The Nation Institute on Drug Abuse defines addiction as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often self-destructive, behaviors.”

This definition is important in remembering that addiction is a brain disease, rather than a person’s choice.
DSM 5 has adapted, also, the definition of Alcohol Use Disorder (AUD), by combining the definitions of Alcohol Use and Alcohol Dependence. Any individual who can answer ‘yes’ to 2 of the following 11 criteria in the past 12 months can be diagnosed with AUD. A ‘yes’ to 6 or more is defined as severe.

Had times when you ended up drinking more, or longer than you intended?

More than once wanted to cut down or stop drinking, or tried to, but couldn’t?

Spent a lot of time drinking? Or being sick or getting over the aftereffects?

Experienced craving — a strong need, or urge, to drink?

Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?

Continued to drink even though it was causing trouble with your family or friends?

Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

What is Alcoholism?

Alcoholism can be defined by the same criteria that the DSM used for Alcohol Use Disorder. It is also defined as a chronic, progressive, potentially fatal disorder marked by excessive and usually compulsive drinking of alcohol leading to psychological and physical dependence or addiction.

Symptoms include, but are not limited to:

A desire or craving to drink

Inability to control these cravings

The inability to stop drinking, even when wanting to

Increased tolerance

Lying about drinking

An inability to get through everyday activities without drinking

What is Substance Abuse?

What is Addiction?

What is Alcoholism?

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