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Basic InformationMore Information"I have benefited from AA and the 12 Steps... Very much so!"A Better MeetingAA Is To Shame As A Hot Knife Is To ButterAging and Alcohol UseAlcoholic's Anonymous, Outcomes and New Research on AlcoholismAlcoholics Anonymous (AA) is a Cult ?An Alternative to PowerlessnessAttachment to OutcomesAwakeningConcerning Problems Within AADefining and Understanding the Concept of Denial, Addictions and OtherwiseGauging the Effectiveness of One Component of Alcoholics AnonymousHow Drugs Affect The BrainHuffing: Parents and Kids BewareIts Never Too LateLike Phoenix Risen from the Ashes of Addiction, A New Addiction Recovery ProgramNIDA InfoFacts: Drug Abuse and AIDSNIDA InfoFacts: Drug Addiction Treatment MethodsNIDA InfoFacts: Drugged DrivingNIDA InfoFacts: Pregnancy and Drug Use TrendsNIDA InfoFacts: Understanding Drug Abuse and AddictionOn the Question of Medical MarijuanaPain Pills, A Real PainPerverse MotivationRandom Thoughts About Addiction, Delusions and HallucinationsRecoverySelf-EfficacyStaying Sober: Dealing With TemptationsSteering Versus DriftingThe Author of Your FateThe Enlightened PathThe Impeccable PathThe Mentality of ChildhoodThe OPEN PathThe Paradoxical Sinclair Method For Treating Alcohol DependenceTwo MindsWise Counsel Interview Transcript: An Interview with Annie Fahy, MSW on Motivational InterviewingWise Counsel Interview Transcript: An Interview with John C. Fleming, MD on Preventing AddictionWise Counsel Interview Transcript: An Interview with Laurence Westreich, MD on Helping Families Help Addicted MembersWise Counsel Interview Transcript: An Interview with Marc Kern, Ph.D. on Rational Alternatives to Alcoholics AnonymousWise Counsel Interview Transcript: An interview with Morteza Khaleghi, Ph.D. on the Importance of Treating Emotional Trauma in Addiction Wise Counsel Interview Transcript: An Interview with Patt Denning, Ph.D. on Harm Reduction Psychotherapy for Substance Abuse and AddictionWise Counsel Interview Transcript: An Interview with Stefanie Goldstein, Ph.D. on Mindfulness and Addiction TestsLatest NewsComputer-Based Screening May Reduce Teen Substance AbuseTeen Impulsiveness Has Different Sources in ADHD, Substance UseAccelerated Aging Evident in Cocaine-Dependent IndividualsMany Who First Misuse Prescription Pills Get Them From Friends, Family: ReportCocaine Habit Might Speed Brain AgingUse of Ecstasy, Speed by Teens Tied to Later DepressionHalf of Young Cigarette Smokers Also Smoke Pot: Survey12-Step Meetings May Help Teens Beat Alcohol, Drug AbuseAlcohol Use With Opioids Common Even Without Abuse PastSubstance Abusers, Even Recovering Ones, May Face StigmaDrug, Alcohol Abuse Common Among U.S. Teens, Study FindsAlcohol Effects on Brain Activity Vary With Blackout HistoryPrenatal Meth Exposure Linked to Behavioral ProblemsExcessive Drinking Costs U.S. Colleges Millions AnnuallyKids Using Synthetic Pot a Growing Public Health ConcernSpring Break Boozing May Put Young Brains at RiskMany Alcoholics Suffered Childhood Trauma: StudyGenes Play a Role in Drug Abuse Risk Among Adopted Kids: StudyNarcotic Painkillers Another Threat to Traumatized War Vets: StudyDrinking Scenes in Movies May Spur Teens to Do the SameStrict Underage Drinking Laws May Deter Delinquency in TeensEcstasy Use During Pregnancy May Harm Fetus: StudySupport for Tougher Liquor Laws Rises When Booze, Crime LinkedBooze in Movies May Fuel Teenage Drinking1 in 10 U.S. Kids Lives With Parent Who Has Abused Alcohol: ReportStop-Smoking Drug May Also Curb Problem DrinkingIllicit Drugs Bought Off Internet May Be Poisons, Experts WarnHard Drug Use in Middle Age Could Prove Fatal, Study FindsDrinking Late in First Trimester May Be Most HazardousAlcohol Targets Brain 'Reward Centers' in Heavy DrinkersOne in Six Americans Binge Drink: CDCMeth Users Much More Likely to Try SuicideFor Some Couples, Binge Drinking Is RoutineStates Crack Down on Drunk Drivers This Holiday SeasonDrug Overdoses Kill More Americans Than Car Accidents: CDCAlcohol Use Down, Pot Use Up Among U.S. TeensDrunk Driving-Related Deaths Surge During the Holidays'Ecstasy' May Cause Long-Term Changes in Brain ChemistryToo Much Alcohol Linked to Unsafe Sex, Study ConfirmsIf Parents Drink and Drive, Their Kids May Too: StudySmart Kids More Likely to Try Illicit Drugs as Young AdultsHelping Others Helps Teens Beat Substance AbuseDrugs Slipped Into Drinks Sending Many to ER: ReportHeavy Meth Use Linked to Schizophrenia'Fake Marijuana' May Trigger Heart Trouble in TeensMore Than a Third of Teens Turning to Alcohol, Drugs: StudyMore People Landing in the ER After Abusing Muscle Relaxant: ReportDeaths From Abuse of Painkillers Triple in a Decade: CDCNational Drug Take-Back Day Scheduled for SaturdayPot Can Mimic Brain Changes Seen in Schizophrenia Questions and AnswersLinksBook ReviewsSelf-Help Groups |
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Symptoms - Alcohol or Substance DependenceDSM-IV-TR (APA)The Diagnostic and Statistical Manual of Mental Disorders (currently the fourth edition, text-revision) is the standard reference against which all mental disorders (substance use disorders included) are made. The criteria involved for making a formal Substance Dependence diagnosis is as follows: - The patient shows . . . A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
- Tolerance, as defined by either of the following:
- a need for markedly increased amounts of the substance to achieve intoxication or desired effect
- markedly diminished effect with continued use of the same amount of the substance
- Withdrawal, as manifested by either of the following:
- The characteristic withdrawal syndrome for the substance
- The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms
- The substance is often taken in larger amounts or over a longer period than was intended
- There is a persistent desire or unsuccessful efforts to cut down or control substance use
- A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recover from its effects
- Important social, occupational, or recreational activities are given up or reduced because of substance use
- 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 (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)
When a diagnosis of Substance Dependence is made, the diagnosing doctor must also specifiy whether or not the patient is Physiologically Dependent. Physiological dependence, in this case means that there is evidence of tolerance or withdrawal (as defined in the first two criteria). Note that it is possible to be diagnosed with Substance Dependence without displaying either tolerance or withdrawal.
Note that only a doctor can make a formal diagnosis of substance abuse or substance dependance. Criteria sumarized from:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition. text revision Washington, DC: American Psychiatric Association. |
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