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Definitions in Chemical Dependency

What is Drug Addiction?

Drug addiction is a complex illness. The path to drug addiction begins with the act of taking alcohol or other drugs. Over time, a person's ability to choose not to take drugs is compromised. This in large part is a result of the effects of prolonged alcohol and other drug use on brain functioning, and thus on behavior. Addiction, therefore, is characterized by compulsive, drug craving, seeking, and use that persists even in the face of negative consequences.

What Is Alcoholism?

Alcoholism, also known as "alcohol dependence," is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It includes four symptoms:

• Craving: A strong need, or compulsion, to drink.
• Impaired control: The inability to limit one's drinking on any given occasion.
• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety, when alcohol use is stopped after a period of heavy drinking.
• Tolerance: The need for increasing amounts of alcohol in order to feel its effects.

How can we tell if someone is abusing or addicted to drugs?

The Diagnostic and Statistical Manual, is used to diagnose psychological and psychiatric problems. It defines substance abuse problems as 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:

• Substance is often taken in larger amounts or over longer period than intended
• 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 given up or reduced because of substance abuse
• Continued substance use despite knowledge of having a persistent or recurrent psychological, or physical problem that is caused or exacerbated by use of the substance
• Tolerance, as defined by either: a) need for ready amounts of the substance in order to achieve intoxication or desired effect; or b) markedly diminished effect with continued use of the same amount
• Withdrawal, as manifested by either: a) characteristic withdrawal syndrome for the substance; or b) the same (or closely related) substance is taken to relieve or avoid withdrawal symptom.

The International Classification of Diseases – 10 (ICD-10)

ICD-10 is a standardized manual used to classify diseases. According to the clinical diagnostic guidelines are listed below, if you have experienced three or more of the following at some time during the previous year you could be classified as suffering from addiction:

• Difficulties in controlling substance-taking behavior in terms of its onset, termination, or levels of use
• A strong desire or sense of compulsion to take the substance
• Progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects
• Persisting with substance use despite clear evidence of overtly harmful consequences, depressive mood states consequent to heavy use, or drug related impairment of cognitive functioning
• Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses
• A physiological withdrawal state when substance use has ceased or been reduced, as evidence by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms.

Addiction, Dependence, Abuse and Misuse

You don’t have to be addicted to alcohol or other drugs to have a problem with them. Some people experience what is called dependence, abuse or misuse. Someone may be psychologically dependent on alcohol or other drugs and not have experienced the bio-chemical changes characteristic of addiction.

Some people may not be addicted or dependent, but may “over do” (abuse) alcohol and other drugs. Sometimes people may intentionally or unintentionally use or combine alcohol and other drugs resulting in misuse and significant impairment. The impact can be just as devastating if you are not an alcoholic or addict. If you get behind the wheel of a car when you are drunk or high and kill or injury someone in an accident, they are just as dead or crippled, regardless of whether you are an addict or alcoholic.

Remember, the consequences of abuse, misuse, dependence and addiction can all be the same. You don’t have to be an alcoholic or drug addict to have problems with substance abuse.

Check out the CAGE-AID quiz to see if your use of alcohol or drugs puts in at risk for problems. The professionals at CASI can help. Do not hesitate to call us.

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