An addiction: what is it actually? When you think about this, you will notice that it is quite difficult to define what exactly an addiction is. It has to do with various factors such as your own norms and values and the rules that have been officially set for diagnosing an addiction according to the Diagnostic Statistic Manual of Mental Disorders (DSM).

What is an addiction?

What is an addiction? You will notice that it is difficult to give a short answer to this. This partly has to do with your own norms and values. Imagine: your neighbor drinks two beers a day. Do you think he is addicted or not yet? Officially speaking, according to rules and criteria drawn up by humans, you are already alcohol addicted if you consume at least two alcoholic drinks per day. Many people will see this differently; Opinions on this will be divided. In order to draw a clear line here, a number of criteria have been drawn up. This can be used to determine whether there is an addiction. These criteria are included in the Diagnostic Statistic Manual of Mental Disorders; or the DSM. Of course,an addiction does not relate to alcohol. There are many other possibilities that fall within an addiction, such as drug addiction, food addiction, gaming addiction, etc. For convenience, substance abuse will now be discussed.

An addiction according to the DSM

The Diagnostic Statistic Manual of Mental Disorders includes a number of criteria related to diagnosing an addiction. This looks like this:Diagnostic Criteria for Substance Abuse and Dependence (DSM-IV-TR): Substance abuse:A. Abusive pattern of substance use leads to clinically significant impairment or distress as manifested by one or more of the following characteristics within a 12-month period:1. Recurrent substance abuse resulting in inability to meet major demands at work, school or home.2. Recurrent substance abuse in situations where it is physically dangerous3. Recurrent substance abuse-related legal problemsContinuing to abuse substances despite having recurring social or interpersonal problems caused by or exacerbated by the effects of the abuse.B. Symptoms do not meet the criteria of drug dependence for this type of substance.Substance addiction is diagnosed when 3 or more of the following symptoms occur simultaneously within 12 months:1. Tolerance occurs, i.e. more and more of the addictive substance is needed to achieve the desired effect or less and less effect occurs when using the same amount of the addictive substance2. Withdrawal symptoms occur, specific to that substance, or similar substances are taken to cope with the withdrawal symptoms.3. The drug is taken in increasingly larger quantities, over a longer period of time than was actually intended4. There is the urge to stop taking the drug, several (unsuccessful) attempts have been made to stop, to reduce 5.A lot of time is spent obtaining the drug and/or using the drug6. Important social, work and/or leisure activities are given up or reduced due to substance use7. Even though the person knows that the drug being taken causes or worsens physical or psychological conditions, he or she continues to use it.Source: Diagnostic Statistic Manual of Mental Disorders (DSM-IV-TR, 2000) – Dutch translation 

Resume

In the DSM criteria we read various things that influence the ability to diagnose an addiction. First of all, it is written that a number of symptoms must occur over a period of 12 months. This basically means that someone is addicted when substance abuse is so prominent that it hinders the person in daily functioning. For example, someone may have problems at work or at school. It is also possible that someone creates dangerous situations as a result of substance abuse. This could include getting into a car drunk; because this has resulted in reduced control and dangerous situations for yourself and others. Someone can also develop psychological problems or become socially isolated because their entire life revolves around the substance that someone uses.Part B discusses symptoms of the actual substance addiction. At least three of these points must apply. For example, tolerance often occurs; your body gets used to a substance and becomes resistant to it. That explains why one person can be drunk with, say, six beers, while another might need 30; the body has a higher tolerance. If the person were to immediately stop using the drug, withdrawal symptoms may occur. A person may become extremely nervous or anxious, have sweat attacks, etc. People also become more and more reckless in their quantities, which means that large quantities soon become normal. It also often happens that the person would like to stop taking the drug, but is no longer able to do so; there is no way back. The person has often made several attempts to quit but failed. The drug controls a person’s life; the day is all about using or purchasing the drug. Someone isolates themselves and withdraws from contact with others, just to be able to use the drug. Someone also often continues to use the drug, despite knowing the consequences.An addiction is a complicated phenomenon. Remember that addiction can only be diagnosed by a qualified person such as a psychiatrist!