The National Institute on Drug Abuse defines drug 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 the harmful behaviors seen in people who abuse drugs."1
HBO's special documentary, Addiction, notes the American Psychiatric Association's definition of a person that is dependent on a substance if their pattern of substance use leads to distress in three of more ways over a 12-month span of time:2
Tolerance of the drug:
- Need for increased amounts of the substance to achieve intoxication or desired effect
- Diminished effect with continued use of the same amount of the substance
- Characteristic withdrawal symptom of the substance
- The same of a closely related substance is taken to relieve or avoid withdrawal symptoms
Loss of control:
- The substance is taken in larger amounts or over a longer period than was intended
- Persistent desire or unsuccessful efforts to cut down or control substance use
- A great deal of time is spent in activities to obtain substance, use of the substance or recover from its effects
Continuation despite consequences:
- 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 recurrent physical or psychological problem that is likely to have been cause or exacerbated by the substance 2
Typically, alcohol abuse and alcoholism do not happen over night. One binge does not mean you have a problem. A problem develops after repeated use that builds up one upon the other, eventually leading to the problem.
Because of this gradual process, many alcoholics are high functioning and many do not realize they have a problem.
There are key stages in alcoholism that give basic signals that a person has a problem.
- The drinker is no longer drinking for the same reasons he/she started drinking for in the first place.
- Drinking for the effects that alcohol can produce, including mood change, stress relief, "taking the edge off."
- Hasn't lost total control of his/her life or body.
- Drinking more often and for any reason. May be fabricating problems to drink over.
- Exceeds socially acceptable limits or loss of control of physical and mental capabilities.
- Family and friends becomes aware of the problem, but the alcohol abuser may think the problem is his friends and family.
- Abuser believes that he/she could "quit any time."
- Damage done to the body after a significant amount of drinking can begin to happen. It may be irreversible and can result in hepatitis, heart failure, cirrhosis of the liver, etc.
- Talking about the problem may drive the abuser to use more.
- It often takes a traumatic or embarrassing event to get the user's attention to the extent that he/she knows he/she should get help.3
The types of treatment that are right for an alcoholic are dependent on the person's needs and characteristics. For example, inpatient versus outpatient programs offer very different benefits and treatment capabilities, which may be more in line with your needs. This is why it is important you find a treatment center that properly assesses and screens you or your loved one, evaluating areas including drinking behavior, signs, symptoms, and severity of alcohol dependence.4
2) "Understanding Addiction: When Is Someone Addicted?" Addiction. HBO. Date downloaded: June 22, 2010.
3) "Stages of Alcohol Withdrawal Symptoms." Affordable Alcohol and Drug Rehab Directory. Date downloaded: June 25, 2010.
4) Donovan, D.M. Ph.D., "Assessment to Aid in the Treatment Planning Process." National Institute on Alcohol Abuse and Alcoholism. Date downloaded: June 28, 2010.