Addiction 101

Addiction: Definitions and key concepts

Many people are affected, directly or indirectly, by addiction, which may also be called substance use disorder if a person is addicted to alcohol or other drugs.

The indicators of addiction can be summarized using the memory aid ABCDE (ASAM, 2011):

    inability to abstain
    little control over behaviour
    craving or "hunger" for substances or rewarding experiences
    decreased ability to recognize major problems in their behaviour and relationships
    a problematic emotional response.

For people working in the addiction field, having definitions of substance-related and addictive disorders can make it easier to diagnose a problem and suggest a treatment program. The Diagnostic and Statistical Manual of Mental Disorders (5th edition; APA, 2013), also called the DSM-5, categorizes substance use and gambling disorders and provides criteria for diagnosing these problems.

An element of addiction is the way a person responds to certain situations and stressors, and not necessarily the amount or frequency of the substance use or addictive behaviour. People with an addiction problem are pre-occupied with obtaining rewards (i.e., alcohol or other substances, gambling). They continue pursuing these rewards, even though there are negative consequences. These behaviours can be compulsive or impulsive and may signal a loss of control.

Note: There are differences in how clinicians diagnose their patients. They may be influenced by the culture and region in which they practice, or by the client’s race, class or gender. Additionally, what is identified as a disorder is always changing in response to new research or social awareness. For example, although substance use disorder and gambling disorder are the only recognized addiction diagnoses in the DSM-5, Internet gaming disorder is currently being considered for future editions of the DSM (APA, 2013).