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Basic InformationMore InformationTestsLatest NewsMarijuana Use Rising Among High School Seniors: Report'Predrinking' Nearly Doubles Booze Consumption: StudyIn Terms of Drinking, the Rich Are Different, Study SaysDelayed Auditory Processing Found in Fetal Alcohol SyndromeHeavy Smokers, Drinkers May Face Pancreatic Cancer Earlier in LifeDrinking, Driving Drops by Half Among Teens: CDCModerate Drinking May Increase Risk of Heart Rhythm Disorder: StudyHealth Tip: Don't Combine Medication and AlcoholWhy Some Mothers (Wrongly) Let Kids Try AlcoholAlcoholism Treatment Saves Families MoneyDoctors Should Screen Adults for Alcohol Misuse, U.S. Panel SaysPrescription Drug Abuse Drops Among U.S. Young AdultsCognitive Ability, Motivation Tied in Addictive BehaviorExtra Steps Urged to Cut Alcohol, Drug Use in Military: ReportQuitting Drinking May Help Alcoholics' Bone Loss'Doctor Shopping' Tied to Fatal Prescription Drug OverdosesHeavy Drinking Linked to Earlier StrokePot Use May Raise Risk of Testicular Cancer: StudyWomen's Brains React Differently Than Men's to Alcoholism, Study FindsHeavy Marijuana Use in Teen Years May Lower IQ LaterPrior Substance Abuse Linked to Opioid Abuse in Young MenTeens Who Drink, Smoke More Likely to Abuse Painkillers: StudyStudy Affirms Marijuana, 'Spice' Harmful in PregnancyBrain Scans May Spot Teens at Risk for Problem DrinkingBooze, Energy Drinks, Casual Sex Combo Common in College: Study'Bath Salts' Demonstrate High Potential for AbuseIllegal 'Bath Salts' Mimic Cocaine in the Brain: StudyEffects of Heavy Alcohol Exposure During Pregnancy EvaluatedHeavy Drinking in Pregnancy Linked to Host of Problems in ChildrenMom's Pot Use Doubles Risk of 'Preemie' Birth: Study'Abuse-Resistant' Oxycontin May Be Driving Addicts to HeroinTeach Prescribers About Dangers of Long-Acting Pain Meds: FDAMethadone for Pain Relief Leading Cause of Fatal Overdoses: CDCSummer Is Peak Time for Teens to Try Drugs, Alcohol: Report40 Million Americans Addicted to Cigarettes, Alcohol or Drugs1 in 10 Fibromyalgia Patients Uses Marijuana to Ease PainGenes May Influence Reactions to PainkillersMore Mental Health Woes in College Kids Who Abuse Prescription DrugsTeen Drinkers May Feel Like Social Outcasts: StudyState Laws Cut Teen Drinking and Driving, Large Study ShowsMental Health Woes Raise Odds for Prescription Painkiller AbuseNeural Link Between Resiliency and Alcohol, Drug Use Identified Questions and AnswersBook ReviewsSelf-Help Groups |
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Important Diagnostic Concepts Regarding Alcohol and Substance AbuseMark Dombeck, Ph.D. Addictions are diagnosed based primarily on the severity of a patient's drug or alcohol problems. Milder cases of addiction are termed "Substance Abuse", while more severe cases are termed, "Substance Dependence". Most of the time, people who have an addiction are blind to it, or in denial about it. They will not or cannot see the extent of the problems they are experiencing. Because of this denial, addictions cannot be self-diagnosed. An objective appraisal of a person's alcohol or drug use, and the problems a person is experiencing due to their substance use must be made by an experienced clinician before any diagnosis can be made. How do the experts make the distinction between mild substance 'Abuse' and more severe substance 'Dependence'? The answer depends largely on whether or not the addicted person experiences Tolerance and Withdrawal. Tolerance is the name given to the case when, over time, a drug or alcohol user requires more and more substance to get the same amount of 'high' effect they are seeking. Typically, the more a person takes drugs or alcohol, the more that he or she will become tolerant to its effects, requiring more and more of the substance to get the same effect. Tolerance, then, is what is happening when someone starts needing to drink six drinks to get the same 'buzz' that they used to get by only drinking three drinks. Withdrawal is the name given to the negative experiences and cravings that a drug or alcohol user may have when they stop taking using drugs or alcohol. For example, an alcoholic who stops drinking abruptly may experience one or more of the following negative symptoms: anxiety, sweating, increased heart rate, hand tremor, insomnia, vomiting, agitation, hallucinations, and even seizures. A drug or alcohol user in withdrawal becomes highly motivated to get and take more drugs or alcohol, as this relieves their feelings of sickness. As one might figure, an alcoholic who experiences such an array of negative symptoms even once, will be highly motivated to remain drunk so as to avoid ever having to experience them again. A person must be experiencing significant social, relationship, family and/or occupational difficulty due to their substance use in order to qualify for a Substance Abuse diagnosis, but they need not have ever experienced Tolerance or Withdrawal. A diagnosis of Substance Dependence, however, cannot be made if Tolerance or Withdrawal is not present. Read our 'Symptoms' articles to learn how the DSM-IV (the formal medical Diagnostic Manual for mental disorders used by doctors) defines Substance Abuse and Substance Dependence.
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