Many people ask me: What is addiction and how do I know if a loved one or I have it?

In order to make the diagnosis of opioid substance use disorder (AKA addiction) the health care provider uses the eleven criteria that are listed in the DSM-5 book. The number of criteria the person has helps determine the severity (or problem the person is having with the disease). If a person has two or three of the items they have a mild substance use disorder. Four or five symptoms indicate moderate and six or more symptoms indicate a severe substance use disorder.

Criteria for Substance Use Disorders:

1. Taking the substance in larger amounts or for longer than you're meant to.

2. Wanting to cut down or stop using the substance but not managing to.

3. Spending a lot of time getting, using, or recovering from use of the substance.

4. Cravings and urges to use the substance.

5. Not managing to do what you should at work, home, or school because of substance use.

6. Continuing to use, even when it causes problems in relationships.

7. Giving up important social, occupational, or recreational activities because of substance use.

8. Using substances again and again, even when it puts you in danger.

9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.

10. Needing more of the substance to get the effect you want (tolerance).

11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.

Addiction can be summed up as craving (preoccupation about the drug or constant need to take more of the drug) that leads to negative consequences in life (work, family, financial and possible legal issues), isolation, anxiety, and depression issues.

Once the symptoms of addiction occur, the brain pathways have been permanently altered making it impossible for the person to control their choices.

Unfortunately, this is a disease the person can’t control without help. The logical thinking part of the brain has been bypassed by the impulsive part of the brain and the person reacts rather than respond with the reasoning part of the brain. The person with the disease of addiction would like to think they are in control, or can “handle it”, but they are only deluding themselves.

So without help, they won’t get better. The types of help and where a person can find it will be discussed in future articles.
Teddy Saddoris M.D. Board certified in Addiction Medicine.