Addiction
Characteristics of the Behaviour
DSM Criteria
- The DSM contains 10 categories of substances that can cause addiction. These are: alcohol, caffeine, cannabis,
hallucinogens, inhalants, opioids, sedatives, stimulants, tobacco and ‘other’
- In addition to substances, the DSM also recognises the behaviour of gambling as a distinct addiction.
- Gaming, exercise and sex are noted as possible excessive behavioural patterns but are not included as specific
addictions as there is a lack research support.
- Disorders are broadly spilt into two categories, substance use disorders and substance induced disorders.
- All addictions produce an intense activation of the brain’s reward centres, typically activating the pleasure
systems to give a high.
- There are 11 criteria of diagnosis for addiction which apply to all substances, and to be diagnosed with a disorder,
a patient must present with 2-3 symptoms for a mild addiction, 4-5 for moderate addiction and 6 or more for a
severe addiction.
1. The individual may take the substance in larger amounts or over a longer period was originally intended.
2. The individual may express a persistent desire to cut down or regulate substance use and may report
multiple unsuccessful efforts to decrease or discontinue use.
3. The individual may spend a great deal of time obtaining the substance, using the substance or recovering
from its effects.
4. Craving is manifested by an intense desire or urge for the drug that may occur at any time
5. Recurrent substance use may result in a failure to fulfil major role obligations at work, school or home.
6. The individual may continue substance use despite having persistent or recurrent social or interpersonal
problems caused or exacerbated by the effects of the substance
7. Important social, occupational, or recreational activities may be given up or reduced because of substance
use.
8. Recurrent substance use in situations where it is physically hazardous
9. The individual may continue substance use despite knowledge of having a persistent or recurrent physical
or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Tolerance is signalled by requiring a markedly increased dose of the substance to achieve the desired
effect or a markedly reduced effect when the usual dose is consumed.
11. Withdrawal symptoms are present upon ceasing to consume the substance.
- There are also criteria for specific substance use disorders, which draw on the 11 characteristics but are more
specified to a particular substance.
- For example, the criteria for gambling does not include tolerance or withdrawal, but refers specifically to financial
implications of gambling.
- The DSM is useful in diagnosing substance use problems, but aside from gambling it fails to provide criteria for
other behavioural addictions though people receive treatment for disorders which fall outside of these criteria.
Other Methods of Classifying Addiction
- Mark Griffiths (2005) suggested that there are 6 criteria to be met if a behaviour is to be considered an addiction
(originally written for behavioural addictions but can be applied to substances)
- Salience: The activity has become the most important thing in the person’s life. It dominates their thoughts
feelings and behaviour even when they are not directly engaging in the behaviour.
- Mood Modification: When the individual engages in the behaviour, they experience a change in mood, whether a
high or a feeling of numbness. Addiction is used to cope with problems they may be experiencing.
- Tolerance: As time goes on the individual will need. more of the drug or behaviour to achieve the same effects as
they have built up a tolerance to it. This is usually associated with chemical addictions but can be applied to
behaviour. Griffiths 1993: Gamblers heart rates decreased faster than non-regular gamblers, suggesting they need
to gamble sooner after to attain arousal.
- Withdrawal Symptoms: If the behaviour is stopped then the individual will experience withdrawal symptoms
which can be physical (insomnia, nausea, headaches) or psychological (irritability)
- Conflict: Addicts will often experience interpersonal conflict, compromising jobs or relationships because of the
addiction or intrapsychic conflict when they are annoyed with themselves for being unable to stop.
- Relapse: Reverting back to addictive behaviours when stressed, upset or experiencing change even if they have
gone years without using the substance.
Characteristics of the Behaviour
DSM Criteria
- The DSM contains 10 categories of substances that can cause addiction. These are: alcohol, caffeine, cannabis,
hallucinogens, inhalants, opioids, sedatives, stimulants, tobacco and ‘other’
- In addition to substances, the DSM also recognises the behaviour of gambling as a distinct addiction.
- Gaming, exercise and sex are noted as possible excessive behavioural patterns but are not included as specific
addictions as there is a lack research support.
- Disorders are broadly spilt into two categories, substance use disorders and substance induced disorders.
- All addictions produce an intense activation of the brain’s reward centres, typically activating the pleasure
systems to give a high.
- There are 11 criteria of diagnosis for addiction which apply to all substances, and to be diagnosed with a disorder,
a patient must present with 2-3 symptoms for a mild addiction, 4-5 for moderate addiction and 6 or more for a
severe addiction.
1. The individual may take the substance in larger amounts or over a longer period was originally intended.
2. The individual may express a persistent desire to cut down or regulate substance use and may report
multiple unsuccessful efforts to decrease or discontinue use.
3. The individual may spend a great deal of time obtaining the substance, using the substance or recovering
from its effects.
4. Craving is manifested by an intense desire or urge for the drug that may occur at any time
5. Recurrent substance use may result in a failure to fulfil major role obligations at work, school or home.
6. The individual may continue substance use despite having persistent or recurrent social or interpersonal
problems caused or exacerbated by the effects of the substance
7. Important social, occupational, or recreational activities may be given up or reduced because of substance
use.
8. Recurrent substance use in situations where it is physically hazardous
9. The individual may continue substance use despite knowledge of having a persistent or recurrent physical
or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Tolerance is signalled by requiring a markedly increased dose of the substance to achieve the desired
effect or a markedly reduced effect when the usual dose is consumed.
11. Withdrawal symptoms are present upon ceasing to consume the substance.
- There are also criteria for specific substance use disorders, which draw on the 11 characteristics but are more
specified to a particular substance.
- For example, the criteria for gambling does not include tolerance or withdrawal, but refers specifically to financial
implications of gambling.
- The DSM is useful in diagnosing substance use problems, but aside from gambling it fails to provide criteria for
other behavioural addictions though people receive treatment for disorders which fall outside of these criteria.
Other Methods of Classifying Addiction
- Mark Griffiths (2005) suggested that there are 6 criteria to be met if a behaviour is to be considered an addiction
(originally written for behavioural addictions but can be applied to substances)
- Salience: The activity has become the most important thing in the person’s life. It dominates their thoughts
feelings and behaviour even when they are not directly engaging in the behaviour.
- Mood Modification: When the individual engages in the behaviour, they experience a change in mood, whether a
high or a feeling of numbness. Addiction is used to cope with problems they may be experiencing.
- Tolerance: As time goes on the individual will need. more of the drug or behaviour to achieve the same effects as
they have built up a tolerance to it. This is usually associated with chemical addictions but can be applied to
behaviour. Griffiths 1993: Gamblers heart rates decreased faster than non-regular gamblers, suggesting they need
to gamble sooner after to attain arousal.
- Withdrawal Symptoms: If the behaviour is stopped then the individual will experience withdrawal symptoms
which can be physical (insomnia, nausea, headaches) or psychological (irritability)
- Conflict: Addicts will often experience interpersonal conflict, compromising jobs or relationships because of the
addiction or intrapsychic conflict when they are annoyed with themselves for being unable to stop.
- Relapse: Reverting back to addictive behaviours when stressed, upset or experiencing change even if they have
gone years without using the substance.
