Some people who start as casual drinkers or drug users will stay that way. But others will become substance abusers or dependent, feeling that they need a drug to feel alive. The difference between abuse and dependence is not always clear to the general public, but medical professionals use a set of criteria to distinguish between these two categories of problem use.
The essential feature of abuse is a pattern of substance use that causes someone to experience harmful consequences. Clinicians diagnose substance abuse if, in a twelve-month period, a person is in one or more of the following situations related to drug use:
Dependence is more severe. Medical professionals will look for three or more criteria from a set that includes two physiological factors and five behavioral patterns, again, over a twelve-month period. Tolerance and withdrawal alone are not enough to indicate dependence. And not all behavioral signs occur with every substance.
The physiological factors are:
The behavioral patterns are:
"Reprinted from Addiction: Why Can't They Just Stop (c) 2007 Rodale, Inc."