Jul 4, 2022 | By Tim Stoddart

Signs of Addiction: Who is an addict?

Miscellaneous

Defining addiction and exactly when it is one crosses the line from heavy use of a substance to full on addiction can be perplexing at best. There are many factors that make up the criteria for determining the level of trouble an individual may be in with relationship to their substance use. The information below can help make determinations regarding the nature and seriousness of one’s disorder.

Defining Addiction:

A simplified version of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition) definition of addiction would include the following:

• Impaired Control – This is when we find ourselves using more than we intended to and meaning to cut back but not doing so.

• Social Problems – Avoiding things we once enjoyed doing so that we can spend more time drinking or engaging in harmful behavior is one way to describe this category. Neglecting relationships, tasks at home, and things we once enjoyed all point to a slippery slope ahead. At this stage our alcoholism and substance abuse are subtly positioning itself for a quiet takeover.

• Risky Use – When we find ourselves increasingly willing to disregard the risk factors or even ignoring them entirely so that we can engage in these potentially destructive behaviors, we can be certain that we have reached a new level of potential dependency on a substance. Using despite unwanted outcomes and consequences is a sure signal that things are only about to get worse.

• Physical Dependence – Once we find ourselves at this level of addiction, we are going to experience very unpleasant and potentially dangerous physical side effects called withdrawal if we try to stop using. This is the phase that finds us experiencing actual physical manifestations of unpleasant and even painful symptoms (shaking hands, sweating, insomnia, digestive upset, cramping, etc.). By this stage we are fully emersed in physical addiction, not just emotional dependency. From here it is no longer about the “high” or the euphoric buzz. By this point we are simply using to manage our withdrawal. The pleasure and the pleasant numbing feelings have become elusive. Our addiction is in full bloom at this point and will require medically supervised detox to safely reset and begin the road to sobriety and recovery.

Signs of Addiction:

There are also stages of severity that are used to assess one’s level of dependency when treating alcoholism and substance use disorders. Not all people enter recovery at the same level of addiction. According to the National Institute of Alcohol Abuse and Alcoholism there are three basic levels of addiction. These classifications are Mild, Moderate, and Severe based on the amount of “yes” answers we give to a list of questions.

• Someone answering “yes” to only 2-3 questions on the assessment would be considered Mild. 
• An individual answering 4-5 questions with a “yes” response would be considered Moderate. 
• Lastly, 6 or more “yes” answers would indicate a severe level of dependency requiring the most intensive treatment modalities.

According to the NIAAA the list of questions could resemble the following:

• Had times when you ended up drinking more, or longer, than you intended?
• More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
• Spent a lot of time drinking? Or being sick or getting over other aftereffects?
• Wanted a drink so badly you couldn’t think of anything else?
• Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, to drink?
• More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unprotected sex)?
• Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
• Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

Trusting the Process:

Once a determination is made about the level of severity of the addiction it will be necessary to determine what the next best steps for treatment should look like.

Determining whether to do an inpatient stay, an Intensive Outpatient Program (one that allows for patients to return home daily and even work during their program), or simply to begin attending regular 12-step recovery meetings will be a pivotal decision and one that a trained recovery professional can help make. The best outcomes involve addiction recovery professionals who understand alcoholism and substance use disorders. 

For those who are more 12-step averse and may not need inpatient treatment there are programs like SMART Recovery (Self-Management and Recovery Training). This program has various chapters around the country and exists to help individuals find freedom from any number of addictive behaviors. SMART Recovery sees itself as a more science-based program and not a spiritual one which is one distinction it has from its 12-step counterparts. It also discourages labels such as “addict” and “alcoholic.”

Regardless of the modality for treatment that we choose the most important step is to admit the reality of our situation to ourselves, a trusted friend, and ultimately a trained professional for a fair assessment of the stage and severity of our disorder. Trusting the process is difficult but will pay great dividends in the best outcomes.