Addiction has always been a mysterious condition. Until recently very little was understood about addiction, making it challenging to determine when an addiction exists. Even today there is often confusion and debate on the topic among medical professionals and the public. In previous generations, addiction was recognized primarily in extreme cases and was felt to be a personal issue that should be dealt with privately by the individual and their family. It was not discussed in public or considered a societal issue or health problem. This prevented patients or families from seeking medical help and clinicians from identifying the problem or attempting to intervene.

Until recently there also was very little that could be done to treat addiction. Though 12-Step programs such as Alcoholics Anonymous have been available and effective for treating alcohol use disorder since the early 1930’s, few know much about them since they do not “advertise” per se. During this time several other forms of addiction have also been recognized with similarly few options for effective treatment. These factors coupled with the minimal training of medical professionals in addiction has made it challenging to effectively identify and address this illness.

The sad irony of the recent opioid epidemic has been that it has resulted in extensive media coverage of the topic of addiction and increased awareness and education about this disease for both the public and clinicians. This has helped to align our society around the seriousness of this illness and the need to address it on a personal, family, and societal level. However, most still feel uncertain of where the line exists between use and abuse of a substance, and between episodes of abuse and the disease of addiction. There is also an awareness that there can be an addiction to things other than drugs and alcohol. How do I know when I (or my loved one) have crossed the line and need to seek help before there is irreparable damage?

There are specific criteria for diagnosing addiction. These are found in the Diagnostic and Statistical Manual (DSM), the text used by psychiatrists to diagnose mental illnesses. They are as follows:

1. Taking the substance in larger amounts or for longer than you 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 the 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.

Having 2 or more of these over a 12 month period of time meets the criteria for addiction. The more criteria that are endorsed, the more severe the addiction.

The good news is that there are effective treatments for addictions of all types. There are also resources available in most communities and coverage on most health insurance plans for addiction services, making options and access to treatment better than ever before.

*If you have additional questions about addiction or found that you or someone you love meets the criteria from the list above and want to discuss the next steps of getting help, click the link below to schedule an appointment with our Addiction Specialist, Dr. Leslie Massoglia. If you do not live in a state in which she is licensed, you can still receive her care – just schedule an appointment with any of the MyCatholicDoctor providers who are licensed in your state and they can do a provider-to-provider consult with her.

Author: Leslie Massoglia, MD, Former Addiction Specialist with MyCatholicDoctor

Editor: Samantha Wright, Director of Education and Online Resources with MyCatholicDoctor