What is an addiction?

When we say that a person has a substance addiction, what do we really mean?

Over the years, many answers have been proposed; however, there is no clear consensus on a definition of addiction, nor its core components.

While definitions vary, most involve the concept of a repeated powerful motivation to engage in an activity with no survival value, acquired through experience with that activity, despite the harm or risk of harm it causes (West, 2015).

Defining Addiction

The Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) uses the term ‘substance use disorder’ instead of addiction. Read this (albeit very long!) definition:

A problematic pattern of substance use leading to clinically significant impairment or distress, manifested by at least two of the following, occurring within a 12-month period:

• The substance is often taken in larger amounts or over a longer period than was intended.

• A persistent desire or unsuccessful efforts to cut down or control substance use.

• A great deal of time spent in activities necessary to obtain the substance, use the substance, or recover from its effects.

• Craving, or a strong desire or urge to use the substance.

• Recurrent use resulting in a failure to fulfil major work, school, or home obligations.

• Continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by its effects.

• Important social, occupational, or recreational activities given up or reduced because of substance use.

• Recurrent use in situations in which it is physically hazardous.

• Use is continued despite knowledge of a persistent or recurrent physical or psychological problem likely to have been caused or exacerbated by the substance.