An addiction is a disorder characterized by the pathological search for reward or relief from a certain substance or action. Addictions involve dependence and a loss of control.

In this article, we talk about the symptoms of two major groups of addictive disorders. These are substance abuse disorders (drug addiction) and non-substance-related addictive disorders (pathological gambling). The descriptions of the symptoms will help you understand what these addictions entail.

Types of addictions

There are different types of addictions. For example, there are addictions to substances, like drugs. Then, there are behavioral addictions where a person compulsively carries out certain actions. This means they lose their freedom and get hooked on that particular behavior.

The DSM-5 states that behavioral addictions are those not related to substances. For example, pathological gambling. However, the DSM-5 uses the term disorder as opposed to addiction, due to the negative connotations of the term addiction. In this article, we talk about the symptoms of both kinds.

Symptoms of Substance Addiction

Substance addiction means addiction to any kind of drug. The DSM-5 categorizes these addictions as substance-related addictive disorders. It defines them as a class of disorders that are “related to the taking of a drug of abuse (including alcohol)”. These behaviors are expressed through different symptoms.

For the disorder to be diagnosed, the patient must suffer at least two of the following symptoms for at least 12 months.

• Taking the substance in larger amounts or for longer than desired.
• Wanting to cut down or stop using the substance but being unable to.
• Spending a lot of time obtaining, using, or recovering from substance abuse.
• Feeling intense cravings to use the substance.
• Not meeting obligations due to its consumption.
• Continuing to use it even if it causes social problems.
• Reducing important social, work, or recreational activities because of using the substance.
• Using the substance in dangerous situations, causing physical or mental harm.
• Continuing to take the substance despite the physical and psychological danger.
• Tolerance. Needing more of the substance to get the desired effect.
• Withdrawal. This is a group of symptoms that tends to occur as use of the substance decreases.

Specifications

According to the DSM-5, the severity of the symptoms of the substance-related addictive disorders must be specified. The manual stipulates three levels:

• Mild. Presence of two to three symptoms.
• Moderate. Presence of four or five symptoms.
• Severe. Presence of six or more symptoms.

Clinicians may also specify if the addiction is at an early or sustained phase of remission. In addition, if it occurs in a controlled environment or if the patient is on some kind of maintenance program.

Four types of criteria and symptoms

As we’ve already mentioned, the DSM-5 diagnoses substance use disorder (addiction) by the application of the 11 symptomatic, behavioral, and temporal criteria we listed above. These criteria may be grouped into four categories:

• Impaired control.
• Social deterioration.
• Risky use.
• Pharmacological indicators (tolerance and withdrawal).

Pathological gambling or gambling disorder

In the DSM 5, gambling disorder is the sole behavioral addiction included in the chapter entitled “Substance-Related and Addictive Disorders”.

The medical profession first recognized pathological gambling as being a possible disorder at the beginning of the 21^st century. However, researchers soon came to realize it was actually an extremely serious public health problem. This became apparent when the American Psychiatric Association (APA) introduced the category of pathological gambling in the DSM- III in 1980. It was the first time they actually defined diagnostic criteria for the condition of pathological gambling.

Symptoms of gambling disorder

The DSM-5 defines gambling disorder as “persistent and recurrent problematic gambling behavior leading to clinically significant impairment and stress as indicated by the individual exhibiting four (or more) of the following in a 12 month period”.

• The need to gamble with increasing amounts of money to achieve the desired excitement.
• Being restless or irritable when attempting to cut down or stop gambling.
• Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
• Is often preoccupied with gambling. For example, reliving past gambling experiences or planning how to get money for the next.
• Gambling when feeling distressed to escape symptoms of dysphoria (hopelessness, guilt, anxiety, depression, etc).
• After losing money in a game, they return another day to get even.
• They lie to conceal their degree of involvement.
• They’ve jeopardized or lost a significant relationship, job, or educational opportunity due to gambling.
• They rely on others to provide the money to relieve desperate situations caused by gambling.
• The gambling isn’t due to a manic episode.

As mentioned in the criteria, it’s important to establish that the behavior isn’t caused by a manic episode.

In addition, symptoms of addiction, both behavioral and substance may vary from person to person. However, almost always the sufferer feels a loss of control and great emotional exhaustion. For this reason, they must always seek professional help. It doesn’t matter whether the addiction is to a substance, to gambling, or to other behaviors or actions like sex or shopping.

“And a core part of addiction, I came to think, and I believe the evidence suggests, is about not being able to bear to be present in your life. “

-Johann Hari-

New Addictions: Classification and Intervention

In addition to the addictions that everyone is familiar with like drugs or gambling, there are addictions that have only recently come onto the scene. Read more »

 

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