Alcohol/Substance Dependence

Alcohol/Substance Dependence

SYMPTOMS Dependence upon alcohol or a specific substance (such as cocaine, nicotine, marijuana, etc.) is characterized by a maladaptive pattern of alcohol or substance use, leading to clinically significant impairment or distress, as manifested by 3 or more of the following, occurring at any time in the same 12-month period: Tolerance, as defined by either of the following: A need for markedly increased amounts of the alcohol or substance to achieve intoxication or desired effect Markedly diminished effect with continued use of the same amount of the alcohol or substance Withdrawal, as manifested by either of the following: 2 or more of the following, developing within several hours to a few days of reduction in heavy or prolonged alcohol or substance use: Sweating or rapid pulse Increased hand tremor Insomnia Nausea or vomiting Physical agitation Anxiety Transient visual, tactile, or auditory hallucinations or illusions Grand mal seizures The same substance (or another substance) or alcohol is taken to relieve or avoid withdrawal symptoms The substance or alcohol is often taken in larger amounts or over a longer period than was intended There is a persistent desire or unsuccessful efforts to cut down or control use of alcohol or the substance A great deal of time is spent in activities necessary to obtain alcohol or the substance (e.g., visiting multiple doctors or driving long distances), using alcohol or a substance (e.g., chain-smoking), or recovering from its effects Important social, occupational, or recreational activities are given up or reduced because of the continued alcohol or substance use The substance or alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption) General Treatment Overview