Do I Have an Addiction?

How to Tell if You Have an Addiction?

Addiction is a chronic disease that can lead to poor physical and mental health, damaged relationships, legal problems and other complications. You may have an addiction if you find your use of alcohol or drugs is out of control, is interfering with your relationships, and is causing you problems at work or school. The primary feature of addiction is a loss of control: if you want to stop using drugs or alcohol but can’t, you may have an addiction. Simply asking, “Do I have an addiction?” may provide important insights and might suggest that you could benefit from professional treatment.

What is Addiction?

Mental health and behavioral health experts refer to addiction to drugs and alcohol as substance use disorders. The American Society of Addiction Medicine, an organization of addiction medicine doctors and specialists, defines addiction like this:

“Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.”

Scientists have an understanding of how addiction develops. The brain tracks pleasurable activities in a reward system, and codes them using a molecule called dopamine. When drugs and alcohol enter your brain from the bloodstream, they strongly activate the brain’s reward system, flooding it with dopamine. Since the brains of all animals are wired to seek reward, over time an increasing amount of brain cell activity becomes dedicated to the pursuit of pleasurable substance. Addiction develops when this pursuit regularly outcompetes more typical brain activities like planning your day or balancing your checkbook.

Some people are at a greater risk of developing an addiction than others. These factors increase addiction risk:

• a family history of addiction, which indicates a genetic predisposition to this disease
• experimenting with drugs or alcohol at an early age
• having an aggressive or impulsive personality
• living in poverty as a child
• having easy access to substances

Risk factors don’t guarantee that you will become addicted or seal your fate. Many people have risk factors and never misuse substances; many people without risk factors also develop addictions. Anyone, regardless of age, gender, family history, or circumstances, can become addicted.

How to Know if You Have an Addiction

Having an addiction means that you consistently, over and over, cannot stop from using a substance. It is a set of repeated behaviors, not one or two instance of drug use or drinking. However, it is important to understand that any misuse of substances can be problematic and consequential, and can eventually lead to an addiction.

If you — or those who support you — suspect you have an addiction, it is important to be evaluated by a mental health or addiction professional. You can also take a look at your behaviors and compare them to the official criteria for diagnosing substance use disorders.

Ask yourself these questions. If you can answer yes to just two or three of these and say that they cause significant distress or impairment in your life, you may have at least a mild addiction:

1. Do you often find yourself using more of a substance or using it more often than you had planned?
2. Have you tried, more than once, to cut back your substance use but keep failing?
3. Do you spend a lot of time and/or money trying to get drugs or alcohol, being high or drunk, or recovering from using?
4. Do you experience strong cravings for substances?
5. Are you often unable to fulfill responsibilities at home, do your job adequately, or keep up at school because of substance use?
6. Does your substance use cause problems with friends, family or a partner? And do you continue to use them in spite of these issues?
7. Are you giving up activities, work, school, or socializing to spend more time using drugs or drinking?
8. Have you used substances in situations that put you in danger, like when you needed to drive for instance?
9. Do you keep using substances even though you know that they are causing you physical or mental health issues?
10. Have you developed a tolerance to substances that you use, needing more and more to get the same effect?
11. Do you experience uncomfortable withdrawal symptoms, like irritability, confusion, or pain, when not using?

How Do I Know If I Have a Drug Problem?

A substance use disorder may involve the use of drugs, alcohol, or both. If you have a drug problem, or an addiction to drugs, you will experience several symptoms: an inability to control use of the drug, trying to quit and failing, sacrificing activities, responsibilities, and relationships in order to use, and others. Addiction professionals often abbreviate these symptoms as “the three Cs”: cravings, compulsion and continued use despite negative consequences.

It is important to understand that drug abuse is not limited to illegal substances. Many people assume that addiction only refers to things like cocaine, crystal meth, or heroin. You can also become addicted to legal prescription drugs and even over-the-counter drugs like cough syrups or household chemicals.

If you are using prescription or other legal medications in any way other than as prescribed or recommended by your doctor, it is considered abuse. This kind of behavior in itself does not mean you are addicted to the drug, but it can lead to an addiction if it continues.

As marijuana becomes increasingly accepted and legalized in several states for recreational use, it is also important to be aware that this drug can cause addiction. Public health experts recognize that legalization tends to make people more comfortable with a drug and contribute to a perception that the drug is safe. Marijuana is a psychoactive substance that can be abused and can trigger an addiction, even when its use is fully legal.

How to Know if You’re Addicted to Alcohol

Alcohol can also be problematic for similar reasons. Because it is legal and normalized in society, it is easy to assume it is safe — or at least safer — than drugs. Alcohol use disorder is a costly health issue. You can become addicted to alcohol in the same way as legal and illegal drugs. The signs of alcohol addiction are the same as for any other substance use disorder.

Because drinking is socially acceptable in many societies, it can be hard to know whether or not you are misusing alcohol. As with drugs, any misuse of alcohol can lead to an addiction. Some problematic behaviors which create an increased risk for addiction include:

• Binge drinking, which is defined as four or more drinks in one sitting for women and five or more for men. Any drinking that causes blood alcohol concentration to reach 0.08 or higher is considered binge drinking.
• Heavy drinking, which is binge drinking five or more times in a month.
• Consistently drinking in order to relax at the end of the day, be more comfortable in social situations, or to avoid any negative feelings.
• Alcohol has started to feel like a reward, like something you deserve and look forward to after a challenging day or difficult situation.
• You start avoiding friends who don’t drink or situations where you know alcohol won’t be present.
• You’re drinking in secret.
• Drinking has become increasingly important in your life and a regular habit.
• Drinking is disrupting your life in some way, causing hangovers that make you late for work, for instance, or causing fights with your partner.

Addiction is a very real and serious health problem. It is also treatable. Similar to other chronic medical conditions like diabetes, asthma and rheumatoid arthritis, addiction has no direct cure, but it has many effective treatments, with treatment success rates similar to other chronic conditions. Even if you don’t think you are abusing alcohol or drugs, asking “Do I have an addiction?” can give you the opportunity to make a serious evaluation of your use of alcohol or drugs and make changes if necessary. If you do think you have an addiction, seek a diagnosis and treatment from addiction specialists.

References:

Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. 2, Substance Use Disorders.

American Society of Addiction Medicine (2019). ASAM Definition of Addiction. \

Diana M. (2011). The dopamine hypothesis of drug addiction and its potential therapeutic value. Frontiers in Psychiatry, 2, 64.

National Institute on Drug Abuse. (2018). Drugs, Brains, and Behavior: The Science of Addiction.

Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, et al. (2013). DSM-5 criteria for substance use disorders: recommendations and rationale. The American Journal of Psychiatry, 170(8), 834–851.

Medscape (2018). Alcoholism Clinical Presentation: History, Physical, Causes.

National Institute on Alcohol Abuse and Alcoholism. Drinking Levels Defined.

National Institute on Drug Abuse (2018). How Effective is Drug Addiction Treatment?