Drug or substance abuse, dependence or addiction? Abuse and dependence (sometimes termed addiction) are formal psychiatric diagnoses with specified criteria. These criteria, which apply to all psychoactive substances, are provided in the DSM-IV used in the US and the International Classification of Diseases-10th revision used elsewhere in the world. The concepts, as well as the actual criteria, are actually quite similar.

Dependence refers to a loss of control over use of the drug. This results in continued use despite adverse consequences and inability to control how often or how much is used.

Treatment for drug dependence or abuse starts with pinpointing the problem. And, although “denial” was once considered as an addiction symptom, modern studies now show that addicted people are actually much less likely to deny the problem if they receive respect and empathy from other people instead of when they are “confronted” or forced into admitting it.

While a definitive addiction diagnosis often occurs after being evaluated by an addiction counselor, psychologist or psychiatrist, the first step usually starts with a family doctor. Blood tests, while often used to determine use a particular substance in the recent past, are not used to actually diagnose addiction.