Some people know when their use of alcohol and drugs has reached the level of addiction. Others, however, are not able to make this assessment on their own. The American Psychiatric Association (APA) recognizes two levels of problem use of drugs and alcohol. In substance abuse a person may misuse a substance but they still have the ability to modify use of the substance. Dependence is marked by an inability to modify or control use.

If you are not sure if your use of alcohol and/or other drugs has become an addiction, the following guidelines from the APA may help you to determine where you stand. As you read them ask yourself honestly if these apply to you.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, commonly referred to as the DSM-IV-TR, offers diagnostic tools that identify the two levels of AOD problems: dependence and abuse. For a diagnosis of substance dependence, a person needs to demonstrate a pattern of drug use that leads to significant impairment or distress. This is determined by the presence of three or more of the following, occurring within a twelve-month period:

1. Tolerance, as defined by either of the following:

1. A need for markedly increased amounts of the substance to achieve the desired effect
2. Markedly diminished effect with continued use of the same amount of the substance

1. Withdrawal, as manifested by either of the following:

1. the characteristic withdrawal syndrome for the substance
2. the same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms

1. The substance is often taken in larger amounts or over a longer period than was intended
2. There is a persistent desire or unsuccessful efforts to cut down or control substance use
3. A great deal of time is spent in activities necessary to obtain the substance, to use the substance, or to recover from its effects
4. Important social, occupational, or recreational activities are given up or reduced because of the substance use
5. The substance is used despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance. (APA, 2000, p. 197)

Substance abuse is another level of AOD problem that is diagnosed as a pattern of use leading to clinically significant impairment or distress as manifested by one or more of the following, occurring within a twelve-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home
2. Recurrent substance use in situations in which it is physically hazardous
3. Recurrent substance-related legal problems
4. Continued substance use despite having persistent or recurrent social or inter-personal problems caused or exacerbated by the effects of the substance. (APA, 2000, p. 199)

If you fit either of these diagnostic criteria you are an appropriate candidate for addiction treatment.