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Basic InformationMore InformationIs Alcohol A Problem?"I have benefited from AA and the 12 Steps... Very much so!"A Better MeetingAA Is To Shame As A Hot Knife Is To ButterAging and Alcohol UseAlcoholic's Anonymous, Outcomes and New Research on AlcoholismAlcoholics Anonymous (AA) is a Cult ?An Alternative to PowerlessnessAttachment to OutcomesAwakeningConcerning Problems Within AADefining and Understanding the Concept of Denial, Addictions and OtherwiseGauging the Effectiveness of One Component of Alcoholics AnonymousHow Drugs Affect The BrainHuffing: Parents and Kids BewareIts Never Too LateLike Phoenix Risen from the Ashes of Addiction, A New Addiction Recovery ProgramNIDA InfoFacts: Drug Abuse and AIDSNIDA InfoFacts: Drug Addiction Treatment MethodsNIDA InfoFacts: Drugged DrivingNIDA InfoFacts: Pregnancy and Drug Use TrendsNIDA InfoFacts: Understanding Drug Abuse and AddictionOn the Question of Medical MarijuanaPain Pills, A Real PainPerverse MotivationRandom Thoughts About Addiction, Delusions and HallucinationsRecoverySelf-EfficacyStaying Sober: Dealing With TemptationsSteering Versus DriftingThe Author of Your FateThe Enlightened PathThe Impeccable PathThe Mentality of ChildhoodThe OPEN PathThe Paradoxical Sinclair Method For Treating Alcohol DependenceTwo MindsWise Counsel Interview Transcript: An Interview with Annie Fahy, MSW on Motivational InterviewingWise Counsel Interview Transcript: An Interview with John C. Fleming, MD on Preventing AddictionWise Counsel Interview Transcript: An Interview with Laurence Westreich, MD on Helping Families Help Addicted MembersWise Counsel Interview Transcript: An Interview with Marc Kern, Ph.D. on Rational Alternatives to Alcoholics AnonymousWise Counsel Interview Transcript: An interview with Morteza Khaleghi, Ph.D. on the Importance of Treating Emotional Trauma in Addiction Wise Counsel Interview Transcript: An Interview with Patt Denning, Ph.D. on Harm Reduction Psychotherapy for Substance Abuse and AddictionWise Counsel Interview Transcript: An Interview with Stefanie Goldstein, Ph.D. on Mindfulness and Addiction TestsLatest NewsIs Alcohol A Problem?Computer-Based Screening May Reduce Teen Substance AbuseTeen Impulsiveness Has Different Sources in ADHD, Substance UseAccelerated Aging Evident in Cocaine-Dependent IndividualsMany Who First Misuse Prescription Pills Get Them From Friends, Family: ReportCocaine Habit Might Speed Brain AgingUse of Ecstasy, Speed by Teens Tied to Later DepressionHalf of Young Cigarette Smokers Also Smoke Pot: Survey12-Step Meetings May Help Teens Beat Alcohol, Drug AbuseAlcohol Use With Opioids Common Even Without Abuse PastSubstance Abusers, Even Recovering Ones, May Face StigmaDrug, Alcohol Abuse Common Among U.S. Teens, Study FindsAlcohol Effects on Brain Activity Vary With Blackout HistoryPrenatal Meth Exposure Linked to Behavioral ProblemsExcessive Drinking Costs U.S. Colleges Millions AnnuallyKids Using Synthetic Pot a Growing Public Health ConcernSpring Break Boozing May Put Young Brains at RiskMany Alcoholics Suffered Childhood Trauma: StudyGenes Play a Role in Drug Abuse Risk Among Adopted Kids: StudyNarcotic Painkillers Another Threat to Traumatized War Vets: StudyDrinking Scenes in Movies May Spur Teens to Do the SameStrict Underage Drinking Laws May Deter Delinquency in TeensEcstasy Use During Pregnancy May Harm Fetus: StudySupport for Tougher Liquor Laws Rises When Booze, Crime LinkedBooze in Movies May Fuel Teenage Drinking1 in 10 U.S. Kids Lives With Parent Who Has Abused Alcohol: ReportStop-Smoking Drug May Also Curb Problem DrinkingIllicit Drugs Bought Off Internet May Be Poisons, Experts WarnHard Drug Use in Middle Age Could Prove Fatal, Study FindsDrinking Late in First Trimester May Be Most HazardousAlcohol Targets Brain 'Reward Centers' in Heavy DrinkersOne in Six Americans Binge Drink: CDCMeth Users Much More Likely to Try SuicideFor Some Couples, Binge Drinking Is RoutineStates Crack Down on Drunk Drivers This Holiday SeasonDrug Overdoses Kill More Americans Than Car Accidents: CDCAlcohol Use Down, Pot Use Up Among U.S. TeensDrunk Driving-Related Deaths Surge During the Holidays'Ecstasy' May Cause Long-Term Changes in Brain ChemistryToo Much Alcohol Linked to Unsafe Sex, Study ConfirmsIf Parents Drink and Drive, Their Kids May Too: StudySmart Kids More Likely to Try Illicit Drugs as Young AdultsHelping Others Helps Teens Beat Substance AbuseDrugs Slipped Into Drinks Sending Many to ER: ReportHeavy Meth Use Linked to Schizophrenia'Fake Marijuana' May Trigger Heart Trouble in TeensMore Than a Third of Teens Turning to Alcohol, Drugs: StudyMore People Landing in the ER After Abusing Muscle Relaxant: ReportDeaths From Abuse of Painkillers Triple in a Decade: CDCNational Drug Take-Back Day Scheduled for Saturday Questions and AnswersLinksBook ReviewsSelf-Help Groups |
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Important Diagnostic Concepts Regarding Alcohol and Substance AbuseMark Dombeck, Ph.D. Addictions are diagnosed based primarily on the severity of a patient's drug or alcohol problems. Milder cases of addiction are termed "Substance Abuse", while more severe cases are termed, "Substance Dependence". Most of the time, people who have an addiction are blind to it, or in denial about it. They will not or cannot see the extent of the problems they are experiencing. Because of this denial, addictions cannot be self-diagnosed. An objective appraisal of a person's alcohol or drug use, and the problems a person is experiencing due to their substance use must be made by an experienced clinician before any diagnosis can be made. How do the experts make the distinction between mild substance 'Abuse' and more severe substance 'Dependence'? The answer depends largely on whether or not the addicted person experiences Tolerance and Withdrawal. Tolerance is the name given to the case when, over time, a drug or alcohol user requires more and more substance to get the same amount of 'high' effect they are seeking. Typically, the more a person takes drugs or alcohol, the more that he or she will become tolerant to its effects, requiring more and more of the substance to get the same effect. Tolerance, then, is what is happening when someone starts needing to drink six drinks to get the same 'buzz' that they used to get by only drinking three drinks. Withdrawal is the name given to the negative experiences and cravings that a drug or alcohol user may have when they stop taking using drugs or alcohol. For example, an alcoholic who stops drinking abruptly may experience one or more of the following negative symptoms: anxiety, sweating, increased heart rate, hand tremor, insomnia, vomiting, agitation, hallucinations, and even seizures. A drug or alcohol user in withdrawal becomes highly motivated to get and take more drugs or alcohol, as this relieves their feelings of sickness. As one might figure, an alcoholic who experiences such an array of negative symptoms even once, will be highly motivated to remain drunk so as to avoid ever having to experience them again. A person must be experiencing significant social, relationship, family and/or occupational difficulty due to their substance use in order to qualify for a Substance Abuse diagnosis, but they need not have ever experienced Tolerance or Withdrawal. A diagnosis of Substance Dependence, however, cannot be made if Tolerance or Withdrawal is not present. Read our 'Symptoms' articles to learn how the DSM-IV (the formal medical Diagnostic Manual for mental disorders used by doctors) defines Substance Abuse and Substance Dependence.
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