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The purpose of the DSM-IV is to provide mental health professionals a manual that lists the mental disorders that they are able to use when diagnosing patients and the criteria for those disorders. The manual is extremely detailed in each disorder and includes specific and associated features and any other relevant information for that disorder. Any mental health professional that works in a clinical setting will use the DSM-IV for diagnosis. Most insurance companies will not pay unless there is a diagnosis in place.


Addiction defined is when a person meets the criteria or manifests three out of ten symptoms.  These symptoms range from compulsion to tolerance and from intoxication to withdrawal.

Substance Dependence

Substance dependence is when the body is physically or mentally dependent on a drug or alcohol and can suffer withdrawal symptoms when not using.  Substance dependence is when a person creates a tolerance in which they either use more drugs or alcohol to feel high or are only maintaining to avoid withdrawal symptoms at a certain amount.  Substance dependence is when a person takes more drugs or drinks alcohol for a longer time then what they originally intended and their lifestyles and relationships have reduced because of the dependence.  When someone is dependent on alcohol or drugs they use them even if they understand the physical and mental negative consequences yet continue to use even if their lifestyle destructs.

Substance Abuse

Substance abuse is when a person will use alcohol or drugs and fail to fill their role in life whether it’s being a parent, employee, student, or friend.  When someone is abusing alcohol or drugs they could get physically violent and hurt their social relationships.  Typically, someone who is abusing does not meet the criteria for being dependent but without proper help dependence is typically very close.

The DSM-IV (American Psychiatric Association, 2000) does not use the word addiction because it will then classify the problem as a disease.  When using the word disease it is hard to describe therefore, to avoid certain laws they use the specific criteria to either classify the patient as a dependent or abuser.  Addiction is only diagnosed when the patient’s answers meet the criteria.

Fisher, Gary L., and Thomas C. Harrison. Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. Boston: Pearson/Allyn and Bacon, 2005. Print.
"NIDA - Diagnosis and Treatment of Drug Abuse in Family Practice - Introduction." ARCHIVES - National Institute on Drug Abuse - The Science of Drug Abuse and Addiction. Web. 23 Feb. 2011. .