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Last reviewed: 12.07.2025
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Addiction is a chronic relapsing disorder associated with excessive use of certain substances. Most often, addiction is caused by nicotine, alcohol, opioids, psychostimulants (in particular, cocaine). The transition from use to abuse of a particular substance and then to the formation of dependence on it is associated with several factors: individual predisposition, activity of the substance, social conditions. Clinical manifestations of various forms of addiction are determined by the pharmacological properties of the drugs that the patient abuses. Accordingly, the clinical picture of opioid addiction differs from the manifestations of cocaine, alcohol or nicotine addiction. However, there are features common to all types of addiction: uncontrolled acquisition and use of the substance, a tendency to relapse even after prolonged abstinence. Treatment of addiction involves long-term behavioral correction. Treatment results can be improved with medications that reduce withdrawal symptoms and help prevent relapse. Since addiction is a chronic, relapsing disorder, the main goals of therapy are to improve quality of life, reduce symptoms, and prolong periods of abstinence or at least moderate use of the addictive substance. From this perspective, addiction treatment is similar in nature to treatment of other chronic disorders.
Causes of addiction
When drug addicts are asked why they take a particular substance, most answer that they want to get a “high.” This refers to an altered state of consciousness characterized by feelings of pleasure or euphoria. The nature of the sensations experienced varies greatly depending on the type of substance used. Some people report taking drugs to relax, relieve stress, or relieve depression. It is extremely rare for a patient to take painkillers for a long time to relieve chronic headaches or back pain and then lose control of their use. However, if each case is analyzed more closely, it is impossible to give a simple answer. Almost always, several factors can be found that led to the development of addiction. These factors can be divided into three groups: those related to the substance itself, the person using it (the “host”), and external circumstances. This is similar to infectious diseases, where the possibility of a person becoming infected upon contact with the pathogen depends on several factors.
Addiction - Causes of Development
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Symptoms of addiction
Addiction is a complex biopsychosocial problem that is poorly understood not only by the general public but also by many health care professionals. The primary symptom of this disorder is behavior characterized by compulsive acquisition and use of psychoactive substances. The diagnosis of addiction (also called dependence) is established in accordance with the criteria of the American Psychiatric Association. These criteria apply to any form of addiction and require the presence of behavioral symptoms associated with the acquisition and use of psychoactive substances. According to these criteria, a diagnosis of addiction can be established if at least three of these symptoms are present. These behavioral symptoms represent actions to obtain the drug that are integrated into normal daily activities. Although the presence of tolerance and withdrawal are taken into account in the diagnosis, they are not sufficient in themselves to establish the diagnosis. Tolerance is characterized by the need for a significant increase in the dose of the substance to achieve the desired effect or a marked weakening of the effect with continued administration of the same dose.
Diagnostic criteria for addiction (according to DSM-IV)
The pattern of substance use causes clinically significant impairment or distress, as demonstrated by at least three of the following symptoms occurring simultaneously for 12 months.
- Tolerance
- Withdrawal syndrome
- The substance is often taken in higher doses or for longer periods of time than intended
- A persistent desire or unsuccessful attempt to reduce or control substance use
- The actions of obtaining the substance (such as visiting multiple doctors or traveling long distances), using the substance, or recovering from its effects take up a significant amount of time