Substance Dependence - a medical diagnosis as specified the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM IV) -
A maladaptive pattern of substance use , leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:
tolerance, as defined by either of the following:
a need for markedly increased amounts of the substance to achieve intoxication or desired effect
markedly diminished effect with continued use of the same amount of the substance
withdrawal, as manifested by either of the following:
the characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances)
the same (or closely related0 substance is taken to relieve or avoid withdrawal symptoms
the substance is often taken in larger amounts or over a longer period of time than was intended
there is persistent desire or unsuccessful efforts to cut down or control substance use
a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain-smoking), or recovering from its effects
important social, occupational, or recreational activities are given up or reduced because of substance use
the substance use is continued despite knowledge of having a persistent of recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induce depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)