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Addiction Disorders Treated with Cognitive Behavior Therapy (CBT) at New York Behavioral Health

Addiction Definition

Addiction is a persistent dependence on a substance, despite harmful consequences, that causes tolerance with use and withdrawal symptoms when use declines or ceases.

The DSM-IV-TR includes the terms substance abuse and substance dependence instead of addiction.

Substance abuse is the maladaptive use of a substance that causes significant functional impairment and/or distress.  It also involves at least one of the following symptoms, which must occur within the last 12 months:

  • 1) failure to meet the demands of one's social role (e.g., employee, parent, student)

  • 2) recurrent use where physical harm may result (e.g., operation of a motor vehicle while intoxicated)

  • 3) use results in legal problems

  • 4) use continues despite causing or exacerbating social or other interpersonal dificulties (e.g., fighting or arguments)

Substance dependence is the maladaptive use of a substance that causes significant functional impairment and/or distress.  It also involves at least three of the following symptoms, which must occur within the last 12 months:

  • 1) tolerance

  • 2) withdrawal

  • 3) larger than anticipated amounts or durations of use than intended

  • 4) presence of desire and/or unsuccessful efforts to decrease or terminate use

  • 5) significant time and energy are used to obtain, use, or recover from use

  • 6) important activities are reduced or terminated because of use

  • 7) use continues despite knowledge of physical or psychological detriment

It may be specified if physiological dependence is present or absence

The DSM-V (yet to be officially published) is likely to combine and modify these diagnoses.

Addiction Description

Addiction is one of the most controversial terms in the diagnostic literature. It is defined very differently by various professions and from different theoretical orientations within the same field.  Alcohol, cocaine, heroin, nicotine, barbiturates, benzodiazepines, and many other substances are considered addictive.  A wide variety of behaviors or activities have also been labeled as addictive.  Examples include gambling addiction, compulsive shopping (aka retail therapy), binge eating, overeating, compulsive internet use, pornography addiction, sex addiction, or even exercise.  However, these do not adhere to the standards some use to define addiction.  Some experts that address these issues may even prefer terms of compulsions or abuse, which complicates matters.

Addiction Treatment

There are many different theories of addiction and treatments for addiction. Twelve Step Programs, Cognitive Behavioral Therapy, pharmaceutical interventions, and religious interventions are all common.  There is a great deal of evidence that treatment is effective.  The earlier someone addicted seeks help the better. But, it is vital to be in the care of a professional, as withdrawal symptoms can be dangerous, therefore it is important for a proper assessment to be conducted and treatment plan to be developed.