FAQ
How do we tell whether someone is addicted or not?
It is a relatively simple to diagnose addiction or to know when one’s addiction related activities are problematic. When there are objective, irrefutable indications, including the amount of time and energy spent acquiring a substance, thinking about the substance, getting high, being high, etc. – in other words, the extent to which his/her life revolves around a mind/mood altering chemical or activity, and how one’s life is impacted, i.e. health, relationships, occupational, academic, legal or financial problems, etc.
When there is marked evidence of problems or deterioration, it is almost certain that there is a pathological dependence, and that these problems will sooner or later precipitate treatment. We may call this an objective dependency.
It’s important to keep in mind the distinction between the existence of an addiction and its severity because there are profound treatment implications. The severity of resultant problems usually corresponds to the severity of the addiction.
When there are few or no objective indications, it becomes much more difficult to know whether someone is addicted. When there is a lack of irrefutable evidence, the tendency is to discount the existence of an addiction. “If there are no problems or consequences, there must not be an addiction.” One might wonder whether it even matters.
What if a person doesn’t care whether s/he is addicted or not and as long as s/he is maintaining a high level of functioning, and is choosing to maintain his/her involvement? It is certainly possible be addicted and remain relatively high functioning.
The challenge is still to determine whether there is an addiction or ‘subjective’ dependency. A subjective dependency requires accurate interpretation of subjective indications to know whether or not there is an addiction.
In order to make a diagnosis as soon as possible, during the early and mid ranges of an addiction’s progression and before it reaches its destructive potential, subjective criteria must again be applied. For example, when there are obvious addiction-related problems, but the person is not willing or able to even entertain the possibility of an addiction, the possibility of undesirable consequences, or the possibility of needing help to address those problems.
Take the case of a relatively high-functioning addict who claims not to be addicted, and sees no ill effects. S/he claims to be using the substance recreationally; but it becomes apparent that his/her recollection of facts regarding amounts, frequency and duration of use is inconsistent. It becomes further apparent that the person is making an effort to conceal, cover up, minimize or justify his/her use to him or herself and to other people, but isn’t aware of doing so. It finally becomes apparent that this person is in denial. The person’s story is a denial-laden story. At this point, a bell rings and we know.
The rule of thumb is that wherever there is denial, there is dependency – otherwise, there would be nothing to deny. One doesn’t exist without the other.
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About Daniel Linder, MFT
Relationships. I was born with a keen sense about relationships, was always assessing how close and intimate people are with each other. I had a knack for relationships. The importance of relationships cuts to the core of who I am. The combination of clinical training, 25 years of professional experience treating dysfunctional, non-intimate couples and families, as well as rigorous self analysis has given me a lot to work with. I put what seemed to come naturally to me under a microscope in an effort to break the process of building healthy relationships down to concrete essentials: Understanding of Basic Principles, Communication Skills, Self-realization and Intimacy.