Who should be treated for addiction?

There are generally three groups of people who are concerned with identifying the signs of addiction and the need for counseling or treatment:

  • Individuals who use addictive substances or engage in addictive behaviors
  • Friends, teachers and family members of the above
  • Physicians, therapists, and other healthcare providers


This process involves identifying suspicious signs, filling out self-administered questionnaires, and answering questionnaires administered by physicians and healthcare providers. The purpose of these questionnaires is not to diagnose addiction, but rather to help identify whether an individual should seek further counseling and clarification about whether he or she may suffer from addiction. The questionnaires and diagnostic tools vary depending on the addictive substance and behavior.

The final diagnosis of addiction is done by a professional in accordance with defined criteria.


Identifying Addiction (by non-professionals)

  Family members, parents, and friends are often the first to identify problematic engagement with addictive substances and behaviors and to suspect addiction. It is important to emphasize that this identification is not enough to diagnose addiction, but rather helps detect warning signs — including physical, psychological and behavioral signs — that should be evaluated by a professional. Physical signs include changes in sleep patterns or appetite, significant weight loss, deterioration of appearance, unusual smells from body or clothes, slurred or slow speech, trembling, and coordination problems. Psychological signs include sudden changes in interaction with others, mood swings, tantrums, prolonged periods of restlessness and hyperactivity, lack of motivation, feelings of anxiety and mistrust. Behavioral signs include absenteeism or decreased performance in work or school, unexplained financial problems, suspicious behavior, sudden changes in social circle or social behavior, frequent involvement in events such as accidents, fights, and illegal behavior. To repeat, these criteria are not a complete list, and are not sufficient for diagnosing addiction. Rather, they are intended to assist in determining whether to refer a family member, friend or student to counseling in order to evaluate if he or she is suffering from addiction.  

Identifying Addiction (by healthcare professionals)

  Physicians, therapists and other healthcare providers frequently use screening questionnaires, made up of a few questions, in order to detect the possibility of addiction. The purpose of these questionnaires is to initially determine if there is any danger of addiction, and, if so, to refer the patient to a more in-depth evaluation of the need for treatment.    

Criteria for diagnosing addiction

  In contrast to the questionnaires, which are used in initial stages to evaluate whether a suspected problem should be investigated further, there is a list of criteria used for the accurate diagnosis of addiction. According to the World Health Organization, an individual can be diagnosed with addiction if three or more of the following signs occurred simultaneously over the past year:

  • Difficulties in controlling substance-taking behavior in terms of its onset, termination, or levels of use;
  • A physiological withdrawal state when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or closely related) substance with the intention of relieving or avoiding withdrawal symptoms;
  • Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses (clear examples of this are found in alcohol- and opiate-dependent individuals who may take daily doses sufficient to incapacitate or kill non-tolerant users);
  • Progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects;
  • Persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to periods of heavy substance use, or drug-related impairment of cognitive functioning; efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm.


Self-administered questionnaires

  The following questionnaire, for example, is designed to be self-administered. An affirmative answer to one or more of the several questions is an indication to seek advice from a professional.

  • Have you tried to stop using drugs or alcohol, but not succeeded?
  • Has a family member or loved one expressed concern about your drinking habits or drug use?
  • Have you felt guilty about drinking alcohol or using drugs?
  • Has your work, home, or school performance been impaired by drug or alcohol use?
  • Have you lied to someone about taking a drug or medication, or drinking alcohol?
  • Has your alcohol or drug use induced physical symptoms such as tremors, vomiting, or paranoid thoughts?
  • Have you ever struggled to have a good time without using drugs or alcohol?
  • Has anyone close to you expressed concern about your drug or alcohol use?
  • Have you often thought that your life would be better without using drugs or alcohol?

  Again, these questions do not serve to diagnose addiction, but rather to help people decide whether they should consult a professional about the need for treatment.  



  The final diagnosis of addiction is done by a healthcare professional in accordance with defined criteria.