1. Biological Reinforcement: Biological reinforcement that promotes continued use of alcohol and other drugs. (NIAAA 1996)
2. Tolerance: Progressive tolerance that requires increased amounts to achieve the desired state of reinforcement. (DSM-IV Criteria #1)
3. Withdrawal: Acute & Post Acute Withdrawal Syndromes when substance use is stopped. (DSM-IV Criteria #2)
4. Loss of Control: Inability to control over the quantity of substances consumed and length of substance use episodes.
5. Inability To Abstain: Inability to maintain long-term abstinence.
6. Addiction Centered Lifestyle: The development of an addiction-centered lifestyle. (DSM-IV Criteria #5)
7. Addictive Lifestyle Losses: Giving up previously valued lifestyle activities due to substance use. (DSM-IV Criteria #6)
8. Progressive Substance-related Problems: The development of progressive substance-induced biopsychosocial problems. (DSM-IV Criteria #7)
9. Continued Use In Spite Of The Problems: The pain caused by the problems creates craving for more drug use rather than a desire to correct the problems. With renewed drug use awareness of the problems recedes from conscious awareness. (DSM-IV Criteria #7)
10. Biopsychosocial Deterioration: Progressive physical, psychological and social deterioration as a long as substance use continues which ends in serious physical illness. Serious psychiatric illness, suicide, death, or involvement in treatment.