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.

This is from T. Gorski – for more information visit www.tgorski.com