What Are the 6 Types of Drug Dependence?

Drug dependence is classified as a “Substance Use Disorder” in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Diagnostic criteria includes evidence of: 

• Impaired control 
• Social impairment
• Risky use
• Pharmacological criteria

Substance abuse disorders are classified as mild, moderate, or severe based on the number of diagnostic criteria met by an individual:

• One or more abuse criteria within a 12-month period and no dependence diagnosis; applicable to all substances except nicotine, for which DSM-IV abuse criteria were not given.
• Three or more dependence criteria within a 12-month period.
• Two or more substance use disorder criteria within a 12-month period.
• Withdrawal not included for inhalant and hallucinogen disorders.

Drug dependence progresses through four stages: 

• Stage 1: Experimentation
  • Voluntary use of drugs without any negative social or legal consequences 
  • The person using the drug sees it as a single use opportunity get drunk or high, which can open the path to addiction
  • At this stage, those who are able to stop using the substance on their own will do so, while others who are using the substance to feel good or solve their problems will move on to the next stage
• Stage 2: Regular use
  • At this stage, some people may be able use drugs or alcohol regularly without developing an addiction, though the risk for dependence increases significantly
  • The risk of participating in high-risk behaviors, such as driving under the influence, increases 
  • An occasional drink or use of a drug becomes a common occurrence and part of a person’s routine 
  • The person may be lulled into a false sense of security that they can still easily quit
  • While some may feel guilt or shame for their substance use, most will try to justify it or make excuses
• Stage 3: High-risk use 
  • There is a thin line between regular use and high-risk use, which is defined as the continued use of the substance despite severe social or legal consequences
  • The substance use now takes precedence over other facets of life, and the user becomes either unafraid or unaware of the consequences of the behavior
  • Cravings become unbearable and can cause the person to do things they wouldn’t normally do to just get more of the substance
  • The person may start to justify dangerous behaviors, and work, relationships, and other obligations tend to suffer 
• Stage 4: Addiction 
  • At this stage a person is addicted and completely dependent on the substance
  • When they don’t use, the body goes through withdrawal symptoms such as shaking, tremors, sweats, and frantic behavior
  • The addict spends most of the time drunk or high, and does not want anything to get in the way of using the substance
  • At this stage, even if someone tells the user their life depends on stopping the substance use, they are not able to do so