Addiction is a biopsychosocial disease, a distinct disorder requiring ongoing treatment and intervention, not only episodic or acute care. A person's addictive disorder cannot be addressed in isolation from addressing his or her biological, psychological or social needs.

The Diagnostic and Statistical Manual - IV (DSM-IV) describes addiction as a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

• Substance is often taken in larger amounts or over longer period than intended.
  
  
• Persistent desire or unsuccessful efforts to cut down or control substance use.
  
  
• A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain smoking), or recover from its effects.
  
  
• Important social, occupational, or recreational activities given up or reduced because of substance abuse.
  
  
• Continued substance use despite knowledge of having a persistent or recurrent psychological or physical problem that is caused or exacerbated by use of the substance.
  
  
• Tolerance, as defined by either:
  
  
  • Need for markedly increased amounts of the substance in order to achieve intoxication or desired effect; or
    
    
  • Markedly diminished effect with continued use of the same amount.
    
    
• Withdrawal, as manifested by either:
  
  
  • Characteristic withdrawal syndrome for the substance;
    
    
  • The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.

 

Hawaii Department of Health
Alcohol and Drug Abuse Division
601 Kamokila Blvd. Room 360
Kapolei, Hawai'i, 96707
(808) 692-7506