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
- Substance is often taken in larger amounts or over longer period
- Persistent desire or unsuccessful efforts to cut down or control
- 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
- 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
- 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