What Are the Four Components of Addiction?

Reviewed on 3/25/2022
Man speaking to an addiction therapist and looking distraught
The four components of addiction symptoms include impaired control, social problems, risky use, and drug effects.

Addiction is a disorder characterized by a compulsive desire to continue taking a drug or continue a harmful behavior, such as gambling, despite harmful consequences. 

People who have an addiction are often aware of their problem but are unable to stop, even if they want to. 

There are four components in which symptoms of addiction are categorized: 

  • Impaired control
    • Intense cravings or strong urges to use the substance or continue the behavior
    • Failed attempts to reduce or stop using the substance or behavior
  • Social problems
    • Interpersonal problems with family members, friends, or co-workers
    • Failure to complete work, school, or home tasks 
    • Reducing or quitting social, work, or leisure activities because of substance use or behavior
  • Risky use
    • Use of substance in risky settings
    • Continuation of behavior despite risks
    • Continued use of substance/participation in behavior despite known harmful consequences
  • Drug effects
    • Tolerance (needing larger amounts to get the same effect)
    • Withdrawal symptoms (different for each substance)

Addiction may be accompanied by other psychiatric disorders.

What Causes Addiction?

According to the National Institute on Drug Abuse, people abuse substances for various reasons, such as:

  • To feel good: getting high or intoxicated
  • To feel better: for stress relief, to forget problems, or to feel numb
  • To do better: for improved performance or thinking
  • Curiosity, peer pressure, or experimentation

Most of the time, people start using alcohol or drugs voluntarily, but after repeated use, brain changes interfere with a person’s self-control and ability to stop taking the substance.

Drugs usually affect the brain's “reward circuit,” causing euphoria as well as flooding the brain with the neurotransmitter dopamine. Surges of dopamine reinforce pleasurable but unhealthy behaviors such as drinking alcohol or taking drugs, which cause people to repeat the behaviors.

Continued use of drugs or alcohol causes the brain to adapt by reducing the ability of cells in the reward circuit to respond to it, which results in a person needing larger amounts to get the same effect (called tolerance). 

How Is Addiction Diagnosed?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines substance use disorders as mild, moderate, or severe based on the number of diagnostic criteria met by an individual. 

Diagnostic criteria for substance use disorders and addiction includes evidence of: 

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

What Is the Treatment for Addiction?

Treatments for addiction first involve recognizing there is a problem. If a person does not perceive a problem with substance abuse, it may be difficult for them to recover. 

Addiction often requires several types of treatment, and a combination of medication and individual or group therapy tends to be most effective. 

Recovery plans are tailored to a person’s specific needs and may include:

  • Hospitalization for medical withdrawal management (detoxification)
  • Therapeutic communities (highly controlled, drug-free environments) or sober houses
  • Outpatient medication management and psychotherapy
  • Intensive outpatient programs
  • Residential treatment (“rehab”)
  • Support groups helpful (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery)
  • Self-help groups for family members (Al-Anon or Nar-Anon Family Groups)

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Reviewed on 3/25/2022
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