Diagnosing Drug & Alcohol Addiction

An alcohol or drug addiction diagnosis is done by someone who is licensed or certified to diagnose a substance abuse disorder. This could be a family physician, a psychiatrist, a therapist, a substance abuse counselor, or any other person that the law recognizes as having the knowledge or education necessary to make a medical diagnosis. There are certain criteria that must be met before a diagnosis of addiction can be made, and an extensive assessment should be done before this, or any other, diagnosis is made.

The criteria that must be met to come to a diagnosis of addiction may be termed abuse or dependence. Abuse is defined by the American Psychiatric Association if one or more specific acts occur within a year time period, and these acts include a failure by the alcoholic to fulfill obligations at school, work, or home, using the substance more than once when it is clearly dangerous to do so, like driving a car or operating dangerous machinery, legal problems that stem from or are related to the substance use, like DUIs and physical fights, and the continued use of alcohol even if it leads to stress in relationships and distance in family. Dependence is the next step up.

Dependence occurs when there is abuse of drugs or alcohol and the person still continues the use of it, if compulsive use is a common behavior, when there is a physical tolerance, or if withdrawal occurs when the substance is stopped. An extensive assessment should be done before addiction is diagnosed, and this includes interviews with the clinician in addition to questionnaires that are filled out by the person being diagnosed. Some typical questionnaires include the CAGE, the Alcohol Use Disorders Identification Test, or AUDIT, the Trauma Scale, and the Primary Care Evaluation of Mental Disorders, or PRIME-MD.

The questions on these tests generally focus on two things, any consequences of the substance abuse and the patient’s view of the behavior. These questions will allow the clinician to determine the risk or diagnosis. It is very important that any other possible medical condition be ruled out before the diagnosis of addiction is made. There are some diseases and disorders that will cause symptoms that may mimic intoxication. Some of these diseases include trauma to the brain, hypoglycemia, an imbalance of electrolytes, ketoacidosis, diabetic acidosis, meningitis, both bacterial and viral, any condition that is neurological like MS, a stroke, and pneumonia.