According to the WHO (ICD-10), dependency is when three or more of the following criteria occur together over a long period of time.
- A strong desire or compulsion to take the substance. (Something inside you pushes you to get high.)
- Difficulty in controlling substance use in terms of starting, stopping or the extent of use. (You are no longer one hundred per cent in control.)
- Physiological withdrawal symptoms when substance use is stopped or reduced. (When you don’t get high, your body reacts. You may experience withdrawal symptoms.)
- Signs of increased drug tolerance, so that higher doses of the psychoactive substance are needed to achieve the effects initially achieved with lower doses. (You need to increase the dose to get the same high.)
- Progressive neglect of alternative pleasures or interests due to psychoactive substance use, increased time spent to procure or take the substance or to recover from its effects. (You spend a lot of time obtaining and consuming intoxicants. You neglect other interests and socialise less.)
- Continued substance use despite clear evidence of obvious harmful effects. (Even though you know that intoxicants are not good for you, you continue to use them.)
The American Psychiatric Association (DSM-V diagnostic criteria) refers to “substance use disorder” rather than “dependence.”