header image


It is important to understand that what typically starts as casual drug use often leads to substance dependence, also known as drug addiction – the uncontrollable need to use illegal drugs or medications in order to function normally.

defines drug addiction as a “chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addict and those around them.”

If you find yourself asking why is addiction called a “brain disease”, please note that the abuse of drugs leads to changes in the structure and function of the brain. “Over time, the changes in the brain caused by repeated drug abuse can affect a person’s self-control and ability to make sound decisions, and at the same time, send intense impulses to take drugs.” – Adapted from the National Institute on Drug Abuse.

Once a person is addicted, he or she may not be able to control their drug use. When such substances are unavailable, the user suffers from withdrawal. Once this happens, although the user may have good intentions to quit, he or she will often find that this can’t happen without help from family, friends, support groups, doctors and/or treatment programs.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; the current official text in which diagnoses are based upon), substance dependence is defined as:

“When an individual persists in use of alcohol or other drugs, despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with substance abuse, are considered Substance Use Disorders.”


The FamilyWe have learned that addiction is an illness. We believe addiction is a family disease and that changed attitudes can aid recovery. It is a physical, mental and spiritual disease that affects every area of life. It can be arrested, but never cured. We who care the most suffer from the addict’s behavior.

We ultimately think we are to blame and assume the guilt, fears and responsibilities of the addict. It is painful to watch our loved ones slowly destroy their lives with drugs. If the addict is a spouse, we may watch our finances slip away. If the addict is a child, all our hopes and dreams for them begin to fade. If the addict is a parent, we may never have a childhood because we have assumed the parental role at an early age. If the addict is our friend, sibling or coworker, we may cover for them, blame them, or excuse unacceptable behavior. We ultimately take on the addict’s responsibilities, make excuses and try to cover up for them. This becomes our anxiety, and we become enablers.

The obsession of the family becomes apparent when we try to control the addict’s using. We become obsessed with where the addict is, what he or she is doing, and how we can control the situation. We want to believe that the problem has solved itself even though our gut feeling tells us that this is not the case. We pretend and begin to believe the addict’s promises, but we are uneasy because common sense tells us there is something wrong. We are in denial.

We must understand that the use of drugs does not indicate a lack of affection for the family. It is not a matter of love, but of illness. The addicts’ inability to control their use of drugs is a symptom of the addiction. Even when they know what will happen when they take the first drink, pill or fix, they will do so. Only complete abstinence from the use of drugs, including alcohol, can arrest this disease. No one can prevent the addicts’ use of drugs. When we accept that addiction is a disease, and that we are powerless over it, we become ready to learn a better way to live.

To move toward recovery, it is important to first learn about the nature of drug abuse and addiction (how it starts, what the signs are and how it can quickly and easily take over your life), in order to give you a better understanding of the problem and how to deal with it in order to recover – and we will recover. New people will emerge. Change will take place.

Let’s first address the signs.

The above information was adapted from Nar-Anon Family Groups.
The Diagnostic & Statistical Manual of Mental Disorders (DSM-IV-TR), which is the current official text that the American Psychological Association bases their diagnoses on, does not define “addiction” specifically. Rather, problems that fall under the umbrella of addiction can be classified along a continuum of substance use → abuse → dependence.

One or more of the following criteria must be met within a 12-month period to be indicative of substance abuse:

  • Failure to fulfill major obligations
  • Use when physically hazardous
  • Recurrent legal problems
  • Recurrent social or interpersonal problems

Substance dependence can be diagnosed with or without physiological dependence, and evidence of tolerance or withdrawal. Three or more of the following criteria must be met within a 12-month period to be indicative of substance dependence:

  • Tolerance
  • Withdrawal
  • Substance taken in larger amounts or over longer periods than intended
  • Unsuccessful efforts to minimize or control use
  • Large amounts of time spent on getting or using drugs or recovering from use
  • Time spent in obtaining the substance replaces social, occupational or recreational activities
  • Continued use despite adverse consequences

If you are worried about your own drug use or the drug use of a friend or family member, please know that you are not alone and help is available.

Continuum of use:
Social - Abuse - Dependence


Codependency is defined as a psychological condition or a relationship in which someone is in an unhappy and unhealthy relationship that involves living with or providing care for another person who is typically affected by a pathological condition (such as drug addiction or alcohol abuse). Codependent individuals are emotionally dependent on another person at the expense of their own health and quality of life, however this type of behavior is reversible. Please refer to the following signs/behaviors to identify co-dependency:

  • Unhealthy dependence on relationships
  • Difficulty communicating, making decisions or identifying feelings
  • Denial
  • Defensiveness
  • Preoccupation of others’ recovery
  • Compulsive/impulsive behaviors
  • Poor communication
  • Withdrawal/isolation
  • Irritability
  • Hopelessness/despair
  • Self-pity and poor self esteem
  • Fears of abandonment
  • Self-sacrifice
  • Problems with intimacy
  • Poor boundaries
  • People-pleasing