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Office of the Assistant Secretary for Policy
Drug-Free Workplace Advisor
Employee Education

Understanding Addiction

Employees with drug and/or alcohol problems often are unhappy with their lives, but fail to realize that their use of alcohol and/or drugs is a major contributing factor to their unhappiness.

The struggle with addiction is characterized by repeated failures to control use, an increase in the number and severity of problems caused by use and the need for greater amounts of the substance to achieve the desired effect. However, not everyone who uses alcohol or experiments with illegal drugs becomes addicted.

Formal attempts to standardize definitions used to describe alcohol and drug disorders have not been entirely successful for a number of reasons, including the fact that the differences between use, abuse and addiction are not easily recognized based on isolated observable behaviors that individuals may exhibit. Nevertheless, the following descriptions of use, abuse and addiction are used by health care professionals who specialize in drug and alcohol disorders and reflect the progression that may occur from normal, non-problematic use to abuse and addiction.


Alcohol and other drugs may be used in a socially accepted or medically authorized manner to modify or control mood or state of mind. Examples include having a drink with friends or taking an anti-anxiety agency as prescribed by a physician. Described below are different ways that people use alcohol and other drugs without necessarily becoming addicted.

  • Experimental use - Out of curiosity and/or at the urging of peers, individuals may try drinking or using drugs illegally. If the illegal drug use is not repeated, or discontinues after a short time, such experimentation may not be problematic. Likewise, deciding to drink alcoholic beverages after early experimentation is not problematic for most adults.
  • Social/Recreational use - Drinking alcoholic beverages is permitted in American society, and some excessive use may even be condoned. If use doesn’t cause problems for the user, or those around him/her, most people would consider such use to be social or recreational. Some use marijuana in a similar manner--only in certain social or recreational situations and without immediate adverse consequences. However, marijuana use is illegal, except in a few states.
  • As a stress reliever - Many people use alcohol or other drugs to help them cope with pressure or stress. If this type of use is infrequent and doesn’t create more stress or other difficulties for the individual or those around him, it may not lead to addiction. However, alcoholism and drug addiction often begin with relief drinking.

The use of a substance to modify or control mood or state of mind in a manner that is illegal or harmful to oneself or others is considered problematic use, or abuse. Examples of potential consequences of harmful use are:

  • Accidents or injuries
  • Blackouts
  • Legal problems
  • Poor job performance
  • Family problems
  • Health problems


A number of individuals occasionally use or abuse alcohol or drugs without becoming addicted, but for many abuse continues despite repeated attempts to return to more social or controlled use and leads to addiction. Addiction is characterized by the repeated, compulsive seeking or use of a substance despite adverse social, psychological and/or physical consequences.

A wide range of substances, both legal and illegal, can be abused addictively. Addiction is often, but not always, accompanied by physical dependence, a withdrawal syndrome and tolerance . Physical dependence is defined as a physiological state of adaptation to a substance such that the absence of the substance produces symptoms of withdrawal. A withdrawal syndrome consists of a predictable group of signs and symptoms that result from abrupt removal of, or rapid decrease in the regular dosage of, a psychoactive substance. Tolerance is a state in which a drug produces a diminishing biologic or behavioral response, which means higher doses are needed to produce the same effect that the user experienced initially.

Addiction to alcohol and other drugs is:

  • Chronic - Once you have developed an addiction, you will always have to deal with it. You may manage to stop using alcohol or other drugs for significant periods of time, but for most the disease doesn’t disappear but rather goes into remission. Should you attempt to resume “normal” use, you will rapidly return to addictive, out of control use and abuse.
  • Progressive - Addiction gets worse over time. With some drugs, the decline is rapid; with others, like alcohol, it can be more gradual, but it does get worse. Alcohol and other drugs cause a biochemical change in the nervous system that can persist even after the substance leaves the blood. Repeated use causes progressive damage.
  • Primary - Addiction is not just a symptom of some underlying psychological problem, a developmental stage or a reaction to stress. Once your use of alcohol or drugs has become an addiction, the addiction itself needs to be medically treated as the primary illness.

  • Terminal - Addiction to alcohol and/or other drugs often leads to disease and possibly death.
  • Characterized by denial - One of the most disturbing and confusing aspects of addiction is that it is characterized by denial. The user denies that his/her use is out of control or that it is causing any problems at home or on the job. The user often seems to be the last to know that his/her life is out of control. There are effective strategies employed by professionals for helping to break through this denial, which must be overcome before treatment can take place.