Substance Dependence Criteria
Criterion 1(a): Increased Tolerance Yes No
You need more of the substance to achieve the desired effect. Examples:
. John used to get high on two or three drinks. He now often consumes six or more drinks before he feels high.
. Wanda used to take two tablets of Valium per day. She now takes six and often uses other tranquilizers and al-
cohol, because two pills don’t do anything for her.
Criterion 1(b): Decreased Effect Yes No
You experience a diminished effect with continued use of the same amount of a substance. Examples:
. Delinda used to drink a pint or more of liquor every day to feel “the buzz.” Now, when she drinks the same
amount, she does not feel “the buzz” as before.
. Alphonso regularly used large quantities of opiate drugs, alcohol, and tranquilizers in the past. Now when he
uses the same quantities, he does not even feel high.
Criterion 2(a): Withdrawal Sickness Yes No
You experience a specific withdrawal symptom when you stop using or cut down on the amount you use.
Examples:
. When Michelle stops using alcohol, she becomes nauseous and anxious and has tremors.
. Russ gets stomach cramps, diarrhea, a runny nose, and gooseflesh when he stops injecting heroin or other nar-
cotic drugs.
Criterion 2(b): Use to Avoid Withdrawal Sickness Yes No
You continuously use a substance, use similar types of chemicals (e.g., you substitute Valium for alcohol), or use
first thing in the morning to avoid being sick with withdrawal symptoms. Examples:
. Betty takes tranquilizers constantly because she’s afraid she will get sick if she doesn’t always have them in her
system.
. Dean takes a few belts of whiskey in his coffee every morning to quell his shakes and get him settled down so
he can go to work. At lunch he has a few drinks to hold him over until after work when he can drink more
freely.
Criterion 3: Loss of Control Yes No
You use a greater quantity of alcohol or drugs than you intended or for longer periods of time than you intended.
Examples:
. Ron bought an ounce of marijuana and planned to use it over a period of several months but ended up smok-
ing it all in less than a week.
. Lisa constantly tells herself she’s going to have only a few drinks at parties each weekend, but she always gets
drunk.
Criterion 4: Inability to Cut Down or Control Use Yes No
You try to cut down but succeed for only short periods of time. You quit, only to go back to using again.
Examples:
. Dennis has quit smoking at least times in the past few years for periods from several days to months, but
he always goes back to smoking.
Dennis C. Daley, G. Alan Marlatt
Overcoming Your Alcohol or Drug Problem: Recognizing Your Substance Use Problem. Copyright © 2006 by Oxford University Press
Oxford Clinical Psychology | Oxford University Press
. Liz buys a $ rock of crack cocaine when she gets her check with the intention of not smoking more than
that amount. However, she always ends up purchasing more crack and more often than not uses her entire
check to buy the drug, smoking continuously until she runs out of drugs and money.
Criterion 5: Preoccupation or Compulsion Yes No
You spend a great deal of time on activities necessary to obtain the substance, use the substance, or recover from its
effects. Examples:
. Sandy, a nurse in a large hospital, spends a considerable amount of time figuring out ways to steal narcotic
drugs at work to support her habit.
. Stephen plans his work day so that he’s able to use cocaine at several points. Also, his weekends are almost
entirely dedicated to getting high on drugs.
Criterion 6: Psychosocial Impairment Yes No
You give up or lose important social, occupational, or recreational activities because of substance use. Examples:
. Melissa has lost two jobs due to absenteeism caused by alcohol use. She has also quit swimming and playing
tennis.
. Leonard, once a star athlete with a promising college career, was kicked off the football team because he tested
positive for drugs on three different occasions. As a result, he also lost his scholarship and dropped out of
college.
Criterion 7: Continued Use Despite Negative Effects Yes No
You continue to use even though you know that a physical, psychological, family, or other problem is likely to
occur as a result. Examples:
. Don continues to drink despite warnings from his physician that his liver was damaged from years of excessive
drinking.
. Roberta continues to smoke over two packs of cigarettes each day despite recommendations from her physi-
cian to stop because of chronic respiratory problems.
Write the number of symptoms that you checked “Yes” for.
0
Dennis C. Daley, G. Alan Marlatt
Overcoming Your Alcohol or Drug Problem: Recognizing Your Substance Use Problem. Copyright © 2006 by Oxford University Press
Oxford Clinical Psychology | Oxford University Press
