Substance Abuse

Substance Dependence





The 12 Steps






Stage One

Stage Two

Stage Three

For educational purposes I have included the DSM IV diagnostic guidelines that distinguishes between abuse and dependence. This was created to assist professionals diagnosing severity of psychoactive substance use. We consider abuse being psychological addiction and dependence being physiological addiction. DO NOT USE THE FOLLOWING FOR DIAGNOSING, AS SPECIALIZED TRAINING IS REQUIRED.


A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

(1) Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (eg, repeated absences or poor work performance related to substance use; substance related absences, suspensions, or expulsions from school; neglect of children or household)

(2) Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

(3) Recurrent substance related legal problems (e.g., arrests for substance- related disorderly conduct)

(4) Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

B The symptoms have never met the criteria for substance dependence for this class of substance.


The first withdrawal experience or hangover for the experimenting substance abuser is of great significance. It is at this time the user consciously or unconsciously decides what their using will be like. If the withdrawal was unpleasant enough and there is no biological predisposition to drugs then the decision will be to limit consumption or no use at all. If however a substance abuser finds the withdrawal tolerable and the using experience positive then they will continue to use. This abuser will continue using and develop a psychological dependence on the drug. This may be most difficult to stop as the abuser sees it as harmless use, which if left unchecked may lead to, increased tolerance and physical dependence.
Email: ralph@recoverme.ca                Phone: 403.919.2750