Definition of Addiction: Many definitions, Many Lenses
Addiction has many accepted definitions. Each definition of addiction reflects a different way of thinking. Medical models emphasize biology and brain change. Psychological models emphasize learning and behavior. Mutual-help groups emphasize lived experience and recovery values. Policy and legal systems add further language and rules. A clear glossary should show these differences.
DSM-5: Substance Use Disorder, Not “Addiction”
DSM-5 is the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, used by clinicians to diagnose mental disorders. The DSM-5 does not use addiction as a diagnosis or define a definition of addiction. DSM-5 uses the term substance use disorder (SUD). The definition of Substance Use Disorder is really more of a model for clinical professionals to evaluate and diagnose individuals than it is a dictionary definition. The DSM describes patterns of symptoms that continue despite harm. The model draws on extensive research and clinical practice.
Clinicians look for ongoing use that continues despite harm. The criteria capture control, physiology, social impact, and risk. This framework offers a consistent, research based description of problems.
Diagnosis does not require every symptom. Instead, clinicians count how many are present. The total sets severity as mild, moderate, or severe. Clinicians also confirm that symptoms cause distress or impairment. They gather information through interviews, screening tools, and records. When helpful, they request input from family or other providers.
Therefore, severity guides level of care, treatment intensity, and supports. Plans adjust over time as needs change. This approach links assessment to concrete next steps in care.
Narcotics Anonymous: Lived Experience Definition of Addiction
Narcotics Anonymous speaks from lived experience. NA writes, “Most of us do not have to think twice about this question. We know! Our whole life and thinking was centered in drugs in one form or another, the getting and using and finding ways and means to get more. We lived to use and used to live. Very simply, an addict is a man or woman whose life is controlled by drugs. We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions, and death.” See “Who Is an Addict.” https://www.uwana.org/docs/group-readings.pdf
NA also frames addiction as a disease. In “Another Look,” NA notes the diversity of definitions. “There are probably as many definitions of addiction as there are ways of thinking, based on both research and personal experience.” The piece then offers four “not” statements. “Addiction is not freedom.” “Addiction is not personal growth.” “Addiction is not goodwill.” “Addiction is not a way of life.” https://na.org/wp-content/uploads/2024/05/3105_Another-Look-IP-5-English.pdf
ASAM: A Medical Disease Model
The American Society of Addiction Medicine offers a concise medical definition of addiction. “Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.” This definition stresses treatment and biology. It also includes environment and life experience. https://www.asam.org/quality-care/definition-of-addiction
APA: Broad Usage and Related Terms
The American Psychological Association offers a broad description definition of addiction. “Addiction is a state of psychological and or physical dependence on the use of drugs or other substances, such as alcohol, or on activities or behaviors. The term is often used as an equivalent term for substance use disorder or substance dependence and can be applied to non substance related behavioral addictions, such as sex, exercise, and gambling.” This language covers substances and behaviors. It also reflects how people use the term. https://www.apa.org/topics/substance-use-abuse-addiction
Older systems used the term substance abuse. Here is a concise paraphrase of that entry. Substance abuse describes compulsive use with significant adverse consequences. The framework lists nine major drug classes. They include alcohol, amphetamines, cannabis, and cocaine. They also include hallucinogens, inhalants, and opioids. They include phencyclidines. They include sedatives, hypnotics, or anxiolytics. DSM-5 replaced abuse and dependence with one spectrum.
Gabor Maté: Trauma Focus and Ongoing Debate
Gabor Maté writes about addiction and trauma. He avoids the strict disease label. He emphasizes complex causes and lived pain. In The Myth of Normal, he offers this definition of addiction: “Addiction is a complex psychological, emotional, physiological, neurobiological, social, and spiritual process. It manifests through any behavior in which a person finds temporary relief or pleasure, and therefore craves, but that in the long term causes them or others negative consequences, and yet the person refuses or is unable to give it up.” In In the Realm of Hungry Ghosts, he argues that unprocessed trauma often drives addiction. He rejects moral failure narratives and blame. His trauma focus is influential and controversial. Many clinicians value the lens. Others question its scope and supporting evidence. The debate shows how definitions shape care and messaging.
Medical and Psychological Lenses
Medical definitions of addiction emphasize brain circuits and physiology. They point to genetics, development, and neuroadaptation. They support medications and structured levels of care. They also support chronic care and relapse risk management.
Psychological definitions emphasize learning and motivation. They examine reinforcement, cues, thoughts, and emotion. They support therapies that build skills and change behavior. They also stress family systems and social context.
Both lenses add value for most people. Biology and behavior interact in daily life. Integrated care addresses both sides together. Teams can adjust methods as needs change over time.
Addiction Versus Substance Abuse
For years, clinicians used two diagnoses: substance abuse and substance dependence. In 2013, a new version of the DSM came out, the DSM 5, and in the new version, it combined them into one diagnosis called substance use disorder, or SUD. The new model uses a single set of criteria with mild, moderate, and severe levels. This change replaced confusing labels with a clearer spectrum.
The shift also aimed to reduce stigma. The word abuse carries moral and criminal overtones that blame the person. Dependence also caused confusion because many prescribed medicines create physical dependence without addiction. SUD uses neutral, clinical language that focuses on health needs. It helps match treatment intensity to the person’s symptoms.
The word addiction still appears in clinics and daily speech. People may use it to mean severe SUD, or they may use it more loosely. That can create confusion about scope and diagnosis. Person first language helps.
Language also varies by community. Many in Narcotics Anonymous and other recovery groups prefer “addiction” and “addict” inside their culture. They do not view these words as negative, but rather, they are an important part of identification and belonging. Overly clinical wording can feel cold in peer settings. When unsure, ask people which terms they prefer.
Why the Definition of Addiction Varies and Why That Matters
Each definition of addiction highlights different truths. DSM-5 offers measurable criteria and severity. That supports diagnosis, research, and coverage. ASAM centers treatment and a medical frame. That reduces stigma and expands clinical options. NA centers community and shared experience. That offers hope, structure, and belonging. APA bridges substances and behaviors. That widens the lens to compulsive patterns. The Gabor Maté definition of addiction brings
Different lenses guide different interventions. Medical models support medications and withdrawal support. Psychological models support therapy and skills practice. Mutual-help models support peer connection and meaning. Policy models support funding and public health tools. Many people need several approaches over time. Good care integrates these strengths for each person.
In practice, teams match care to needs and goals. Assessment clarifies severity and risks. Planning sets realistic steps and supports. Treatment builds skills, safety, and stability. Recovery continues in community settings. Language matters because it shapes those steps. Clear definitions help people get the right help.
Learn more about Great Falls Wellness and our approach to addiction care.