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What is Addiction?

The Four C's of Addiction

Addiction isn’t just about liking something a lot—it’s when a person loses control over their use of a substance or behavior, even when it causes problems. Experts use the 4 C’s to help explain what addiction looks like:

  • Compulsion
    • This means feeling a strong urge or need to use the substance (like drugs or alcohol).
    • It’s not just a want—it feels like you have to do it, even if you don’t really want to.

 

  • Craving
    • Craving is the intense desire for the substance.
    • It can take over your thoughts and make it hard to focus on anything else.
    • People might feel anxious, restless, or even physically uncomfortable when they crave something.

 

  • Control (Loss of)
    • Someone with an addiction often can’t control how much or how often they use.
    • Even if they try to stop or cut back, they might find it really hard or impossible.

 

  • Consequences
    • Addiction continues even when it causes serious problems—like health issues, trouble at school, or problems with friends and family.
    • The person keeps using despite knowing it’s hurting themself or others.

Together, these 4 C’s help determine when someone’s use of a substance has become an addiction – not just a habit or a bad choice.

Addiction is a brain disease because drugs change how a brain works, especially the brain’s natural inhibition and reward centres. Addiction is a treatable illness.

Explaining Addiction

Addiction, Visualized

Medical Definition of Addiction

From a medical perspective, addiction is the severe form of substance use disorder (SUD). SUD is on a spectrum. Clinicians specify how severe SUD is depending on how many of the following symptoms are identified in a 12-month period: 2-3 mild; 4-5 moderate; 6 or more indicates an addiction:

  • The substance is often taken in larger amounts or over a longer period than was intended.
  • There is a persistent desire or unsuccessful effort to cut down or control use of the substance.
  • A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
  • Craving, or a strong desire or urge to use the substance.
  • Recurrent use of the substance resulting in a failure to fulfill major role obligations at work, school, or home.
  • Continued use of the substance despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of its use.
  • Important social, occupational, or recreational activities are given up or reduced because of use of the substance.
  • Recurrent use of the substance in situations in which it is physically hazardous.
  • Use of the substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.

 

Tolerance, as defined by either of the following:

  • A need for markedly increased amounts of the substance to achieve intoxication or desired effect.
  • A markedly diminished effect with continued use of the same amount of the substance.

 

Withdrawal, as manifested by either of the following:

  • The characteristic withdrawal syndrome for that substance.
  • The substance (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

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