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Addiction Diagnosis

The Assessment and Addiction Diagnosis Process

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Updated July 15, 2011

The diagnosis of an addiction can seem like a daunting experience, but it can be the starting point for making positive changes in your life.

Where Should I Go for a Diagnosis?

If you recognize the symptoms of addiction in yourself, the easiest way to find out whether you have an addiction is to make an appointment with your family doctor. They may decide to refer you to a specialized addiction clinic or clinician who specializes in addictions for a full assessment and addiction diagnosis if appropriate.

Who Will Make the Diagnosis?

Many different health care professionals are trained to conduct addiction assessments, including addictions counselors, physicians, psychologists, nurses, social workers and other therapists. They are often called “clinicians” when they are carrying out assessments or therapy.

Occasionally, there is more than one person involved in making the addiction diagnosis. For example, you may be interviewed once by a counselor and again by a physician. Do not let this put you off – you will have two experts’ opinions instead of one!

All health care professionals are trained to treat people with addictions with courtesy, respect, and a non-judgmental attitude. You can trust them to keep the information you give them confidential.

How Will They Decide If I Am Addicted?

The clinician will make the addiction diagnosis using a combination of objective criteria and clinical judgment.

Objective criteria are usually based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), which lists the symptoms of addiction for substance and gambling addictions. As some addictions, such as sex addiction and computer addiction, are not included in this version of the DSM, the clinician should use the most recent diagnostic criteria published in scientific journals.

Diagnostic information can be gathered in several different ways, including:

  • Standardized assessment tools and other questionnaires that the clinic staff will give you to fill out.

  • Face to face “open-ended” interviewing, which is like a conversation, with the clinician making notes. This is best for history-taking so you can explain the circumstances in your own words.

  • Face to face “structured” interviewing, in which the clinician will ask standard questions and write down your answers. It’s a bit like completing a questionnaire, but you can discuss questions as you go along.

The questions and focus of the discussion will involve some or all of the following:

  • The history of your addiction, including when and how you started the addictive behavior, how it has progressed, and factors which have contributed to its development.

  • Your current pattern of addictive behavior – what your addictive behaviors are, how much and how often you engage in them.

  • Your current symptoms of addiction.

  • The effects of your addiction on the other areas of your life, including your family, social life, work life and financial situation.

  • Your readiness to change.

You may also be asked for a urine sample to assess the levels of drugs in your system. Blood samples are not routinely taken, but if you have signs or symptoms of serious physical illness, a clinician may request a blood sample, for example, to assess your liver function. Not all addiction clinics are set up to take urine or blood samples.

A good diagnostic assessment will also gather information on your general mental and physical health to assess whether you are suffering from another condition such as depression, anxiety disorder or personality disorder. You might be referred to medical physician if there are specific physical concerns, or to a psychiatric physician if there is an indication of another significant mental health issue. Inpatient or outpatient detoxification may also be advisable at this stage.

Co-existing conditions can and should be treated at the same time as the addictive behavior.

It will help the process if you follow these Tips for Getting an Accurate Diagnosis.

What Next

Most clinics will be able to give you a verbal addiction diagnosis right away. Occasionally, there may be a delay, for example, if a psychologist wants to score your standardized tests before making a diagnosis. If so, you should make an appointment to come back to get your diagnosis in person.

Your diagnosis and the information gathered will form the basis of your treatment plan. This plan will be made in consultation with you, with the opportunity to discuss their recommendations and the options available.

You are free to withdraw from the process at any time. Often times, just knowing your addiction diagnosis can be the start of making positive changes in your life.

Sources

American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders” (4th Edition – Text Revision), Washington, DC: American Psychiatric Association. 1994.

Miller, William R. and Rollnick, Stephen. “Motivational Interviewing: Preparing People for Change.” Guilford, New York. 2002.

Orford, Jim. “Excessive Appetites: A Psychological View of Addictions” (2nd Edition). Wiley, Chicester. 2001.

Ryglewicz ACSW, Hilary and Pepper MD, Bert. “Lives at Risk: Understanding and Treating Young People With Dual Disorders.” Simon and Schuster, New York. 1996.

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