Drug addiction — known clinically as substance use disorder — is a pattern of drug use that continues despite causing real harm to a person’s health, relationships or responsibilities. It is a recognised medical condition, not a question of willpower or character, and it affects people across every walk of life, including the most capable and successful.
How drug addiction is diagnosed
The DSM-5, the standard diagnostic manual used by clinicians, defines drug addiction as a problematic pattern of use causing significant impairment or distress, indicated by at least two of the following within a twelve-month period:
Taking the drug in larger amounts, or over a longer period, than intended.
A persistent wish to cut down or stop, and repeated unsuccessful attempts to do so.
Spending a great deal of time obtaining the drug, using it, or recovering from its effects.
Cravings — a strong urge or desire to use.
Use that results in failing to meet responsibilities at work, school or home.
Continued use despite the social or relationship problems it causes or worsens.
Giving up or cutting back important work, social or recreational activities because of use.
Using in situations where it is physically dangerous.
Continued use despite knowing it is causing or worsening a physical or psychological problem.
Needing markedly more of the drug to achieve the same effect — tolerance.
Withdrawal symptoms when use is reduced or stopped.
The number of criteria met indicates severity, from mild to severe. If several of these are familiar — in yourself or someone close to you — it is worth taking seriously.
Prescription and over-the-counter drugs
There is a common belief that prescription and over-the-counter medicines are inherently safer than illicit drugs. They are not. Taken over long periods, in high doses, or alongside other substances such as alcohol, they can cause severe physical and psychological harm, and they can be every bit as addictive.
Prescription medications that are frequently misused include narcotic painkillers such as OxyContin and Vicodin, sedatives such as Xanax and Valium, and stimulants such as Adderall and Ritalin. For high-functioning people in particular, prescription dependence often develops quietly, beginning with a legitimate prescription and a genuine need, which is part of what makes it so easily overlooked.
How drug addiction is treated at Istana
Addiction is rarely the whole story. Beneath it there is usually something else — trauma, burnout, depression, or the particular pressures of a demanding and exposed life — and lasting recovery means addressing both.
At Istana, treatment begins with a thorough clinical assessment, followed by medically supervised detoxification where it is needed, and a programme built around the individual. We treat one client at a time, in complete privacy, so that the work can happen without exposure and without the distraction of a group environment.
Frequently asked questions
What is the difference between drug dependence and drug addiction?
Dependence is a physical state — the body has adapted to a drug and produces withdrawal symptoms without it — and can occur even with correctly prescribed medication. Addiction is broader: compulsive use that continues despite harm, often alongside physical dependence but defined by the loss of control over use, not by withdrawal alone.
Can you be addicted to prescription medication?
Yes. Prescription medications, particularly opioid painkillers, sedatives and stimulants, can be as addictive as illicit drugs. Dependence often begins with a legitimate prescription, which can make it harder to recognise and to acknowledge.
When should someone seek help for drug use?
When use continues despite the problems it is causing, when attempts to cut down have failed, or when it has become central to managing daily life. Earlier is considerably easier than later. The diagnostic criteria above are a useful guide, but the simplest signal is the quiet sense that something is no longer under control.
If you or someone you know is struggling with any kind of drug use, WhatsApp us or request a call. We respond personally, promptly and in complete confidence.