Substance dependence Definition physiologic addiction behaviors that include: tolerance need to take larger amounts for the same desired effect withdrawal persistent desire or unsuccessful attempts to cut down disturbance of life function significant energy spent obtaining, using, or recovering from substance impaired control over substance use (work, school, relationships suffer and time spent doing these activities is reduced) continued use in light of the problems caused by the drug Substance use disorder Definition less emphasis on biochemical addiction; one or more of the following: impaired control over substance use (work, school, relationships suffer and there is failure to fulfill major obligations in these areas) compulsive use (use in physically hazardous situations) continued use despite harm recurrent substance-related legal problems Stages in overcoming substance addiction Pre-contemplation - no acknowledgement of the problem Contemplation - acknowledgement of the problem, but not ready to make a change Preparation/Determination - getting ready to change behavior Action/Willpower - process of changing behavior Maintenance - maintaining the behavioral change Relapse - returning back to old behavior