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Addiction: the basics

Information about addiction, information about abused substances, links to information to assist with gaining sobriety, and help for those concerned about an addicted person.

Understanding addiction

What is addiction?

Many people consider addiction to be a problem of personal weakness, initiated for self-gratification and continued because of an unwillingness or lack of sufficient willpower to stop. However, within the medical and scientific communities, the notion that pleasure-seeking exclusively drives addiction has fallen by the wayside. Clinicians and scientists alike now think that many people engage in potentially addictive activities to escape discomfort — both physical and emotional. People typically engage in psychoactive experiences to feel good and to feel better. The roots of addiction reside in activities associated with sensation seeking and self-medication.

People allude to addiction in everyday conversation, casually referring to themselves as “chocolate addicts” or “workaholics.” However, addiction is not a term clinicians take lightly. You might be surprised to learn that until the current Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), the term addiction did not appear in any version of the American Psychiatric Association’s diagnostic manual, the reference book that physicians and psychotherapists use to identify and classify mental health disorders. In this most recent edition, addiction is included as a category and contains both substance use disorders and non-substance use disorders, such as alcohol use disorder and gambling disorder, respectively.

Howard J. Shaffer, PhD, CAS. Harvard Health Blog. 19 June 2017 https://www.health.harvard.edu/blog/what-is-addiction-2017061911870

U.S. Department of Health and Human Services. (2023, December 21). Understanding Drug Use and Addiction Drugfacts. National Institutes of Health. https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction

Commonly abused substances

Drug schedules

What does it mean when a substance is called a "Schedule 1" drug or is considered "not a controlled substance"?

These terms come from the Controlled Substances Act (CSA).  The statute is part of Title 21 of the United States Code and classifies substances in to 5 Schedules or categories:

(1) SCHEDULE I.—

(A) The drug or other substance has a high potential for abuse.

(B) The drug or other substance has no currently accepted medical use in treatment in the United States.

(C) There is a lack of accepted safety for use of the drug or other substance under medical supervision.

(2) SCHEDULE II.— (A) The drug or other substance has a high potential for abuse. (B) The drug or other substance has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. (C) Abuse of the drug or other substances may lead to severe psychological or physical dependence.

(3) SCHEDULE III.— (A) The drug or other substance has a potential for abuse less than the drugs or other substances in schedules I and II. (B) The drug or other substance has a currently accepted medical use in treatment in the United States. (C) Abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence.

(4) SCHEDULE IV.— (A) The drug or other substance has a low potential for abuse relative to the drugs or other substances in schedule III. (B) The drug or other substance has a currently accepted medical use in treatment in the United States. (C) Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule III.

(5) SCHEDULE V.— (A) The drug or other substance has a low potential for abuse relative to the drugs or other substances in schedule IV. (B) The drug or other substance has a currently accepted medical use in treatment in the United States. (C) Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule IV.