Diagnosis of alcohol or drug addictions is generally based on the extent of the person’s drug or alcohol problem. Milder cases are generally referred to as “Substance Abuse”, whereas more acute cases are called "Substance Dependence".

It is common that when people become addicted to drugs (including alcohol) they are either in denial about their addiction, or entirely blind to the situation. As a result, addiction is rarely self-diagnosed. Instead, addiction is better discussed with an objective and professional psychologist, counsellor or other mental health professional.

When a psychologist, counsellor, doctor or psychiatrist is asked to diagnose a situation of drug or alcohol addiction, they will consider whether or not the addicted person suffers from either or both of Tolerance or Withdrawal. (This article is electronically protected - Copyright © Associated Counsellors & Psychologists Sydney PTY LTD)

TOLERANCE occurs when, over time, a drug or alcohol user requires more and more of the substance to get the same effect or ‘high’ that they previously achieved with much less. For example, a person might now be able to drink 8 drinks before they get drunk, whereas they previously only needed 4. Or a person might need 2 or 3 pills to achieve the desired ‘high’ from taking the drug known as Ecstacy, whereas they previously got ‘high’ from only one.

Typically, the result of increased tolerance is increased drug use, which of course only serves to further increase tolerance over time - a potentially vicious cycle for many drug and alcohol users. If you are noticing a tolerance for drugs or alcohol, you may wish to seek counselling from a Psychologist or Counsellor with experience in addictions therapy.

WITHDRAWAL is the term used to describe the physiological and psychological effects that some drug and alcohol users may have when they stop drinking or using. These negative effects or symptoms include:

• Sweating
• Increased heart rate
• Anxiety and intense agitation
• hand tremours
• insomnia
• vomiting
• hallucinations
• seizures (in severe cases).

A person experiencing withdrawal will also feel a powerful craving to take drugs or drink alcohol, particularly as the taking of the drug will provide immediate relief for the symptoms of withdrawal. Indeed, withdrawal can be such an intense and awful experience, that it can be very difficult to pass through, and even harder to consider experiencing again. Again, if you are concerned about withdrawal from drugs or alcohol, this should be a clear sign to you to seek help from an addictions therapist like a counsellor or psychologist, or to see your Doctor to assist you in managing a withdrawal process.


A person who has an increased tolerance to a substance (they need more and more to get an effect), and who suffers the symptoms of withdrawal (they feel physically worse when not using), will generally be diagnosed as suffering from Substance Dependence. In both cases of Substance Abuse and Substance Dependence, the substance use will be having a significant impact on the daily life of the addicted person – on their relationships, their friends and/or their working lives.

If you are worried about yourself, or a loved one, you may wish to look out for the following behaviours to get an indication of whether addiction is present.

Does the person:
• regularly fail to show up for social or work commitments and use a variety of excuses that seem implausible,

• borrow, steal take money or fail to account for money without an obvious cause

• seem moody or are they acting differently to their usual manner.

You can also check yourself or others for physical indicators of addiction although these vary with the drug used. They may include:

• changes in skin colour or infections

• markings on the skin including lines on one’s arms or legs (if the person is using intravenously)

• blood shot eyes, or constricted pupils

• constant sniffling

• constant tiredness or slurring of speech or lack of coordination

• hyperactivity, agitation or restlessness

• smelling of drugs or alcohol

• finding drug related products or paraphernalia

Medical evidence of addiction can also be gathered by a treating doctor through blood and urine tests. If you think that a person you know might be addicted to alcohol or a drug, diagnosis can be an important step because it helps the person to acknowledge their addiction, and it helps medical and therapeutic practitioners to better treat the problem.

Getting an addict to attend at a doctor or psychologist to obtain a diagnosis or receive treatment can be an extremely difficult first step. This is because people with drug or alcohol problems are often very secretive about their use, and, if confronted, will often deny that they have a problem.

Counselling can be an extremely effective way to help addicts get over their addiction. Naturally if a person is heavily addicted to alcohol, prescription medication or other hard drugs like heroin, a period of supervised medical withdrawal may be required before they are able to undergo counselling.

However, it has been shown that motivational enhancement therapy is an effective counselling treatment for drug users who are still in denial about their addiction.

A good guide as to whether a client is suited to treatment by one of our associated counsellors or psychologist may be whether the person is willing to come to the appointment and whether they are able to attend sober and free of the influence of drugs or alcohol. If this is not possible the person may benefit from seeking assistance from their local hospital drug and alcohol department who are likely to have a greater range of resources including inpatient facilities, medical practitioners and psychiatrists, who are better able to coordinate care for clients showing severe dependence with a high likelihood of experiencing significant physical withdrawal symptoms.

To enquire about addictions counselling by qualified and professional Counsellors & Psychologists in Sydney call Associated Counsellors & Psychologists Sydney. We welcome your enquiry.


American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Association.

Benshoff, J. J., & Janikowski, T. P. (2000) The Rehabilitation Model Of Substance Abuse Counseling. Australia; Brooks/Cole, Thompson Learning

Jarvis, T. J., Tebbutt, J., & Mattick, R, (1995) Treatment Approaches For Alcohol And Drug Dependence: An Introductory Guide. Chickchester; John Wiley & Sons

Schuckit, M. A, (1995) Drug And Alcohol Abuse: A Clinical Guide To Diagnosis And Treatment (4th edition). New York & London; Plenum Medical Book Company

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