According to the Diagnostic and Statistical Manual for Mental Disorders, 4th edition, the term substance dependence refers to an unhealthy pattern of substance (alcohol or drug) use that results in at least three of the following experiences:
- The need for more and more of a substance to get the same effect and/or finding that a certain amount of a substance no longer has as strong of an effect on you. These symptoms are also referred to as tolerance.
- Withdrawal symptoms and/or the use of substances to eliminate withdrawal symptoms.
- You find that you are taking the substance in larger amounts or are using the substance over a longer period of time than you originally planned.
- You have a constant desire to quit or cut down your use of a substance.
- You spend a considerable amount of time trying to get the substance, use the substance, or come down from its effects.
- You give up activities that used to be important to you.
- You continue to use the substance even though you know that it has caused (or making worse) physical and/or psychological problems.

