Am I an Alcoholic or an Addict?

When we think of alcoholism, we might imagine someone who’s often hungover, day-drinking, driving while intoxicated, and causing problems at work or in their relationships. While these behaviors can be signs of problematic alcohol use, they don’t tell the whole story. The actual diagnosis of alcohol or substance use disorder involves specific criteria that professionals use to assess the severity and impact of someone’s substance use.

The DSM-5 is a book that helps therapists and doctors understand and diagnose substance use disorders (SUD). It gives them a checklist of things to look for when trying to figure out if someone has a problem with drugs or alcohol. These criteria help them make accurate diagnoses and provide the right help and treatment for those who need it. Here is what they look for: 

  • Using more of a substance than intended
  • Struggling to quit or reduce use
  • Experiencing cravings
  • Continuing to use despite it causing problems in relationships, work, or other important areas of life
  • Using despite knowledge that it worsens another health condition
  • Developing tolerance, or experiencing withdrawal symptoms

While not officially part of the diagnostic criteria, individuals in recovery often recognize their own unique signs that they needed support to make a change. Some people realize they have a problem when they use substances to alter their mood, escape negative emotions, or change their alertness. Others notice they go to great lengths to hide their behavior, like going to different stores or pharmacies, paying in cash only, or keeping a secret stash. Some even seek out excuses to use, like looking for medicinal uses of their substance or self-directed rationalizations such as “I only drink socially” or “I just like the taste.”

Unfortunately, the heavy burden of stigma often prevents people from seeking treatment even when they recognize their need for help. Stigma surrounding substance use disorders leads to shame, social isolation, and reluctance to reach out for support. It’s crucial that we challenge and dismantle these stigmatizing beliefs.

It’s important to understand that substance use disorders are medical conditions influenced by genetics, environment, and psychology. Unlike older models, the current understanding of substance use disorders does not label someone as “an alcoholic” or “an addict.” Instead, therapists use diagnostic criteria to determine if substance use is problematic, and the number of criteria met indicates the severity of the disorder. This approach helps reduce stigma and allows individuals to focus on getting the help they need without feeling defined by labels.

Having a substance use disorder doesn’t make you morally weak or lacking in willpower. By fostering empathy, educating ourselves and others, and promoting open conversations, we can create a more supportive and understanding environment for those affected by substance use disorders. Recognizing the signs and symptoms of a substance use disorder is the first step toward seeking help.

Therapeutic techniques like motivational interviewing (MI) or cognitive-behavioral therapy (CBT) can play a crucial role in the recovery process. A therapist provides a safe and non-judgmental space to explore the underlying factors contributing to substance use, overcome barriers to change, develop coping strategies, and create a personalized plan for recovery.

Regardless of your situation, help is available. If you’d like to learn more about how our team of therapists at Authentic Connections Counseling Center in Castle Rock, Colorado can support you and your family on the road to addiction recovery, we’re here for you. You can book a session by calling 720-370-3010 x100 or emailing us at for more information.

Written By:  Cherisse McNaughton-Balzano, LPC, LAC


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

National Institute on Alcohol Abuse and Alcoholism. (2021). Alcohol use disorder. Retrieved from

Substance Abuse and Mental Health Services Administration. (2019). TIP 34: Brief interventions and brief therapies for substance abuse. Retrieved from