Addiction in Oxford English Dictionary is defined as “the state of being (self-) addicted or given to a habit or pursuit; devotion” and “the state of being addicted to a drug; a compulsion and need to continue taking a drug as a result of taking it in the past”.
To recap, dependence on a drug is defined as a syndrome in which the individual continues to take the drug because of the pleasurable effect which is derived from it. Advances in the understanding of biological and psycho-social aspects of substance abuse has resulted in more valid definitions of dependence that are consistent across cultures and across substances. These definitions are currently embedded in both the DSM-5 and the ICD-10. The essence of both nomenclature systems is that the dependence syndrome is characterised by:
Detoxification or medically-assisted withdrawal is usually the first phase of treatment to ameliorate withdrawal symptoms. The next phase is primary rehabilitation. Commonly, motivational enhancement therapy alongside cognitive behavioural techniques are employed. These assist to foster initial engagement in therapy and coping skills respectively. Relapse prevention techniques are taught and network therapies to involve family and social behaviour network are used. Twelve-step facilitation or Alcoholic Anonymous are examples of group learning. Counselling is an important element of management. Medications to aid abstinence and reduce relapse may be used. However, not all medications are available in Singapore.