'What is addiction?' worksheet

Therapists looking for a “What is addiction?” worksheet can use this article to walk clients through substance use disorder, diagnostic criteria, and whether addiction is psychological. 

We've included a free downloadable understanding addiction worksheet to give to clients and save to your electronic health record (EHR) and use in your practice.

What is addiction?

Addiction (now called substance use disorder) is a chronic but treatable mental health condition, characterized by compulsive substance use despite adverse effects. Like other diseases,  substance use disorder (SUD) affects all areas of the body, including the heart and brain, and can have serious and potentially fatal effects if left untreated.  

According to the National Institute on Drug Abuse (NIDA), SUD is considered a brain disorder due to the changes it causes to the parts of the brain responsible for reward, stress, and self-control. These neurological changes may continue long after substance use has stopped. 

While people initially take substances for recreational reasons, drug use can quickly change to a dependency where people may think they need to continue to take drugs to feel “normal” or to have a good time. 

Before long, they may experience other warning signs of addiction, including: 

• Needing to take more drugs to have the same effect

• Trying to stop, but are unable to do so

• Taking drugs despite the negative consequences

• Intense cravings

• Experiencing withdrawal symptoms when not using substances, or needing to take drugs or drink to avoid withdrawal

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Is addiction psychological? 

Substance use disorder is complex, involving psychological and/or physical dependence. 

According to NIDA, while people choose to take substances initially, continued use can impair the parts of the brain responsible for judgment, decision-making, and controlling behavior, explaining the compulsive nature of substance use disorders. There are also genetic and environmental risk factors that influence someone's risk of developing substance use disorder and the progression of it. 

Like other physical and mental health conditions, the risks vary, as do protective factors which may reduce the risk:

• Risk factors: Family history of substance use and mental health conditions, lack of supervision, poor social support, early substance use, peer pressure, access to substances, the type of drug use, lack of resources, poverty, and stress.

• Protective factors: Being a parent, social support, community, stable housing, and access to resources.

Can addiction be treated?

Yes, addiction can be treated. Substance use disorder is a treatable condition, and people can go on to live a happy and fulfilling life. As with most chronic conditions, recovery requires ongoing maintenance to prevent relapse. However, relapse does not mean failure. The rates of returning to use for substance use disorder are similar to those of other chronic illnesses, emphasizing the importance of maintaining motivation in recovery. 

While relapse can be a feature of some people’s recovery journey, it is crucial to be mindful of their type of substance use, as some drugs present greater risks than others, such as the risk of overdose due to a lower tolerance. The "What is addiction?" worksheet can help clients track these risk factors and stay engaged in their recovery plan.

DSM-5 criteria for substance use disorder

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), a diagnosis of substance use disorder requires a problematic pattern of substance use leading to clinically significant impairment or distress over the last 12 months, and includes at least two of the following criteria:

• Using more substance than intended or using it for longer than planned

• Persistent desire to stop or unsuccessful attempts to cut down or stop using the substance

• Spending a lot of time obtaining the substance, using it, and recovering from its effects

• Experiencing intense cravings or urges to use the substance

• Recurrent use of the substance impacts daily life and the ability to fulfill obligations at home, school, or work

• Continued use despite recurring social or relationship problems caused by the substance

• Substance use that leads to giving up or reducing important social, work, or recreational activities

• Recurrent use in dangerous situations

• Using substances despite having physical or mental health conditions that will be negatively affected by substances

• Increased tolerance to the substance, requiring more to have the same effect or less of an impact despite using the same amount

• Withdrawal symptoms occur when not using the substance, or having the need to take other substances to relieve the withdrawal symptoms

Note: These criteria summarize the DSM-5. Substance use disorders are diagnosed by specific substance, such as alcohol use disorder or cannabis use disorder.

How to use the ‘What is addiction?’ worksheet 

You can download and use the understanding addiction worksheet in several ways:

• Use the worksheet to provide psychoeducation for drug addiction and relapse prevention.

• Give the client a copy of the understanding addiction worksheet to take home.

• Ask the client to reflect on the worksheet and complete the reflection questions between sessions and report their findings at their next therapy appointment. 

• Use the “What is addiction?” worksheet in group therapy sessions to encourage clients to share more about their substance use disorder with other participants.

• Combine this worksheet with other substance use and recovery-related worksheets, including our substance use assessment form, relapse prevention worksheets, and money management in recovery worksheet. 

• Use this worksheet to provide training to interns or supervisees on substance use disorder, relapse prevention, and the importance of maintaining motivation in recovery.

• Share the “What is addiction?” worksheet with coworkers.

• Leave copies of the worksheet in your waiting room or therapy office for clients to review.

Sources

• American Society of Addiction Medicine. (2019). Definition of addiction.

• Guenzel, N., & McChargue, D. (2023). Addiction relapse prevention. StatPearls.

• Harvard Health Publishing. (2021). What is addiction?

• National Institute on Drug Abuse. (2020). Drug misuse and addiction.

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