Lance Dodes, MD is, in my opinion, one of the the best writers on addiction,  He is a psychoanalyst,  and has been the director of substance abuse treatment at two institutions,   and Director of the Boston Center for Problem Gambling.  He has written three excellent books on addiction and in his last one, makes a devastating case for the relative lack of success of AA and the huge number of treatment programs that use AA methods,   He has a wonderful website in which he discusses many of his ideas about addiction and answers questions.   I highly recommend it. 

He differentiates habit from addiction thus: 

      Habits are just automatic behaviors you perform without having to think about them. They can be stopped when you decide to pay attention to them because, unlike addictions, they have no deeper emotional basis. For example, one woman said, “I always had a candy bar after lunch. I figured it would add a pound or two but my weight is okay and it was just something I always did. Then my doctor told me I was pre-diabetic and had to watch my sugar intake. What a bummer. But I have a lot of willpower and let me tell you, that was the end of the candy bars.” The key difference between habits and addictions is that habits, having no deeper emotional function, can be broken with willpower alone. Addictions, of course, cannot. But they can be easily confused unless you figure out what is driving the behavior.

Dodes included a questionnaire in his first book, The Heart of Addiction to help people who drink too much find out if they have an addiction.  I have adopted it for various population by just changing a few words for people who do something  other than drinking they deem as excessive:   gambling, drug-taking, shopping, over-eating, excessive exercise, watching porn.   This questionnaire  has obviously not been validated scientifically but does have face validity.  And I have found it useful as a vehicle for exploring first, whether the behavior seems to represent an addiction or a habit; and second, providing a venue for discussing the client’s compulsive behavior when he or she feels  safe enough to explore it with me.  

DRUG QUESTIONNAIRE

1. Do I take drugs sometimes when I really don’t want them, but feel I have to do something, and there seems nothing else I can do to relieve my tension?    Yes   No 

2.  Even if I like the feeling I get from drugs, is there an intensity to my drug use–a kind of grim determination–that can’t be explained by liking it?  Do I sometimes feel I “have to have  it?”    Yes    No

3.  If I am blocked from using my drug by circumstances or by another person, do I become unusually angry?  Yes   No 

4.  Do I feel better just knowing I’m going to take a drug, even before I do it?  Yes No

5.  Are there certain situations that I know will lead me to taking drugs (not physical situations like being with other drug users, but emotional situations like feeling frustrated, defeated, or helpless, or trapped into doing something that I feel I should do?)  Yes   No 

6.  If I cannot get my usual drug quickly, do I sometimes substitute another activity (taking a different drug or gambling or eating or drinking) that feels as if its accomplishing the same thing?  Yes   No 

7.  Does my drug-taking seem to substitute for a relationship with a person–for instance, do I tend to take drugs if I am lonely?   Yes    No 

8.  Do I take drugs when I feel bad about myself?   Yes    No 

9.  Does my drug usage seem to solve emotional problems, at least while I am doing it?  Yes  No

10.  Do drugs help me feel more in control of my feelings and my life, at least while I am high?    Yes   No 

11.  Do I tend to defend my drug-taking against those who say I have a problem?  Yes   No