Substance Dependence:
The essential feature of substance Dependence is a cluster of cognitive, behavioral and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine. The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogen Dependence). Although not specifically listed as a criterion item, "craving" (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence. Dependence is defined as a cluster of three or more of the symptoms listed below.

Criteria for Substance Dependence:
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12 month period

(1) tolerance, as defined by either of the following
(a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect.
(b) markedly diminished effect with continued use of the same amount of the substance

(2) withdrawal, as manifested by either of the following:
(a) the characteristic withdrawal syndrome for the substance
(b) the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.

(3) the substance is often taken in larger amounts or over a longer period than was intended.

(4) there is a persistent desire or unsuccessful efforts to cut down or control substance use.

(5) a great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g. chain-smoking), or recover from its effects

(6) important social, occupational, or recreational activities are given up or reduced because of substance use.

(7) the substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e.g. current cocaine use despite recognition of cocaine induced-depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption.

worse case-scenario: continued use of cocaine despite recognition that DYFS is going to take your children away and put them in foster homes or possibly up for adoption.