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Friday, September 7, 2007

DEFINING DEPENDENCE: DESCRIBING SYMPTOM CLUSTERS VERSUS CENTRAL CONSTRUCTS
Addiction 102 (10), 1531–1532.




The paper by Li et al. reminds us that the publication of ‘Alcohol dependence: provisional description of a clinical syndrome’ by Edwards & Gross was a watershed event for understanding alcohol and drug dependence.

We may forget that prior to this publication, definitions ofdependence were vague and idiosyncratic. For example, at that time the existing World Health Organization definition was ‘a compulsion to take the drug . . . in order to experience its psychic effects and sometimes to avoid the discomfort of its absence’. The existing Diagnostic and Statistical Manual (DSM) definition for substance dependence was tolerance and withdrawal and for alcohol dependence was ‘pathological use . . . that causes impairment in social or occupational functioning’. The National Council of Alcoholism definition was ‘tolerance and physical dependency; or pathological organ changes’.
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