Addictions

The diagnosis and treatment of addictions is examined in this chapter. Addictions are seen as either secondary (self-medication) or primary, with the former being more common in psychiatric settings than the latter. Addictions are seen as lower in the hierarchy of diagnosis than mood or psychotic states, and caused by the latter. The common report of purported comorbidity is seen as an overestimation, with substance abuse often being part of other conditions. Symptomatic treatment is seen to be questionable in benefit over risk for currently available agents. Alcoholics Anonymous 12-Step–style programs can be effective for primary addictions, but less so for secondary addictions.