In many cases, it is a family member or very good friend who raises concern about the patient’s behavior (rather than the patient himself/herself doing so). The first port of call is usually a GP (general practitioner, primary care physician, family doctor). The doctor will ask several questions, including how often the substance is consumed, whether the substance use has been criticized by other people, and whether the patient feels he/she may have a problem. If the doctor suspects there is an addiction problem, the patient will be referred to a specialist. In cases of nicotine addiction, establishing whether or not there is an addiction is done at the GP-patient level. With more powerful substances there is usually an evaluation by a specialized addiction counselor, psychologist or psychiatrist.
Urine test - this may be ordered to determine whether the substance is still in the body (whether the substance has been taken recently).
Though Addiction is not the same dependence, DSM criteria for substance dependence can guide the diagnosis - a patient diagnosed with substance dependence (an addiction) must meet criteria laid out in the DSM (Diagnostic and Statistical Manual of Mental Disorders), a manual published by the American Psychiatric Association. The criteria for drug dependence that causes significant problems must include three of the following: