What Are The 4 Cs Of Addiction?

The four Cs are a relatively simple tool that people can use to assess whether their drug or alcohol use has developed into a substance use disorder. While the four Cs do not replace an official diagnosis, they are a strong indicator that a person needs help.

What Are The 4 Cs Of Addiction?

The four Cs of addiction are a guideline to help assess whether or not a person is addicted to a particular substance or behavior and whether they are likely to require professional treatment. 

Substance abuse disorders and other addictive behaviors often develop gradually, making it difficult for the affected person to realize that they are addicted to drugs or alcohol. 

By learning about the four Cs of addiction, you can determine whether your loved one is showing signs of addiction and help them recognize that they need to get help. 

Breaking Down The Four Cs

The four Cs are four indications that someone is addicted to a particular substance or behavior. These indications are compulsion, cravings, consequences, and control. 


A person who is chemically dependent on drugs or alcohol will feel compelled to use frequently.


The compulsion to use drugs or alcohol is often accompanied by physical cravings, a by-product of the chemical changes that are occurring in the brain.


People living with addiction often continue to use drugs or alcohol despite negative consequences. 

Common examples include job loss, relationship strain, and interactions with the criminal justice system.


Perhaps the most indicative of the four Cs is the total lack of control. Someone who is experiencing drug or alcohol addiction may try to stop using repeatedly without success.

Diagnosing Addiction

While the four Cs are certainly a useful tool for assessing whether a person may be experiencing addiction, they are not a replacement for a professional diagnosis.

If you or a loved one meets the criteria laid out by the four Cs, then you should talk to a professional. Free and state-funded rehab centers often provide diagnostic services.

Additional Diagnostic Tools

Alcohol and drug addiction are both mental health disorders recognized by the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5). 

When a person with a suspected substance use disorder meets with a professional counselor or psychologist, there are several tools that may be used to diagnose a substance use disorder. 

Addiction Severity Index (ASI)

The ASI reviews seven spheres of a person’s life to assess the severity of their addiction. 

These spheres include:

  • medical
  • employment/support
  • drug/alcohol use
  • family
  • legal
  • social
  • psychiatric

Composite International Diagnostic Interview (CIDI)

The CIDI is a comprehensive diagnostic interview process that is used to assess mental health disorders. This tool is useful for determining whether a person needs dual diagnosis treatment.

Structured Clinical Interview For DSM-5 (SCID)

The SCID is a semi-structured interview that is used to identify mental health disorders according to the DSM-5. 

This assessment tool is primarily used to identify recent symptoms and behaviors within the previous 30 days.

Alcohol Use Disorders And Associated Disabilities Interview Schedule (AUDADIS)

The AUDADIS is a structured interview that is specific to alcohol abuse and drug abuse disorders. In some cases, it may identify co-occurring conditions.

Psychiatric Research Interview For Substance and Mental Disorders (PRISM)

PRISM is a psychiatric interview that is designed to assess current and past substance abuse as well as commonly associated mental health disorders. 

Semi-Structured Assessment For Drug Dependence And Alcoholism (SSADDA)

The SSADDA is used to analyze the social, psychological, and physical manifestations of substance abuse in a given person. 

The Importance Of A Diagnosis

The proliferation of different diagnostic tools is necessary to provide the most accurate diagnosis that will ensure the client receives targeted and effective care.

While the diagnostic process may seem tedious, a clear diagnosis is vital to establishing a treatment plan and increasing the chance that addiction care will be covered by insurance.

Addiction treatment centers that accept Medicaid and/or private health insurance are usually equipped to help clients identify what their insurance will cover according to their diagnosis.

Addiction Treatment Approaches

There are numerous treatments used to address drug and alcohol abuse. Many rehab facilities implement a combination of evidence-based treatments and holistic care to provide the best experience.

Common treatment approaches include:

A client’s specific diagnosis will inform what combination of treatments is used. If the treatment provider is unable to offer a specific treatment or level of care, a referral may be provided. 

Find Substance Abuse Treatment Today

If you or a loved one is displaying the four Cs of addiction, there is help available. Contact FreeRehabCenters.net to learn more about treatment for substance abuse.

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