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What are the 4 C’s of Addiction?

The 4 C’s of addiction offer a framework to understand the complexity of addiction rehabilitation. The 4’c of addiction are:

  • Compulsion
  • Craving
  • Consequences
  • Control

These 4 factors are unique to addiction and applies to not only substance abuse. Other addictions include gambling, video games, shopping, sex, love, codependency, and alcohol. The 4 c’s framework is designed to understand addiction and provide early interventions. 

What are The 4 C’s?

Compulsion – Compulsion is defined by the irresistible urge to engage in a particular behavior, despite negative consequences. In addiction, compulsions drive individuals to use and engage in behaviors that place them at greater risk for relapse without careful thought or consideration.

Craving – Craving refers to the intense desire or urge to use a substance or engage in an addictive behavior. It’s crucial to get a better understanding of the reported cravings. To do so, assessing craving intensity, triggers, duration, emotional or physical aspects, and strategies is an essential step for treatment. Understanding and treating cravings is also a vital component of relapse prevention planning. 

Consequences – Consequences refers to use or addictive behaviors despite the negative consequences it will lead to. Consequences include health, legal, physical, emotional, family, relational and/or financial.

Control – Understanding control is crucial for addiction treatment and recovery. Control can manifest in many ways and present with different flavors. The most obvious is the loss of control pertaining to substances or behaviors and not being able to stop or cut down. Other factors include emotional dysregulation and lack of self-regulation. Regaining control is a fundamental aspect of the recovery journey. To achieve this, an individual must learn healthy coping strategies, tools to decrease cravings, and implementing relapse prevention tools.

Why do we use the 4 C’s?

By assessing addiction through the framework of the 4 Cs, we gain an understanding of the mechanisms at play and the factors that contribute to its tenacity. According to CAMH, the 4 C’s are a simple way of describing addiction: craving, control, compulsion, and consequences. By examining these pillars, “we can more efficiently recognize the signs and symptoms, assess risk factors and vulnerabilities, and develop targeted intervention and support strategies.” (

At Carrara treatment, the 4 C’s are used and incorporated in individualized treatment plans to foster long-term recovery. Carrara offers an integrative and comprehensive approach to treating addiction. By utilizing this framework, the clinical team can add interventions to decrease relapse risk and improve daily functioning.

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