What is the Difference Between Substance Abuse and Addiction?

The terms substance abuse and addiction are often used to describe the same thing.  But, there are some significant differences between the two disorders.  Knowing the difference between them can help a person seek treatment before drastic consequences occur.  

Substance Abuse or Addiction?  Which Is It?

According to the National Institutes of Health (NIH):

Substance abuse is “the use of illegal drugs or the use of prescription or over-the-counter drugs or alcohol for purposes other than those for which they are meant to be used, or in excessive amounts. Substance abuse may lead to social, physical, emotional, and job-related problems.”

According to the National Institute on Drug Abuse (NIDA):

“Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.”

The main difference between substance abuse and addiction is as follows:

• When a person struggles with substance abuse, they still have control over their daily functioning. 
• When substance abuse progresses into addiction, the drug becomes the individual’s primary focus.  The person has no control over their substance use.  As a result, they may lose their job, family, friends, home and ruin their health. 

Contrary to the NIDA and NIH definitions, the DSM-5 categorizes substance abuse, dependence, or addiction under the single category of substance use disorder (SUD).  Under this category, there are three subclassifications of mild, moderate, or severe SUD.  The DSM classifies the symptoms associated with SUD into four groups: (1) impaired control, (2) social impairment, (3) risky use, and (4) pharmacological criteria such as tolerance and withdrawal.  

Understanding Drug Use, Misuse, and Addiction

Many studies have not yet been modified to reflect the DSM-5 classifications.  Therefore, the reports still refer to substance abuse and dependence as separate disorders.  The terms drug use, misuse, and addiction are still defined as follows:

• Drug use:  refers to any illegal substance use such as cocaine, heroin, tobacco, or others.
• Drug misuse:  refers to unhealthy or improper use of prescription medications or alcohol in moderation.  It also includes using drugs in ways other than prescribed or using someone else’s prescription.
• Drug addiction:  refers to a person’s inability to control their drug use despite negative consequences.  

The terms can be confusing and hard to know which to use when.  For instance, rather than use the term “drug abuse”, the NIDA now uses “drug misuse.”  They believe the term “abuse” is shaming and adds to the stigma surrounding SUD.  

Differences Between Dependence, Tolerance, and Addiction

To make things even more confusing, we have to look at the differences between dependence, tolerance, and addiction.  Understanding these terms can help when trying to determine whether professional treatment is necessary.  

Dependence can happen with regular use of a substance whether legal or illegal.  Many prescription drugs cause dependency even when taken as recommended.  With regular use of a substance, the body adapts to the chemicals.  When the substance is withheld, the body produces symptoms of readjustment.  Over time, the symptoms diminish without any further issues.  

Tolerance refers to the body’s response to repeated substance use.  The person finds that they need larger doses of the drug to get the desired effects.  

It’s often difficult to distinguish between dependence, tolerance, and addiction.  The main difference between the three is that addiction can cause a person to resort to drastic means to obtain more of the drug.  They have no regard for the damage to their life, health, or loved ones.  

Side Effects and Health Consequences of SUD

Substance use disorder can result in a range of side effects that differ depending on the drug involved.  However, some common symptoms are felt, regardless of the substance.  They can include mild to moderate symptoms such as:

• Stomach distress
• Headache
• Insomnia
• Hot and cold flashes
• Anxiety, nervousness
• Flu-like symptoms

Severe symptoms can appear after prolonged SUD:

• Heart or lung disease
• Cancer
• Respiratory issues
• Kidney or liver damage
• Mental health problems
• Seizures
• Stroke

SUD can also result in a fatal overdose.  In fact, the CDC reports more than 93,000 fatal overdoses occurred in 2020.  A large number of the deaths were attributed to prescription drugs and illicit substances such as fentanyl and other synthetic opioids.

Overcome Substance Use Disorder at Cycles of Change Recovery

Have you started to worry about your substance use behavior?  If so, it’s time to seek treatment. You should start now before the consequences begin to affect all areas of your life.  Contact us today at Cycles of Change Recovery.  We’re here to help you overcome substance use disorder and take back control of your life.  In our Palmdale, CA facility, you’ll enjoy a comforting environment where you can escape negative influences and focus on healing.  

We offer a unique, customized approach to treatment that adapts to your needs and preferences.  If you are ready to get back on track with your life, contact us today.  It’s never too soon to begin.

Sources:  

• cancer.gov/ – Substance Abuse
• drugabuse.gov/ – The Science of Drug Use and Addiction:  The Basics
• commonwealthfund.org/ The Drug Overdose Toll in 2020 and Near-term Actions for Addressing it