Is There a Difference Between Substance Abuse and Addiction?
As it relates to substance abuse, there are several different terms that are often used interchangeably with one another. Two of these terms include abuse and addiction. Abuse and addiction are two separate terms, and they have different signs and symptoms associated with them.
While there are key differences between substance abuse and addiction, they are related to one another. Abuse is often a precursor to addiction, and the more someone abuses a substance, the more likely they are to become addicted.
Substance abuse can occur with alcohol, prescription drugs, and illicit street drugs. Substance abuse can even occur with some over-the-counter medications. Substance abuse essentially refers to any situation where a person is using the substance outside of how it’s intended to be used.
For example, binge drinking at a party can represent substance abuse. Taking prescription opioids without your own prescription is considered substance abuse, and anytime you’re using a drug recreationally, it’s abuse.
That doesn’t mean you’re addicted, however. Some of the signs, symptoms, and effects of substance abuse can include:
- Experiencing legal or social problems because of something you did while under the influence (for example, being arrested for being publicly intoxicated or getting a DUI)
- Causing physical harm accidentally or purposely to someone else while you’re under the influence
- Harming yourself accidentally or purposely while under the influence
- Continuing to use certain substances even when you experience consequences as a result of your use
- Problems meeting certain responsibilities in relationships or at school or work because of substance use (for example, being late to work because of being hungover)
The Substance Abuse and Mental Health Services Administration has different definitions for substance abuse versus addiction. Substance abuse is characterized as being more casual than addiction. Anything beyond moderate substance use is considered abuse, and it does increase the likelihood the person will develop an addiction.
To put this into context—moderate drinking is defined as up to one drink a day for women, and up to two drinks a day for men. If you’re drinking more than this, in technical terms, you’re exhibiting signs of substance abuse.
While substance abuse can transition into addiction, addiction has much more serious symptoms, side effects, and consequences. Addiction whether to drugs or alcohol is considered a serious disease and mental disorder. Addiction often affects every aspect of a person’s life including their physical and psychological health and well-being, as well as social elements of their life.
In the strictest terms according to the National Institute on Drug Abuse, addiction is a chronic brain disease. Addiction occurs when the use of certain substances is compulsive—it’s no longer under the control of the individual. Even when there are harmful consequences related to the use of certain substances, an addicted individual will keep using them.
Addiction is considered a disease because it changes the structure and function of the brain. In some cases, these changes to the brain can be long-term.
One of the biggest outward differentiators between substance abuse versus addiction is the appearance of withdrawal symptoms. When someone is addicted to alcohol, prescription drugs or illicit drugs, they will often be dependent on them as well.
If you’re dependent on a substance and you try to stop using it suddenly, you will experience withdrawal symptoms. Withdrawal can range from mildly uncomfortable to severe and deadly.
What you’ll see with people who have an addiction is that they no longer use alcohol or drugs to feel pleasant or euphoric. It may have started out that way, but as they develop a tolerance to alcohol or drugs, they may not even get these positive effects anymore. Instead, they continue using alcohol or drugs because of their brain’s compulsions and to avoid withdrawal symptoms.
Common withdrawal symptoms with drugs or alcohol can include changes in mood, sleep disturbances, nausea or vomiting, sweating, shakiness, cramping or abdominal pain, hallucinations and in severe cases, seizures.
Summing Up—Substance Abuse vs. Addiction
Another key way to differentiate substance abuse and addiction from one another is the fact that with substance abuse it may still be a choice. While it may not be a healthy or productive choice, the individual is still ultimately in control of their substance use. Addiction is a disease, and continued substance use is no longer a choice.
Some of the signs of addiction can include the desire to want to cut down or stop using drugs and alcohol but being unable to, as well as using substances well beyond when one intended to. People who are addicted will often have cravings, and no matter the outcome they will keep using the substance until they seek professional help.