The debate between substance abuse, substance dependence and addiction is on-going. Many addiction specialists and professionals use these terms interchangeably and see no difference. Where as others view each term is a separate experience with it’s own qualities. Some find it easier to just focus on substance abuse disorder, which is an actual mental disorder in the DSM. Whether someone is dependent on, addicted to or simply abuses drugs and alcohol, all three present an abundance of issues and consequences.
So what is the difference between these terms?
Substance Abuse:
When an individual abuses drugs and alcohol it doesn’t interrupt their entire life. Substance abuse can appear more casual and recreational. Drugs and alcohol used recreationally alter the brain temporarily rather than permanently. To put it simply, substance abuse is more likely to be a choice whereas addiction is something that is difficult or impossible to control at times.
Substance Dependence:
Substance abuse and dependence used to have separate definitions in the previous DSM, however since then both have been combined as substance abuse disorder. Mental health professionals assess whether someone is dependent or abusing substances based on a scale. Substance abuse is seen in the beginning stages of the scale whereas dependence is more severe and further along the scale. Dependence occurs when someone is physically dependent on a substance or alcohol. For example, someone might be prescribed pain medication for a health issue but needs to keep increasing the dose because their body is becoming tolerant to the medication. Dependence can also be seen when someone experiences withdrawal symptoms and a change in physical state.
Substance Addiction:
Addictive behavior is destructive and has negative effects on the person’s daily life and relationships. Individuals with addictions use their drug of choice in excess and their drug of choice rules their behaviors, thoughts and feelings. Some studies even show that there are neurological differences in someone’s brain with an addiction compared to someone without one. Furthermore, addiction can have permanent effects on the brain.
Some mental health professionals think it is imperative to distinguish the terms in order to provide proper care. While others see no difference. Whether someone views themselves as a substance abuser, addict or dependent, it is important to reflect on the consequences their use as had on their lives and their intent with using substances. No matter how you define yourself, treatment is always a possibility.