When describing substance abuse disorders, many terms are used interchangeably, such as abuse and addiction. Due to the stigma attached to addiction and drug use, mainstream culture generally does not differentiate between these two terms. However, for those ready to recover and seek treatment, knowing the difference between drug abuse and drug addiction will help you understand your next crucial steps toward a life in recovery.
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Drug Abuse vs. Drug Addiction
Drug abuse and drug addiction are considered two different diagnoses. You can abuse a substance without suffering from an addiction, but chronic drug abuse often leads to addiction.
Substance abuse is a pattern of uncontrollable substance use, which results in recurring negative consequences, like repeatedly not going to work or school, arrests, and relationship difficulties. Addiction is the state of physical and psychological dependence on the use of alcohol and other drugs. “Addiction” is often used interchangeably with “substance dependence.”
Drug abuse and addiction can have many overlapping symptoms and causes, so making the distinction between the two diagnoses can be challenging. There are select diagnostic criteria medical professionals use to differentiate between substance abuse disorder and addiction.
Through decades of research and imaging scans, we’ve found that repeated drug abuse can cause physical changes to the brain in areas that affect judgment, decision making, memory and behavioral control. The effects of both drug abuse and addiction can have lasting impacts on many areas of a person’s life, regardless of which diagnosis they receive.
More than 20 million Americans over 12 are affected by SUDs to varying degrees of severity. While the difference between substance use disorders and addiction may be slight, making an accurate diagnosis is critical for finding the right treatment plan to help individuals find success.
Drug abuse and addiction can have many overlapping symptoms and causes, so making the distinction between the two diagnoses can be challenging. There are select diagnostic criteria medical professionals use to differentiate between substance abuse disorder and addiction.
Drug and Alcohol Abuse
Drug abuse is the use of illegal or legal substances in ways you should not be using them. For example, you may exceed the amount of your prescription dosage or use someone else’s prescription. In many cases, people misuse substances to try to ease negative symptoms of medical conditions, relieve stress, avoid reality or feel a pleasing high feeling. People use drugs for various other reasons, including:
- Religious rituals
- Creative inspiration
- Curiosity
Not everyone who uses drugs becomes addicted. You can consume a substance without being addicted to it, but regular abuse often leads to addiction. Ultimately, everyone’s bodies and brains react differently to substances. Some may use a substance for a short period and become addicted quickly, while others may continue to abuse the substance without ever becoming addicted.
Also called substance abuse, drug abuse is generally considered a milder form of harmful drug use. It’s characterized by the destructive use of a drug leading to:
- Recurring legal and financial difficulties.
- Relationship problems.
- Problems at work, school or home.
- Endangering your safety or the safety of others.
Medical professionals weigh these criteria to determine how seriously patterns of drug abuse impact lives and to make an accurate diagnosis regarding the severity of an individual’s drug abuse.
Abused substances could be legal or illegal, including alcohol, narcotics, prescription medications, and illicit drugs like heroin and methamphetamine. In cases of drug abuse, individuals typically do not experience withdrawal symptoms and, therefore, do not require a detoxification process.
People diagnosed with drug abuse often still have control over their lives and may not experience as many major disruptions from their behaviors. Sometimes counseling, intervention or an honest conversation about the consequences of their drug use can inspire a person to take control, change their behaviors and limit or eliminate their use of their chosen substance.
Signs of Drug and Alcohol Abuse
Typical substance abuse signs include:
- Sleep disturbances
- Change in appetite
- Red, watery eyes
- Runny nose
- Trembling hands or sweaty palms
- Poor hygiene
- Hyperactivity or irregular heartbeat
- Twisting jaw and twitching nose
Besides physical signs, your loved one may be misusing substances if they are irritable, paranoid, acting secretively and continuously exhibiting dishonesty. You may notice they change their friends, become over sensitive and disengage from family activities.
Drug and Alcohol Addiction
Far more severe than abuse, addiction is a chronic disease accompanied by both a physical and psychological need for drugs. As the body develops a tolerance to a drug, more and more of the substance is required to have the same effect. A person struggling with an addiction may continue using even though they are aware of the adverse effects.
Addiction is characterized by a lack of control — individuals with addictions often cannot stop using a substance despite damaging consequences. People who are struggling with addictions tend to fail to meet their everyday obligations at work, school and home.
Some of the other characteristics of drug addiction include:
- Severe withdrawal symptoms if drug use stops abruptly.
- Continued use despite negative consequences.
- Feeling powerless to stop even if you want to.
- Inability to function in a productive way.
- Frequent relapse.
Physical dependence is one crucial indicator medical professionals use to identify and diagnose drug addictions. Individuals with drug addictions will develop a tolerance, requiring more of the substance to achieve the same high. Drug tolerances can speed up the negative effects of substance abuse, including psychological and physical damage to an individual’s body.
When an individual develops a drug tolerance, they seek larger or more frequent doses of their chosen substance to achieve the effects they desire. These larger doses can lead to accidental overdoses, which are the leading cause of death among people under 45.
People with drug addictions are also likely to experience intense withdrawal symptoms when the substance is not available or when they attempt to stop using. Withdrawal can range widely depending on how heavily the individual uses the drug and what kinds of substances they use. The process is often unpleasant and even dangerous. A medical detoxification process is the safest way to mitigate drug withdrawal.
Signs of Drug and Alcohol Addiction
When a person has an addiction, they may exhibit the following signs:
- Changes in appetites, weight gain or weight loss
- Sleep disruptions
- Lethargy and fatigue
- Red eyes or pinpoint pupils
- Tremors
- Lack of personal hygiene
- Poor physical coordination
In addition, a person with an addiction may isolate themselves, change friends, act secretively, struggle with performance issues and may be habitually dishonest with loved ones.
What Is the Difference Between Drug Abuse and Drug Addiction?
There is a fine line between drug abuse and drug addiction. Drug abuse is the initial, milder form of alcohol or substance misuse and may not lead to addiction. A person may abuse a substance and face financial, legal or relational problems due to a drop in attendance at work or a lack of investment in relationships. However, this individual is not dependent on the substance they are abusing.
A person with a substance addiction cannot easily stop using or misusing substances on their own. The person’s body develops a tolerance for the drug and experiences withdrawal symptoms when the substance is stopped. There may also be a psychological element that underpins the addiction.
When it comes to drug use vs. drug abuse vs. drug addiction, it all comes down to levels of use. To differentiate, experts consider how much of a particular drug is consumed and how often. Your diagnosis also depends on the severity of the problems that drugs have created in your life and how they affect you personally, professionally, mentally and physically.
Through decades of research and imaging scans, it is evident that repeated drug abuse can cause physical changes to the brain in areas that affect judgment, decision-making, memory and behavioral control. The effects of both drug abuse and addiction can have lasting impacts on many areas of a person’s life, regardless of which diagnosis they receive.
More than 37 million Americans over 12 are affected by substance use disorders to varying degrees of severity. While the difference between substance use disorders and addiction may be slight, making an accurate diagnosis is critical for finding the right treatment plan to help individuals find success.
What Are Substance Use Disorders?
In the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), drug abuse is referred to as substance use disorder (SUD).
Substance use disorders are complex conditions that describe when individuals repeatedly and compulsively use substances despite adverse consequences. People dealing with SUD experience intense cravings to use a specific drug to the point that it impacts their day-to-day functioning. SUDs include:
- Alcohol use disorder
- Illegal drug use disorder
- Prescription drug use disorder
The Future of Diagnosing Drug Addiction
Many mental health professionals and addiction specialists no longer specify between abuse and addiction. Instead, they define addiction based on different levels of severity that are characterized by a person’s relationship with drugs.
As medical professionals continue to learn more about drug abuse and addiction, they will find better ways to identify, diagnose and treat these conditions. Addiction is both a mental illness and a disease, and it often co-occurs with other conditions like anxiety, depression, mood disorders and trauma.
Moving forward, you can expect to see addiction professionals incorporating more neurology, biology and mental health care into the diagnosis process. Understanding the complexities of addiction better allows medical professionals to address a broader range of diagnoses for the most effective treatments.
Additionally, health care reform and evolving policies regarding addiction treatment are making it easier for clients to find the care they need. With greater access to health care services, more people are finding accurate diagnoses for both addiction and co-occurring conditions and getting individualized treatment plans that help them succeed.
Treatment for Drug Abuse and Drug Addiction
The benefit of differentiating between drug abuse and addiction is that determining the severity of your drug use makes it easier to find a successful treatment. While counseling or support groups may be enough for those in the early stages of substance abuse, more severe addictions typically require detox and inpatient substance use treatment.
At Diamond House Detox, our team of substance abuse specialists provides individualized treatment for drug abuse and addiction to ensure you get the help you need. Our expertise allows us to assess your individual needs so we can give you the best possible care. To learn more about our Northern California facility, contact us today.
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Professionally reviewed by Vicky Magobet, PMHNP-BC, on November 21, 2023.
Vicky is a board certified Family Psychiatric Mental Health Nurse Practitioner, certified by the American Nurses Credentialing Center. She began her nursing career in healthcare by working in the intensive care unit, and then an inpatient psychiatric hospital. After realizing the mental health needs of both the patients and the families she served, she became a Psychiatric Nurse Practitioner. Throughout her experience working with clients, she has developed a passion for those with dual diagnoses and specializes in helping individuals recognize the issues driving their substance use. This recognition has been crucial to the individual’s success in treatment. Vicky opened Diamond House Detox so that she can address these issues early on in a therapeutic environment to allow clients to transition to the next level in their recovery.
