Is It Abuse or Addiction?
How to Tell the Difference

They are both serious problems that can lead to substantial difficulties – and in many cases they are related behaviors – but addiction and substance abuse are not the same things.

Substance abuse refers to taking a drug without the supervision of a medical professional, for recreational purposes, or in a manner other than the one for which the drug is designed to be taken.

The most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) describes substance abuse as “a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

  • Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (for example, repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
  • Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
  • Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct
  • Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

Addiction, which may occur in conjunction with (or as a result of) substance abuse, involves a dependence upon a substance and the presence of withdrawal symptoms in the absence of the substance.

The DSM IV defines addiction as occurring  when any combination of three or more of the following symptoms occur within a 12-month period:

  • Preoccupation with use of the chemical between periods of use.
  • Using more of the chemical than had been anticipated.
  • The development of tolerance to the chemical in question.
  • A characteristic withdrawal syndrome from the chemical.
  • Use of the chemical to avoid or control withdrawal symptoms.
  • Repeated efforts to cut back or stop the drug use.
  • Intoxication at inappropriate times (such as at work), or when withdrawal interferes with daily functioning (such as when hangover makes person too sick to go to work).
  • A reduction in social, occupational or recreational activities in favor of further substance use.
  • Continued substance use in spite of the individual having suffered social, emotional, or physical problems related to drug use.

Treatment Can and Does Work

Though both abuse and addiction can be difficult to overcome, neither of these conditions are completely resistant to effective treatment. Several studies have documented that the efficacy of addiction treatment is similar to programs designed to address other chronic medical conditions. However, because misinformation and incorrect perceptions about the nature of drug abuse and addiction remain prevalent in modern society, many individuals who are afflicted with these treatable conditions continue to struggle without the help that could end their suffering.

Especially in cases of addiction, the effectiveness of a treatment program can depend upon myriad factors, including the desire of the client to achieve long-term sobriety, the drug to which the client is addicted, the duration and severity of the addition, and the presence of co-occurring disorders that may have led to, resulted from, or been exacerbated by the addictive behavior.

In most cases, successful recover is the result of a comprehensive, intensive effort to address not only one’s pattern of substance abuse and addiction, but also the underlying issues that were related to the drug use. Cognitive-behavioral therapy is often employed as a means of addressing past problems and preparing for a healthier, drug-free future – and in some cases, pharmacological interventions are used to help ease the pain of withdrawal and speed the detoxification process.

Some people are able to get their addictions under control after receiving intensive outpatient therapy, while others need the more comprehensive treatment, support, and structure that is offered at a residential recovery program.

Regardless of which treatment approach a person chooses, remaining in treatment for as long as possible, then participating in an ongoing relapse-prevention and recovery support program, greatly increases the likelihood of achieving long-term sobriety.

If you or someone you care about is struggling to overcome a problem related to substance abuse or addiction, know that help may be as close as a phone call away. To speak confidentially with a counselor who can help you find the recovery program that best meets your specific needs, call 866-323-5608.