Most people use the terms substance abuse and substance dependence interchangeably. Although both can adversely affect your life, they are not synonymous.

Drug abuse, also called substance abuse or chemical abuse, is a disorder that is characterized by a destructive pattern of using any substance, including alcohol, that leads to significant problems or distress. Those who abuse drugs and alcohol still have control over their lives.

Drug addiction, also called substance dependence or chemical dependency, is identified by an inability to stop using a drug and failure to meet work, social or family obligations. Tolerance and withdrawal reflect physical dependence in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if the drug use is abruptly ceased (withdrawal). Physical dependence alone does not constitute addiction, but it often accompanies addiction.

The ultimate difference between drug abuse and drug addiction is in the number of diagnostic criteria met per the Diagnostic and Statistical Manual of Mental Disorders (DSM) as published by the American Psychiatric Association. The DSM is used by physicians and the court system alike.

Substance Abuse vs. Substance Dependence: How to Tell the Difference

What Constitutes Substance Abuse?

According to the DSM, chronic drug abuse problems are often considered to be less damaging than drug addiction, but the fact is that ongoing use of chemical substances can be just as destructive to the user’s life.

Drug abuse is signified by experiencing one or more of the following issues within a year:
• Legal problems caused by drug abuse or behaviors while under the influence;
• Physical harm to others caused by the individual’s use of drugs and/or their behavior while under the influence (or lack of action caused by the use of drugs);
• Inability to do what is necessary at home, at school or at work or to manage responsibilities in general;
• Ongoing use of drugs despite continued problems in these and other areas caused by substance abuse.

What is Drug Addiction?

If you experience three or more of the following issues within a 12-month period, you meet the DSM criteria for a diagnosis of addiction:
• Onset of physical and psychological withdrawal symptoms when without the drug of choice;
• Using increasing amounts of the preferred drug in order to achieve the same results experienced initially;
• Less interest in old hobbies and interests or career/school pursuits;
• Withdrawing from friends and family;
• Patterns of behavior that revolve solely around getting or staying high;
• Multiple attempts to reduce or stop drug use without success;
• Continued use of drugs and alcohol despite ongoing and growing problems related to their use.
Drug abuse is usually the first step to addiction. Over time, a tolerance to your favorite substance is built up and then you develop cravings for it. Regular use creates a tolerance that in turn can mean the experience of withdrawal symptoms when deprived of the drug. Someone who struggles with drug abuse may experience a number of problems that plague those with addiction but he may be able to stop using all drugs of abuse without a problem for long periods of time.

Substance Abuse vs. Substance Dependence: How to Tell the Difference

Crossing the Line from Substance Abuse to Substance Use Disorder

The first sign of having a substance use disorder is the inability to stop using drugs and alcohol. Psychology Today points out that “substance abuse can be the first step on a path that eventually leads to substance dependence. The threshold between the two is crossed when the sporadic binging turns into continuous use and the motivation switches from pleasurable recreation to needing the substance on a regular basis just to get by.” You experience diminishing pleasurable returns, so you need to take more and more of the substance to get the same buzz or any buzz at all. An addict is unable to stay away from his favored drug and/or other substances despite a keen desire to quit using. He believes that he must have the drug in order to function and his life becomes dominated by the procurement and use of drugs.

Entering rehab can greatly increase the chances of success in recovery because it ensures that the addict makes it through the difficult first weeks. More importantly, it gives them a strong foundation on which to build their life in sobriety.

Unfortunately, the majority of people who try to give up an addiction will fail, often relapsing within the first couple of days after quitting. It commonly takes repeated attempts before the individual is finally able to break free of alcohol and/or drugs, and some people never get to this point. Entering rehab can greatly increase the chances of success in recovery because it ensures that the addict makes it through the difficult first weeks. More importantly, it gives them a strong foundation on which to build their life in sobriety.

The Discovery House, located in the San Fernando Valley area of Los Angeles, utilizes a variety of treatment programs that allow each client to receive the individualized care they deserve. The Southern California rehab center offers a variety of inpatient and outpatient drug treatment programs to help drug addicts and alcoholics achieve and maintain sobriety. Each client at The Discovery House receives customized care to end their dependence on drugs such as heroin and other opiates and/or alcohol and to live a sober life.

Have you watched yourself or a loved one advance from substance abuse to drug addiction? At what point did you know that the line had been crossed? Please share with us on Facebook or Twitter @TDHRehab #Addiction.