What Is the Difference Between Drug Abuse and Addiction?

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.

Drug Abuse vs. Addiction

Drug abuse and drug addiction are considered two different diagnoses. You can abuse a substance without suffering from an addiction, but habitual drug abuse often leads to addiction. In the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), drug abuse is referred to as substance use disorder (SUD). An SUD can be classified as mild, moderate or severe, with the most severe diagnoses categorized as addictions.

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, 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 Abuse

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 own safety or the safety of others.

Medical professionals weigh these criteria to determine how seriously their patterns of drug abuse have impacted their life so that they can make an accurate diagnosis regarding the severity of their 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.

Drug 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.

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.

The Future of Diagnosing Drug Addiction

While drug abuse and drug addiction are different, these two terms tend to be used interchangeably. In many cases, it can be difficult to determine when drug abuse crosses the line into addiction.

In fact, these two terms may be retired in the near future. 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 we continue to learn more about drug abuse and addiction, we 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, we 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 us to address a wider range of diagnoses for the most effective treatments.

Additionally, healthcare reform and evolving policies regarding addiction treatment are making it easier for clients to find the care they need. With greater access to healthcare 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.

Content medically reviewed by Vicky Magobet, PMHNP-BC, on February 23, 2022.

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