The use of substances, ranging from prescription medicine and alcohol to illegal drugs, has become increasingly prevalent. The misuse and overuse of many substances have led to widespread issues that affect individuals and society.
Two terms we often hear used in conversations about substance-related problems are substance abuse and substance addiction. Although you may hear the terms used interchangeably, they reflect different conditions with their own characteristics, implications, and treatment approaches.
Exploring their definitions, symptoms, causes and consequences can give you the knowledge to recognize these issues in yourself or others.
What Is Substance Abuse?
Substance abuse is also known as misuse, and it involves using dangerous or psychoactive substances, including alcohol, illegal drugs and prescription medicines. Unlike addiction, substance abuse doesn’t necessarily include compulsive behavior or physical dependence.
Abuse can, however, include use patterns that lead to significant negative effects in different parts of a person’s life.
Characterizing abuse is the use of substances in a way, frequency or amount that could be detrimental to your health, safety and well-being.
Some of the indicators of substance abuse can be physical, behavioral and psychological.
Physical signs of substance abuse include:
- Changes in appearance include neglect of grooming or hygiene, sudden weight loss or gain, body odors, or bloodshot eyes.
- Health issues such as unexplained injuries or accidents, frequent illnesses or physical signs of drug use, like marks from using drugs intravenously.
- Alterations in sleep patterns like insomnia, excessive sleepiness or erratic sleep schedules.
Behavioral substance abuse signs can include:
- Neglecting responsibilities because of substance use.
- Risky behavior, such as engaging in dangerous activities when under the influence.
- Getting into legal trouble related to substance use.
- Changes in social circles, like associating with new friends and distancing from long-time friends and family.
Psychological signs of substance abuse include:
- Experiencing extreme mood changes like agitation, euphoria or irritability.
- Diminished motivation or interest in once-enjoyable activities and hobbies.
- Problems concentrating, impaired judgment and memory problems.
- Denial and secrecy regarding the extent of substance use and being secretive about activities and behaviors.
What is Addiction?
Substance addiction or substance use disorder differs from abuse in that it’s a chronic, relapsing disease. It’s characterized by compulsive substance use even though this use is causing harmful consequences.
Substance abuse involves harmful substance use without necessarily leading to dependence. Addiction is a deeper and more entrenched relationship with a substance affecting behavior and brain function.
The key differentiator between abuse and addiction is the fact addiction is a chronic disease. It can be compared to other chronic diseases like diabetes and hypertension.
Addiction involves changes to the reward, motivation and memory circuits of the brain, leading to an overwhelming desire to use the substance. As a chronic disease, addiction alters the chemistry and structure of the brain and makes it hard for people to control their use.
Specific effects of addiction that contribute to its medical classification as a chronic disease include:
- Brain changes: Prolonged substance abuse affects dopamine and other neurotransmitter systems. These play a role in reward and pleasure; resulting changes can impair decision-making, impulse control and judgment.
- Loss of control: When you struggle with addiction, you aren’t able to limit or control your substance use, even when it’s creating major problems in your life or you have a desire to stop.
- Relapse risk: As is true with other chronic diseases, substance addiction has a high relapse rate. When you’re in recovery, you have to manage your condition continuously to avoid returning to substance use.
Development from Substance Abuse to Addiction
Substance addiction usually develops from initial substance abuse, and it follows a progression that can vary quite a bit between individuals.
Typically, the steps that occur as abuse develops into addiction can include:
- Initial use and experimentation: People often start using substances because of curiosity, for recreational purposes, or to cope with emotional pain and stress.
- Regular use: With ongoing use, you might start using substances more often or taking larger amounts as you’re trying to recreate the initial pleasurable or euphoric effects you experienced.
- Tolerance: Over time, your brain will adapt to the presence of the substance, leading to tolerance. You would need more of the substance to achieve the same effect, raising the risk of becoming dependent.
- Dependence: Physical and psychological dependence develops as the mind and body get used to the presence of the substance. When you’re dependent, if you don’t use the substance, withdrawal symptoms can occur, which can reinforce your continued use.
- Addiction: At this stage, substance use is compulsive. You might prioritize substance use over other things in your life and experience major impairment in your functioning.
Signs and symptoms of addiction that are used to make a diagnosis include:
- Cravings: Intense, uncontrollable urges to use the substance.
- Loss of control: You’re unable to limit substance use, and you often consume larger amounts for longer periods than you intend.
- Neglecting responsibilities: You ignore important responsibilities across all areas of your life.
- Continued use despite harm: You persist with substance use even though you know it’s causing you problems physically, psychologically and socially.
- Withdrawal symptoms: When not using the substance, withdrawal symptoms can be a combination of physical and mental and include anxiety, nausea, tremors and irritability.
Treatment and Management
You may require professional intervention even if you are only abusing substances and don’t have a diagnosable condition. This is because addiction is progressive, and it worsens over time without treatment. The earlier you get help, the better the outcomes are often.
Once you’ve reached the point of addiction, treatment requires a comprehensive approach to address the social, psychological and physical parts of the disease.
Effective treatment usually combines behavioral therapies, medication and support systems.
Medications are used to manage withdrawal symptoms and cravings and treat co-occurring mental disorders.
Behavioral therapies can help you change your behavior and develop coping strategies.
Also, part of a treatment plan can be support group participation for peer support and accountability and long-term treatment and support to manage addiction as a chronic disease.
Addiction is a chronic disease evolving from substance abuse marked by compulsive use and significant alterations in brain function. When you recognize the signs and understand how addiction develops, it’s crucial for early intervention and effective treatment. With the right support and treatment, you can manage your addiction, improve your quality of life and work toward long-term recovery.
