Substance Abuse vs Substance Addiction

It is a common misperception that substance abuse is the same as substance addiction. In fact, each of these conditions affects different parts of the brain. It doesn’t help that  abuse looks similar to addiction and can ultimately lead to addiction.

Substance Abuse vs Substance Addiction: Defining Abuse

The essential feature of abuse is a pattern of use that causes someone to experience harmful consequences. Clinicians diagnose substance abuse if a person is in one or more of the following situations related to drug use:

  • Failure to meet obligations, such as missing work or school
  • Engaging in reckless activities, such as driving while intoxicated
  • Encountering legal troubles, such as getting arrested
  • Continuing to use despite personal problems, such as a fight with a partner
Substance Abuse vs Substance Addiction: Defining Adiction

Addiction is more severe. Medical professionals look for three or more criteria from a set that includes two physiological factors and five behavioral patterns. Tolerance and withdrawal alone are not enough to indicate dependence. And not all behavioral signs occur with every substance.

The physiological factors are:

  • Tolerance, in which a person needs more of a drug to achieve intoxication
  • Withdrawal, in which they experience mental or physical symptoms after stopping drug use

The behavioral patterns are:

  • Being unable to stop once using starts
  • Exceeding self-imposed limits
  • Curtailing time spent on other activities
  • Spending excessive time using or getting drugs
  • Taking a drug despite deteriorating health

Some people who start as casual drinkers or drug users will stay that way. Others will become substance addicts. Addicts feel that they need to drink or use drugs to cope with life. I can smoke ten cigarettes in one day and not smoke again ever. Despite choosing to smoke on rare occasions, my brain isn’t wired to crave nicotine. Yea, me. I wish my brain worked that way with chocolate. I don’t mean to trivialize substance cravings. To put it in understandable terms, I’ve never eaten simply a few m&m’s. If I open a bag of m&m’s, that shit is going to be eaten. There’s a reason they don’t make snack clips for uneaten bags of chocolate.

Most of my college friends abused alcohol, myself included. I think any time a plastic tube, a funnel and gravity are used to make getting drunk even quicker, that is pretty much the definition of abuse. Flip Cup or Thumper, anyone? It is shocking that anyone would find it shocking that young adults binge drink &/or abuse alcohol &/or drugs. There is a clear link between college binge drinkers who become addicted to alcohol later in life. 

The Centers for Disease Control indicates if a man drinks more than 15 drinks per week, he is abusing alcohol. The same holds true for a woman who drinks more than 8 drinks per week. According to that definition, anyone who has a single glass of wine at the end of the day is on the cusp of abusing alcohol. Or two glasses of wine four times per week. Don’t get me started on the big pour either. Is it just me or does that sound like eating one potato chip? Or should I go back to my inappropriate chocolate example?

substance abuse vs. substance addiction

The Partying Amish

The only drinkers I know who drink less than the CDC advises are probably Amish. I don’t think Amish people are inherently addicts, so maybe I’m onto something here. I mean, have you ever seen a drunk Amish person? Perhaps the break-through therapy for substance abuse is to become Amish! There are lots worse things in the world than simple living and plain attire. Can you imagine how kick-ass it would be to have an Amish Alcoholics Anonymous meeting? You could hide in the back and cover your bloodshot eyes with a wide-brimmed hat.  I bet they’d have incredible fresh-baked goods on the AAA Meeting snack table. You could nosh on some killer zucchini chocolate chip Amish Friendship Bread while taking a fearless moral inventory of yourself. The Amish would OWN that Twelve-Step Program. We might see DBWI’s added to the criminal code. (Driving Buggies While Intoxicated). And I can only imagine the Amish would excel at fermenting moonshine as they do at churning butter.

Sorry- just trying to lighten the mood. Addiction can be such a downer sometimes.


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