Substance Abuse and Drug Addiction

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The terms "substance abuse" and "drug addiction" are often mistaken for one another, but they are in fact two different conditions. The term "substance abuse" refers to the use of a substance in a manner that deviates from societal norms, while the term "drug addiction" describes a disorder where the drug appears to be a dominant influence on the addict's behavior. Drug addiction may or may not be accompanied by physical dependence, but it generally accompanied by psychological dependence. Psychological dependence alone does not equate to addiction. Psychological dependence, much like physical dependence, simply means that the individual requires the substance for normal psychological function. That is, without the substance the addict experiences withdrawal reactions that disrupt normal psychological (or in the case of physical dependence, physiological) function. There are some cases of psychological dependence without addiction to the substance-the substance is necessary for 'normal' psychological functioning, but the motivation to obtain the substance is not strong enough to constitute an addiction to that substance (for example, daily caffeine intake for many people).

There are also some cases where the use of a substance constitutes substance abuse but not addiction. For example, any use of an illegal substance is considered drug abuse even if the substance is used rarely and the individual retains control of their substance use. There are even many cases where the individual seems to lose control of their substance use, but it still doesn't constitute true addiction to that substance. Drug abuse is also defined by the society in which it exists. What is considered drug abuse in one culture may be completely acceptable in another. Drug abuse does not necessarily imply that the motivation to continue use of the substance is strong.

The causes of drug addiction and of drug abuse are at times somewhat different. Drug addiction, although a more intense condition, is actually less complex than drug abuse. Drug addiction involves the drug's action on brain reward and motivation systems resulting in the drug becoming the dominant motivational factor for the individual. This involves an 'incentive contrast' where there is a dramatic increase in the incentive value or attraction to the drug reward and a marked decrease in the incentive value or interest in other, normal rewards. The ensuing motivational toxicity is a characteristic of addiction that requires no pre-existing conditions or special personality types-simply the neurochemical action of certain drugs on the brain.

On the other hand, drug abuse involves the 'misuse' of a substance that may or may not be accompanied by an intense motivation to abuse of the substance. In circumstances where drug abuse appears to be strongly motivated, the motivation actually depends on characteristics of the individual or of the social setting to produce these strong motivational effects. In many cases of pathological drug abuse where the motivation to continue the substance use seems strongly motivated, other psychiatric disturbances are present. These comorbid-disorders are much different than mere addiction to the substance and need to be carefully distinguished from true drug addiction when considering the drug rehab treatment approach.

There are many cases of substance abuse that do not constitute addiction. However, most cases of addiction do involve substance abuse. There are even some cases where drug addiction does not constitute drug abuse such as prescribed high-dose opiate medication for chronic pain.

Determining whether the use of an illegal substance constitutes substance abuse or true drug addiction can seem challenging, but it's actually quite simple. If the substance use is intensely motivated according to the definition of addiction and if the motivation for the substance use is rooted on the brain reward the individual receives, it is considered drug addiction. If specific, social factors are necessary for the substance use to develop (regardless of how strongly that behavior seems to be), then it constitutes substance abuse because it involves more than just the substance's action on brain reward systems. Therefore, it is not truly an addiction to that substance.

If you believe that you or someone you know may suffer from addiction, it is integral that you seek professional diagnosis and treatment. Self-diagnosis can be misleading, and self-treatment virtually impossible. Additionally, it will take a professional to determine if there are other underlying mental illnesses that can complicate treatment.