Substance Use, Misuse, and Abuse: What are the Differences?

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A “substance” is anything that can alter a person’s mood or cognition. Substances can range from caffeine and alcohol to cocaine and heroin. While many people want to differentiate between the concepts of use and abuse, the line can become blurred easily. Many people mistakenly believe they are using a substance responsibly when in actuality, they are putting themselves and their loved ones in harm’s way. Read on to learn more about the differences between substance use, misuse, and abuse.

Is Recreational Use Possible?

Many people only claim to use certain substances recreationally. Alcohol is commonly enjoyed socially, while more states are legalizing recreational marijuana use. However, it does not take much for people to begin experiencing negative health effects from these substances. While many citizens believe marijuana use is safe, the truth of the matter is that roughly one out of every seven users develops a dependency, according to data from the National Institute on Drug Abuse.

The most commonly used drug in the United States is actually caffeine. A cup of coffee in the morning may be fine, but people who consume excessively may experience mood problems and face an increased risk of heart disease. People can become addicted to caffeine and sugar in a similar fashion to other substances, and abuse can result in similar negative health effects.

What is Drug Misuse?

There’s also another common term called “drug misuse” that is often mentioned when talking about substance use or abuse. Drug misuse refers to the use of a substance for a purpose that is not consistent with legal or medical guidelines, most often with prescription medications. This could mean taking more than what is prescribed, or taking a medication that was not prescribed to you. Often drug misuse can lead to substance abuse, but that is not always the case. Drug misuse and abuse are not the same thing.

When Does Use Become Abuse?

Numerous professionals believe the difference between substance use and abuse blurs when chronic use begins impairing specific aspects of life. If regular use results in one of the following, then an individual likely may have a substance abuse problem.

  • Health complications as a result of substance abuse
  • Inability to carry out daily responsibilities
  • Physical dependence
  • Withdrawal symptoms if usage stops
  • “Cravings” for drug or alcohol

The Diagnostic and Statistical Manual of Mental Disorders (DSM) uses the criteria above along with other criteria to determine if a substance use disorder* is present. The DSM-5 no longer uses the terms substance abuse or substance dependence. Additionally, severity of a substance use disorder is based on the number of symptoms present. For our purposes, when we refer to substance abuse, we are referring to someone who would meet the criteria for a mild substance use disorder in the DSM-5, which is 2-3 symptoms from the DSM criteria.

Substance abuse or drug addiction is chronic and repetitive. It alters the brain and the body to the point where someone needs more of the substance to achieve the same rewarding effects. For many, use turns to abuse when it impacts personal relationships, responsibilities, and more; however, every individual is different. There are some high-functioning individuals with substance abuse problems. This reaffirms why the lines between substance use and abuse are often blurred. Additionally, remember that an individual can be high-functioning but still meet the criteria for a substance use disorder diagnosis.

*Does not include caffeine use disorder.

Ultimately, the question anyone needs to ask is, “Does this cause harm?” If your substance use is affecting your daily life, it’s likely an addiction that requires medical attention and treatment. Even if you are unsure, do not be afraid to talk to a medical professional. The differences between substance use, misuse, and abuse are significant and can have lasting consequences.

Pyramid Healthcare provides treatment for adults and teenagers with substance use disorders. Contact us to learn more about our wide range of treatment services, including detox, inpatient residential treatment, and outpatient treatment.

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