Substance Use, Abuse and Dependence
While some people completely abstain from drinking and drug use, others struggle with abuse and dependence. Statistics show that most of us fall somewhere in the middle when it comes to using alcohol and drugs: More than 70 percent of people in the United States reported having at least one drink in the last year, and over 10 percent of people over the age of 12 have used an illicit drug in the last month.
How much is too much? For children and young adults whose brains are still developing, any alcohol or drug use is too much. For adults, the answer is a little more challenging and involves individual choice, your personal and family history of addiction, and how you manage your lifestyle and goals.
Psychologists and the medical community have defined guidelines and definitions around substance use, abuse and dependence to help people recognize if they may have problem with alcohol and drugs. Understanding the definitions can help you, or a loved one, make an informed decision about your relationship with substances and when it may be time to seek help.
Understanding the Differences
The terms use, abuse and dependence (or sometimes addiction) are used frequently – and sometimes interchangeably – when talking about alcohol and drugs. But what do they really mean?
- Use: Substance use is any consumption of alcohol or drugs. Something as commonplace as having a beer with friends during dinner is considered substance use. Substance use may not be a problem or lead to abuse or dependency in some people.
- Abuse: Substance abuse is when someone continues to use drugs or alcohol even when it causes problems, such as trouble with work, family, or their health. For instance, continuing to use drugs knowing you’ll be fired if you fail a drug test is a sign of abuse.
- Dependence: Substance dependence is an addiction to alcohol or drugs. You may be unable to stop drinking or using drugs, and have physical withdrawal symptoms when you try to quit.
Substance Use Disorder
Even with these three definitions in mind, it may still be difficult to distinguish between use, abuse and dependence. For this reason, the American Psychiatric Association has updated its criteria for talking about addiction and now uses the term “substance use disorder,” which includes the following signs and symptoms:
- Using substances in larger amounts for longer than intended.
- Making efforts to stop, but being unable to do so.
- Spending more time getting, using and recovering from using the substance.
- Having cravings and urges to use the substance.
- Continuing to use the substance even though it causes social and relationship problems.
- Giving up important social, work, and recreational activities because of the substance.
- Taking increased risks related to the substance.
- Continuing to use the substance when the user is aware it causes psychological or physical problems.
- Needing more of the substance to get the same effect.
- Developing withdrawal symptoms when stopping the substance.
The more of these signs or symptoms a person struggles with, the greater their substance use disorder. A person who meets none of these criteria likely does not have a problem with drugs or alcohol, while someone meeting six or more may have an addiction.
It’s important to keep in mind that only a mental health professional or addiction specialist can make an accurate diagnosis of a substance use disorder. If you think you may have a problem with alcohol or drugs, it’s important to talk to your doctor to get the help you need.
New Patient Drug and Alcohol Access Center
If you're struggling with substance abuse disorder, please visit Crozer-Keystone's New Patient Drug and Alcohol Access Center.
Assessment and referral can be made for detox services, short/long term rehabilitation services, partial hospitalization, half-way house, intensive outpatient treatment, outpatient treatment, and methadone and suboxone maintenance.
The initial intake process can be lengthy and can take up to two hours. Pre-registering for your visit can help to expedite the intake process.