Is there a difference between substance abuse and substance dependence? It may seem like a game of semantics that an addicted individual would use to avoid taking responsibility for his or her need for drug treatment, but there’s much more to it than that.
Addiction Defined
A very basic definition of addiction is an individual with substance dependence (drugs or alcohol) or impulse control disorder. This broad term could cover anything from alcohol to heroin to opiates to gambling to sex, but the DSM-IV, the industry’s diagnostic bible, is helpful in narrowing those broad terms. It shows there is a difference between substance abuse and dependence. According to the DSM-IV, substance dependence is marked by a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three or more of the following occurring any time in the same 12 month period:
1. Tolerance, as defined by either of the following:
(a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect
(b) markedly diminished effect with continued use of the same amount of the substance
2. Withdrawal, as manifested by either of the following:
(a) the characteristic withdrawal syndrome for the substance
(b) the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms
3. The substance is often taken in larger amounts or over a longer period than was intended
4. There was a persistent desire or unsuccessful efforts to cut down or control substance use
5. A great deal of time is spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g., chain smoking), or recover from its effects
6. Important social, occupational, or recreational activities are given up or reduced because of substance use
7. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by the substance (e.g., current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption)
8. Specify if:
(a) With Physiological Dependence: Evidence of tolerance or withdrawal (i.e., either item 1 or 2 is present)
(b) Without Physiological Dependence: No evidence of tolerance or withdrawal (i.e., neither item 1 nor 2 is present)
That’s a lot of information, but simply put, it shows that addiction is a complex disorder with many facets. Dependence can be one of those facets, but it can also be experienced apart from abuse. For example, someone taking a prescription medication for a medically-approved purpose can still be susceptible to becoming dependent on that substance. Abusing or taking more than prescribed isn’t even always necessary.
Addiction Rehab
If you or someone you love is battling an addiction, call The Canyon at toll-free number. Someone is there to take your call 24 hours a day and answer any questions you have about treatment, financing or insurance.
