Mental Health Blog

Substance Abuse, Dependence & Addiction

Posted by Danielle Fitch on

People tend to use the words Addiction and Dependence interchangeably, most people have their own idea of what it means to be an “addict”, but many do not realize there can be a dependence on a substance that can lead to an addiction. There are some fine lines between these two substance terms, but there are also some clear differences between the two, and it is important to understand what it means to either be a substance user, a substance abuser, substance dependent, or addiction. I meet with quite a few clients who will talk about their substance use on a social level, meaning they will refer to it as “just partying in college” or “I drink but I’m definitely not an addict”, unfortunately, I often hear descriptions of their substance use that is more in the realm of a dependence, which if not careful can lead to an addiction. Unfortunately, since many people only think of using substances in terms of either being an addict or not, they play a dangerous game of abusing and depending on substances and refusing to see that there are such things like substance dependence. So lets break down these terms a bit:

Substance Abuse: When the person using drugs or alcohol continues using either, despite it having negative consequences in their lives.

These negative consequences can range from falling behind in work, unable to perform tasks or show up places from being hungover or still impaired. Some negative consequences can be relationally with friends, family or significant other. Receiving a DUI or legal trouble yet continuing to engage in drinking or using in drugs after.

Substance Dependence: This will happen after repeated use/abuse of drugs or alcohol and you begin to have withdrawals when not using the substance. These withdrawals can be physical symptoms (increased heart rate, sweating, shaking) or emotional (uneasiness, reduced ability to experience pleasure, anxiety, desire to use the substance) and can even lead to psychological distress.

Substance Addiction: Using the substance to excess, need for higher dosages of substance to get same “high” when first used (tolerance), the excessive use is destructive to the persons life and those around him, the substance becomes a priority to the user.

A question up for debate among many people I talk to is whether marijuana can be addictive, I won’t be getting into this debate, but consider this, according to the World Health Organization, they use recreational marijuana users as an example of how use can lead to dependence and even addiction: “At first, starting this behavior is an extra activity, but as the user becomes more dependent on the high, it can turn into the main activity. This is where dependency can turn into a full-blown addiction, when the substance abuse becomes the all encompassing main priority”.

So, just a little food for thought and insight into the differences between these terms. It is helpful to make sure you have a clear understanding since it can be easy to dismiss our behavior as not a problem if we don’t understand how close we are to abusing a substance and on the verge of dependence or addiction.

If you have questions or concerns about your own substance use or of a family member, talking to a counselor is a good first step.


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