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Drug Abuse Vs. Addiction

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An Introduction to Drug Abuse and Addiction

Drug abuse, addiction and alcoholism are three of the most common problems plaguing adolescents, teens, and adults alike. Recent reports place the numbers of Americans, aged 12 and older, suffering from substance and/or alcohol abuse issues above 20 million. Despite the staggering numbers – and the fact that only a fraction of those who need treatment for alcohol and drug abuse and addiction actually receive it – when it is affecting you or someone close to you, there are many things you can do to help address the burgeoning problem of drug abuse.

The Difference Between Drug Abuse and Addiction

While both concepts exist together on a similar continuum, there is a distinction to be made between substance dependence or addiction, and drug abuse. Addiction, by some accounts, begins as a result of using a substance (drugs or medications) that have a measurable impact on the reward center of the brain – but it doesn’t end there. The repeated stimulus of this reward center is enough to effect a change in the functionality of the brain itself – as the process of stimulating the reward circuitry, so to speak, becomes of paramount importance above all other aspects of an otherwise “normal” life. Eating, sleeping, even sexual activity can take a back seat to obtaining and using drugs.

Drug abuse might eventually lead to an addiction but, as a non-clinical concept, ‘abuse’ encompasses any use of illicit substances, or inappropriate use of medications (such as taking larger doses than were prescribed). As we mentioned earlier, not everyone that uses drugs (or abuses them, for that matter) becomes addicted to them. There are various levels or stages of problems and addiction and we’ve spoken to some extent about the multifactorial causes of addiction. To be sure, however, abuse always precedes addiction, and statistics bear out that many suffering from drug abuse do tend to progress to addiction.

Credit: National Institute on Drug Abuse

Substance Abuse Disorder

The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced some new changes to the “Substance-Related and Addictive Disorders” sections. Gone are the separate categories of ‘substance abuse‘ and ‘substance dependence’ – they’ve been superseded by a singular category termed “Substance Use Disorder.” Each substance (e.g. alcohol, opiates) has its corresponding ‘use disorder’ (e.g. alcohol use disorder, opiate use disorder). Despite the distinction by substances, a diagnosis is made for each substance use disorder based on very similar, if not identical criteria.

Diagnosis of substance use disorder is made when 2 or more of the following criteria are seen within a period of one year:

  • Recurrent substance use resulting in a failure to complete obligations and work, school or home.
  • Recurrent substance use in physically dangerous situations (e.g. operating heavy machinery or driving while under the influence).
  • Continued substance use despite experiencing social or interpersonal problems secondary to the effects of the substance.
  • The development of tolerance (needing more of the substance to achieve a desired level of intoxication and/or diminished effects with continued use of the starting amount of the substance).
  • Experiencing withdrawal symptoms when the substance is stopped.
  • The substance is taken for longer periods or in larger doses than intended.
  • There exists a persistent desire or unsuccessful attempts to decrease the use of substance.
  • A significant amount of time and energy is devoted to obtaining the substance.
  • Social, work and recreational activities are forsaken or curtailed secondary to the use of the substance.
  • Substance use persists even with the knowledge of the physical and/or psychological toll that the substance is having on the user.
  • A strong craving or desire to use the substance in question.

Meeting two or three of these categories is enough for a diagnosis of moderate substance use disorder. Four or more places someone at the level of severe substance use disorder.

Confronting Drug Abuse – Addiction Treatment Options

If you or someone close to you has been abusing drugs and are experiencing the problems associated with drug abuse, you know how important it is to stop the addictive cycle but also know how hard it is to do so. What might begin with recreational use can quickly become a seemingly unstoppable compulsion. A variety of drug abuse treatment options exist to help people in your position.

If you see signs of drug abuse or addiction in yourself or someone you love, please contact our 24-hour helpline at . A treatment support professional will offer you confidential assistance and can place you in contact with treatment any time you need it. You can also contact free narcotics and drug abuse hotline numbers.

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Patrick Condron, M.Sc., M.A.C., is an addiction specialist and drug and alcohol counselor. He is Executive Director of Lazarus House, Inc., a transitional residential program for men and women who continue to work on their recovery towards independent living.
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