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Substance Abuse: Abuse vs. Addiction & Signs of Abuse

Substance abuse vs. addiction
Substance abuse is defined as excessive use of any substance that has the potential for addiction.

Substance abuse is excessive use of any substance with the potential for addiction. This may include using alcohol or drugs (illegal or prescription) in a way that is detrimental to yourself, society or both.

As cited in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM], substance abuse is defined as:

A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within 12 months:

  • Recurrent substance use failing to fulfill major responsibilities at work, school or home. For example,
    • repeated absences or poor work performance related to substance use
    • substance-related absence
    • suspensions or expulsions from school
    • neglect of children or household
  • Recurrent substance use in situations in which it is physically hazardous. For example, driving a vehicle or operating a machine when impaired by substance use.
  • Recurrent substance-related legal problems. For example, arrests for substance-related disorderly conduct.
  • Constant substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance. For example,
    • arguments with spouse about consequences of intoxication
    • physical fights

B. The symptoms have never met the criteria for Substance Dependence for this class of substance.

Substance Abuse vs. Addiction

Abuse occurs when substance use causes problems in one’s life but that person is still able to control their use of the said substance.

Addiction is an uncontrollable and compulsive use of drugs (or alcohol) despite negative health and social consequences. Self-control is totally lost.

What substances are commonly abused?

Some of the most commonly abused substances include:


  • Alcohol can affect different individuals in various ways. However, heavy drinking, such as drinking too much too often, will affect your liver. It can also increase your chance of injury or accident. Heavy drinking is defined as:
    • A man who drinks more than four drinks on any given day or more than 14 in a week.
    • A woman who drinks more than three drinks in one day or more than seven drinks in a week.
  • One drink is defined as:
    • 12 ounces of regular beer
    • 8-9 ounces of malt liquor (contains more alcohol than beer)
    • 1 ½ ounce of distilled spirits (such as whiskey or vodka)
    • 5 ounces of wine

Prescription and over-the-counter (OTC) medicines 

  • These are equally dangerous as illicit drugs, and you can abuse this medicine if you:
    • Take the drug for a non-medical reason.
    • Intentionally take an extra drug or don’t take the drug as prescribed by the physician.
    • Take medicine prescribed for someone else.
  • Some of the commonly abused prescription or OTC drugs include:

Cigarettes and other tobacco products

  • Tobacco contains chemical nicotine that gives you little rush and pleasure. Thus, there are high chances of abusing cigarettes and tobacco products.

Heroin, cocaine and marijuana

  • These drugs give you an instant rush of energy. But once the drug wears off, each has different adverse effects:
    • Heroin: Everything slows down, such as your thought process.
    • Cocaine: You may get angry and do things that make no sense.
    • Marijuana: You may forget events that just happened.

Gasoline and paint thinner

  • Some people may get a kick from the smell of gasoline and paint thinner.

Signs of Substance Abuse Problems

While you may be able to control your substance use at first, over time you may need more of that substance to feel an effect. For a number of people, doing so can lead beyond substance abuse to full-on addiction.

The following are signs that may signal a problem with substance abuse:

  • Lacking interest in things you once loved
  • No longer taking care of yourself
  • Sleeping at odd hours
  • Eating less or more than normal
  • Having problems with your family or work
  • Quickly shifting moods or feelings
  • Craving or strongly desiring to use the substance

Whichever type of substance abuse from which you may suffer, it is always possible to recover and find your way back. Therapy and rehabilitation can do wonders for your physical and mental health and improve your quality of life, provided you stick with it and resist the temptation to use the substance.

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