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Addiction Versus Abuse

People often confuse substance abuse with substance addiction, and even though there is a difference, sometimes it can be hard to tell.

Substance abuse is the use of any substance in a manner for which it is not intended and/or amounts which are excessive and chronic. Examples include drinking to "Feel" good, or using a prescribed medication to get a little "High". However, in the case of abuse, the person understands there is a problem and can stop using.

Addiction implies a more severe form of substance abuse. Addiction typically manifests with accompanying brain disease or damage called “dependence”. The symptoms of addiction can be either physical or mental and are usually a combination of both.

Addiction usually starts with with abuse and progresses from there, evolving into a physical and mental dependence.   








The four stages of addiction are:

  • Experimentation: uses or engages out of curiosity
  • Social or regular: uses or engages in social situations or for social reasons
  • Problem or risk: uses or engages in an extreme way with disregard for consequences
  • Dependency: uses or engages in a behavior on a daily basis, or several times per day, despite possible negative consequences


According to the National Institute on Drug Abuse, the term "substance abuse" has been discontinued because the word "abuse" has negative connotations and is associated with judgment or punishment.

“Substance use disorder” is now the medical term used to describe uncontrolled use of a substance despite negative consequences to one’s health, work, studies, family, and day-to-day functioning.