Is it Drug Addiction or Abuse?

Difference between drug abuse and drug addictionThere are a number of different ways that drug use can become a problem for an individual. The one that most people hear about is addiction; another term tossed around is drug abuse. When hearing these terms, a person might wonder if they are the same thing, and if not, what the difference might be.

Most simply, drug abuse is chronic misuse of a substance. Addiction, on the other hand, is a condition marked by a compulsive need to use a substance. These conditions are related to one another and exist on a spectrum; nevertheless, there are marked differences, though sometimes it can be hard to tell what they are.

The discussion below provides a basic, point-to-point comparison of drug abuse and addiction to clarify the differences – and similarities – between the two.

What Drug Abuse & Addiction Have in Common

Before demonstrating how they are different, it can be important to show how drug abuse and addiction are similar. Both conditions are on the spectrum of substance use disorders, the official term through which any mental health disorder regarding substance abuse is defined. As explained by the National Institute on Drug Abuse (NIDA), the diagnosis of substance use disorders is based eleven symptoms described by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

  • Use of the substance in greater quantities or for a longer period than intended
  • Being unable to control use of the substance
  • Being uncharacteristically focused on obtaining and using the substance
  • Having uncontrollable cravings for the substance
  • Losing track of daily responsibilities due to substance use
  • Experiencing problems in personal relationships because of substance use
  • Decreased participation in favorite activities in favor of substance use
  • Getting into risky situations while using the substance
  • Continuing substance use even when experiencing negative effects
  • Feeling a need to use more of the substance to get the same effect (tolerance)
  • Experiencing withdrawal if attempting to stop substance use

The severity of the substance use disorder is based on how many of the above symptoms are being experienced. A person who demonstrates two or three of these symptoms is considered to have a mild substance use disorder, while four or five symptoms can delineate a moderate disorder. Six or more indicates a severe disorder. So, while the general parameters for diagnosis are the same, it is the severity of the disorder that can delineate the difference between drug abuse and addiction, as demonstrated below.

Behaviors: Addiction and Abuse


A person who is addicted to a substance is, as defined by the American Society of Addiction Medicine, experiencing a chronic mental illness that affects the reward, motivation, and memory systems in the brain. This results in an inability to stop using the substance to which the person is addicted, despite multiple attempts to do so.

Because of the inability to control substance use, the person who is addicted to a substance may resort to uncharacteristic behaviors to obtain the substance, including secrecy, theft, or obtaining multiple prescriptions from different doctors and pharmacies. They may try to hide their use, because it causes problems with relationships, work or school, and, potentially, even the law. For people who are addicted to drugs, the inability to stop using the substance begins to interfere with every aspect of the person’s life.


As described by the University of Maryland Medical Center, a person who is abusing drugs is chronically engaging in illicit drug use, or deliberately misusing drugs or alcohol. This can occur for several reasons, some of which include:

  • Taking illicit drugs to experience a “high”
  • Using larger or more frequent doses of a prescription drug for stronger effects
  • Trying to fit into a social group for which drug use is a common activity
  • Self-medicating other conditions, such as depression or anxiety, through illicit or inappropriate drug use

Based on this definition, addiction as described above is a type of substance abuse; however, it is not the only type.

Frequency and Degree of Use


As explained by NIDA, people who are addicted to drugs have an uncontrollable, physical need to engage in drug use. This is because, over time, drug use changes the chemical processes in the brain so the individual becomes unable to function well or feel good without using the drug. As a result, drug use is regular and often heavy.

Because of this, the person may also spend an inordinate amount of time seeking the drug, using it, and recovering from its use. This is the source of the interference. The individual finds it difficult to focus on other aspects of life because the need to use the drug takes center stage.


An article from Psych Central demonstrates that drug abuse can occur on a regular basis, or it can be intermittent. For example, even just experimenting with illicit drugs is considered to be one type of drug abuse, because most illicit drugs are considered to put people at high risk for developing addiction or experiencing overdose or other health risks by using the drug even only once.

Then again, misusing drugs or alcohol only when spending time with a particular social group, but on a regular basis, is a type of drug abuse. A third option is drug or alcohol binges – use that doesn’t occur quite as often, but is still regular, and can involve unusually heavy use of the substance.

Then again, a person who is a regular and heavy user of substances, whether or not the person has the ability to control use, is considered to be engaging in drug abuse. In other words, addiction itself is a type of drug abuse.

Degree of Disorder


As can be seen by the behaviors and frequency analysis above, addiction results in behaviors that cover multiple symptoms on the DSM-5 list. As a result, addiction is considered to be a severe substance use disorder. As such, it is a type of drug abuse. However, as explained above, it is not the only type.


Based on the above explanations, it is clear that substance abuse lies on a full spectrum. Anyone engaging in intentional misuse of drugs or alcohol is considered to be engaging in drug abuse. As a result, drug abuse ranges from the most severe types of substance use disorder, including addiction, to mild types, as defined by the DSM-5 criteria explained above.

The Path to Wellness

Regardless of whether substance abuse is mild or moderate, or it has reached the status of severe addiction, the inappropriate use of substances can be categorized as a mental health disorder that may require treatment to resolve. Through a professional, research-based program that has demonstrated positive results, a person who is experiencing a substance use disorder can get on the road to recovery and learn to live a fulfilling life without substance abuse.

Did you know most health insurance plans cover addiction treatment?