Substance Use, Abuse and Dependence
There is a difference between substance use, abuse and dependence. Substance use, as the name implies, refers to the use of substances in low to moderate amounts and does not interfere with social, occupational or educational functioning.
Substance abuse on the other hand refers to regular use and it is defined in terms of how significantly the substance interferes with the user’s responsibilities and how much it disrupts their life. For an individual to be diagnosed with substance dependence or addiction there has to be an indication that an individual continues to use that substance despite the problems experienced.
Dependence refers to learned habits that once established become difficult to extinguish despite the negative consequences associated with it. (DiClemete, 2003). This is because addiction involves reinforcers that are both psychological and physiological in nature and together they create a powerful reward system that clouds awareness of problematic consequences related to the behaviour, making it difficult to change (DiClemete, 2003).
There are two types of substance related disorders, these are; Substance Use Disorders (substance abuseand substance dependence) and Substance Induced Disorders (Substance intoxication, substance withdrawal, substance-induced delirium, substance-induced persisting dementia, substance-induced persisting amnestic disorder, substance-induced psychotic disorder, substance-induced mood disorder,substance-induced anxiety disorder, substance-induced sexual dysfunction and substance-induced sleep disorder) (Barlow & Durand, 2009; APA, 2000).
It is important to note that addiction is hard to diagnose because most individuals are unlikely to voluntarily mention that they use any substance and often will deny the existence of any problem in their using behaviour due to limited insight into the situation. This is a common characteristic of addiction, often referred to as “denial” (Martin, Weinberg & Bealer, 2007).
- American Psychiatric Association, (2000). Diagnostic and Statistical Manual of Mental Disorders. (4th ed.). Text Revision. Washington, DC: American Psychiatric Association.
- Barlow, D.H., & Durand, V.M. (2009). Abnormal psychology: An integrative approach (5th ed.). Belmont, CA: Wadsworth Cengage Learning.
- DiClemente, C.C. (2006). Addiction and change. How addictions develop and addicted people recover. New York, NY: The Guilford Press.
- Martin, PR., Weinberg, B.A., & Bealer, B.K. (2007). Healing addiction. An integrated pharmacopsychosocial approach to treatment. Hoboken, NJ: John Wiley & Sons, Inc.