Drug Use Versus Substance Abuse: What's the Difference? (2023)

If you've heard the terms "drug use" and "drug abuse," you might be wondering if they mean the same thing or if there's a difference between them.

Both terms refer to the act of usesubstancessuch as alcohol, drugs, nicotine, cannabis or prescription medication.However, one refers specifically to problem use, while the other is a broader term referring to all problem or other substance use:

  • substance use: „substance use” is the act of using a legal or illegal substance, saysMaeve O'Neill, MEd, LPC-S, CHC, CDTLF, Executive Vice President of Addiction and Recovery at All Sober. “Substance use” is a broad term that encompasses all forms and frequencies of harmful substance use.
  • substance abuse: The term "substance abuse" used to be used to describe addiction or risky/hazardous use of a substance or substances, says O'Neill. The professional diagnostic manual known asDiagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)no longer uses the term 'drug abuse' as it can be stigmatizing; the preferred term is "substance use disorder," explains O'Neill.

Read on to learn more about the differences between substance use and abuse (the term “substance use disorder” is used instead of “substance abuse” in the rest of this article).

If you or a loved one are struggling with a substance use disorder, contact theSubstance Abuse and Mental Health Administration (SAMHSA) National Hotline.a 1-800-662-4357Information on support and treatment centers in your area.

For more mental health resources, visit ourNational Database of Support Lines.

Why the term "drug abuse" is no longer used

According to the National Institute on Drug Abuse, the term "drug abuse" was phased out because the word "abuse" has negative connotations and is associated with conviction or punishment.

"Substance Use Disorder" is now the medical term for the uncontrolled consumption of a substance despite negative health consequences.It works out, studies, family and everyday life.

Substance use disorder is viewed as a complexdisease of the brainand a mental illness, which is classified as mild, moderate, or severe based on the criteria each individual meets, O'Neill says.

Maeve O'Neill, MEd, LPC-S, CHC, CDTLF

Historically, the term "substance use" was intended to describe light use of a substance, and the term "substance abuse" was used to describe moderate or heavy use. We no longer use the term "abuse" because language is important.

— Maeve O'Neill, MEd, LPC-S, CHC, CDTLF

How using the right language can destigmatize mental illness


when to havea drinkwith friends or taking a painkiller for a headache (occasional substance use) that progresses to alcoholism or painkiller addiction (substance use disorder)?

When people experience these symptoms, they may be diagnosed with a substance use disorder:

  • experience strongwishesthrough the substance
  • Use more of the substance than intended
  • Not being able to reduce substance use despite constantly wanting or trying to.
  • They spend a lot of time looking for, using, or recovering from the side effects of substances
  • dealing with problems at homeIt works out, or school for substance use
  • Continued substance use despite substance-related relationship problems
  • Reducing or quitting other hobbies and activities as a result of substance use
  • Risky or unsafe behavior while under the influence of substances
  • Using the substance despite the fact that it causes or worsens physical or mental health problems
  • Developing a tolerance to the substance and demanding more and more to achieve the same effect.
  • experiencewithdrawal symptomswhile not taking the substance and feel the need to take it to avoid withdrawal

diagnostic criteria

Based on the number and severity of the person's symptoms, the healthcare provider determines whether the substance use is a cause for concern and whether the person has a mild, moderate, or severe substance use disorder.

Himdiagnostic criteriaThey are as follows:

  • Mild substance use disorder:Two or more of these symptoms in the past 12 months (this is the boundary between occasional substance use and substance use disorder)
  • Moderate substance use disorder:Four to five of these symptoms in the past 12 months
  • Severe substance use disorder:Six or more of these symptoms in the past 12 months


Substance use is often a precursor to developing a substance use disorder. In fact, experimenting with a substance or using it occasionally can be the first step in developing a substance use disorder for some people.

Causes of Substance Use

Substance use often begins in the following ways:

  • Taste of substance:People often start using substances out of curiosity, as an experiment, or for pleasurepeer pressure.
  • Take the substance to feel good:People use substances to experience feelings of intoxication and pleasure, commonly known as a "high."
  • Taking the substance to make it better:Some people use substances to improve their performance, alertness, energy, and cognition.
  • Using the Substance to Feel Better:People sometimes turn to substances to forget their problems, to relieve stress,reduces painand feel numb.

Causes of substance use disorder

Once a person starts using substances, they may be at risk of developing a substance use disorder. Here are some factors that may contribute to your risk of developing a substance use disorder:

  • genetic vulnerability
  • social pressure
  • environmental stressors
  • mental illness
  • individual personality traits.
  • The effect of the substance.

Cultural, social, religious, historical, and legal factors may also play a role in what forms of substance use are acceptable.For example, public laws determine whatsubstancesare legal or illegal and how much of a substance is legal to use. In addition, some cultures discourage the use of certain substances and allow others.

Why mental health disorders coexist with substance use


professionalsthose certified or licensed in addiction medicine can determine if a person's substance use is of concern and diagnose and treat a substance use disorder, O'Neill says. Your family doctor can issue a referral to a specialist if necessary.

According to O'Neill, the diagnostic process involves a thorough evaluation, which typically includes:

  • An interview with the person using a substance
  • Conversations with other people who may be in the person's life.
  • Using diagnostic tools to determine if the person's symptoms meet the diagnostic criteria for a substance use disorder listed in the DSM-5-TR
  • A physical examination or other tests to determine the level of consumption of the person, to assess their state of health and to check for other physical ormental illness

It's important to be open and honest with your doctor about your symptoms and substance use so your doctor can accurately determine if your substance use is of concern and if you have a substance use disorder or are at risk of developing a substance use disorder.

"Proper diagnosis is critical to ensuring you receive the best possible treatment," says O'Neill.


If the person's healthcare professional determines that the substance use is problematic and the person has a substance use disorder, the person may need treatment.

treatmentit includes a professional evaluation and treatment plan to meet a person's individual needs for sustainable recovery, O'Neill says. "The treatment plan may vary depending on several factors, including the severity of the application and the person's resources and sources of support."

According to O'Neill, treatment for a substance use disorder may include:

  • detoxification
  • medicine
  • therapy
  • Self-help group meeting
  • Treatment in an outpatient, inpatient or inpatient facility
  • Aftercare like sober living
  • Other forms of education, awareness, or support

8 Common Misconceptions About Substance Abuse


Below, O'Neill outlines some steps that can help prevent substance use and substance use disorders.

Prevention of substance use

The best approach to preventing substance use is to provide full education and support at every opportunity.

Maeve O'Neill, MEd, LPC-S, CHC, CDTLF

It is important to educate children, adolescents and adults about the prevalence and dangers of substance use and to help them develop resilience skills to avoid substance use.

— Maeve O'Neill, MEd, LPC-S, CHC, CDTLF

Prevention of substance use disorders

Substance use disorders can be prevented if we build systems of care that help us intervene in the early stages of use. Schools and communities must work together to actively find and correct the conditions that lead to substance use disorder, to prevent, ormitigate its effects.


Substance use is a broad term that includes all instances of use of harmful substances such as alcohol, drugs, nicotine,CANNABIS, or prescription drugs. Substance use disorder, on the other hand, is a medical condition that specifically relates to the problematic use of these substances to the extent that the person experiences negative consequences in various areas of their life.

Experimenting with or using a substance occasionally is often a precursor to a substance use disorder, particularly when someone is predisposed to it because of genetic, social, environmental, or individual factors. It is therefore important to take steps to prevent substance use, particularly amongYoung peopleto prevent substance use disorders.

A qualified healthcare professional can diagnose whether a person's substance use problem is problematic and meets the diagnostic criteria for mild, moderate, or severe substance use disorder listed in the DSM-5. Based on their assessment, they develop a treatment plan for the person.

A word from Verywell

If you're concerned about your substance use and think you might be at risk for a substance use disorder, the best thing to do is seek help and information, says O'Neill. “There are many consultants, coaches andSelf-help group meetingthat can help you to understand it and learn more about it. You are not alone and recovery is possible."

How to Help an Addict: Resources and Treatment

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