Several terms are used interchangeably when referring to drug or alcohol use, such as “substance use disorder,” “dependency” and “addiction.”
But aren’t these all the same thing?
Not completely. While there may be functional similarities between these terms — for example they all involve some degree of habitualized substance use — there are some important distinctions to be noted.
Continue reading to learn about the nuances of each of these terms.
What does “substance use disorder” mean?
A substance use disorder (SUD) refers to the problematic consumption of a psychoactive substance. Examples of these include nicotine, alcohol, marijuana, opioids, stimulants, depressants and hallucinogens. An individual develops a SUD when they continue to consume the substance, despite increasingly negative consequences.
The DSM-5 has a list of criteria to help health providers diagnose the condition. These include:
- Using the substance in larger amounts or for longer than intended
- Wanting to cut down or stop using unsuccessfully
- Spending significant time obtaining and using the substance, as well as recovering from its effects
- Craving another use
- Managing commitments or fulfilling obligations less capably due to substance use
- Continuing substance use even when it causes problems in relationships
- Giving up important activities because of substance use
- Continuing to use the substance even when becomes dangerous
- Continuing substance use even when it exacerbates physical or psychological problems
- Developing an increased tolerance for the substance
- Experiencing withdrawal symptoms when not using the substance for a length of time
According to the DSM diagnostic criteria, the presence of an SUD is categorized in the following ways:
- Fewer than 2 symptoms present: no disorder
- 2-3 symptoms present: mild SUD
- 4-5 symptoms present: moderate SUD
- 6 or more symptoms present: severe SUD.
Given this wide range of severity, “substance use disorder” is a generalized, clinical term that can encompass a range of symptoms and stages. SUD applies in some fashion to any experience of dependency or addiction.
What does “dependency” mean?
Chronic exposure to a substance over an extended period of time causes alterations in the body. The brain and the central nervous system change in response to the consistent presence of the substance, like when someone is prescribed an opioid for chronic pain management, for example. The body gradually becomes resistant to the effects of the substance, which is referred to as increased tolerance. This prompts the person to consume higher amounts.
The development of a physical dependence becomes evident when a dose wears off or the individual starts to experience withdrawal symptoms. These are highly unpleasant effects, which vary depending on which substance is involved. Someone who has developed physical dependence may or may not go on to experience addiction.
What does “addiction” mean?
Addiction is the most serious form of SUD. According to the definition provided by the American Society of Addiction Medicine, addiction is “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.”
What sets addiction apart from physical dependency is its compulsive element, which is a result of the effect of the substance on the brain’s reward system. When the substance is ingested, it causes increased dopamine production. Dopamine causes the individual to experience a pleasurable, euphoric effect, which is registered in the reward center of the brain. This leads to cravings, substance-seeking behaviors, and then repeated, compulsive use of the substance, even when continuing the substance use causes harm to the individual’s life.
When a SUD has evolved to the point where the individual is no longer in control of the consumption, despite negative consequences, a comprehensive treatment program can be the best course of action. Through the structured phases of treatment starting with withdrawal management, the individual will learn new ways to manage cravings and other triggers. Just as with other types of disease, a SUD can be managed using a combination of expert and social support systems.
Ashley Addiction Treatment, formerly Father Martin’s Ashley, is a nationally recognized nonprofit leader in integrated, evidence-based treatment for substance use disorders. Our programs are accredited by The Joint Commission, and result in frequent publications of ongoing research into effective treatment methodologies. We offer holistic care that encompasses the mind, body and spirit through inpatient and outpatient treatment, provide drug detox, relapse prevention plans, family wellness programs and a variety of other services tailored to each patient’s unique needs. Our driving principle — “everything for recovery” — reinforces our mission to transform and save lives through the science of medicine, the art of therapy and the compassion of spirituality, and is complemented by our philosophy of healing with respect and dignity. For information about our comprehensive programs, please call (866) 313-6307.