Substance Use vs. Substance Abuse: What Are the Differences?

Table of ContentsView AllTable of ContentsWhy the Term “Substance Abuse” Is No Longer UsedSymptomsCausesDiagnosisTreatmentPreventionSummary

Table of ContentsView All

View All

Table of Contents

Why the Term “Substance Abuse” Is No Longer Used

Symptoms

Causes

Diagnosis

Treatment

Prevention

Summary

If you’ve heard the terms “substance use” and “substance abuse,” you may wonder whether they mean the same thing or whether there’s any difference between them.

Both terms refer to the act of utilizing substances, such as alcohol, drugs, nicotine, cannabis, or prescription medications.However, one refers specifically to problematic use, whereas the other is a broader term that refers to all substance use, problematic or otherwise:

Read ahead to learn more about the differences between substance use and substance abuse (the remainder of the article will use the term “substance use disorder” rather than “substance abuse”).

If you or a loved one are struggling with substance use disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

If you or a loved one are struggling with substance use disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

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.

Maeve O’Neill, MEd, LPC-S, CHC, CDTLFPreviously, the term ‘substance use’ was meant to describe mild use of a substance, and the term ‘substance abuse' was used to describe moderate or more severe use. We don’t use the term ‘abuse’ anymore, as language is important.

Maeve O’Neill, MEd, LPC-S, CHC, CDTLF

Previously, the term ‘substance use’ was meant to describe mild use of a substance, and the term ‘substance abuse' was used to describe moderate or more severe use. We don’t use the term ‘abuse’ anymore, as language is important.

What Is a Mental Health Advocate?

When does having a drink with friends or taking a painkiller for a headache (occasional substance use) turn into alcoholism or a painkiller addiction (substance use disorder)?

When the person starts to experience these symptoms, they may be diagnosed with a substance use disorder:

Diagnostic CriteriaBased on the number and severity of symptoms the person has, their healthcare provider will determine whether their substance use is a cause for concern and whether they have mild, moderate, or severe substance use disorder.Thediagnostic criteriaare as follows:Mild substance use disorder:Having two or more of these symptoms in the last 12 months (this is the threshold that separates occasional substance use from substance use disorder)Moderate substance use disorder:Having four to five of these symptoms in the last 12 monthsSevere substance use disorder:Having six or more of these symptoms in the last 12 months

Diagnostic Criteria

Based on the number and severity of symptoms the person has, their healthcare provider will determine whether their substance use is a cause for concern and whether they have mild, moderate, or severe substance use disorder.Thediagnostic criteriaare as follows:Mild substance use disorder:Having two or more of these symptoms in the last 12 months (this is the threshold that separates occasional substance use from substance use disorder)Moderate substance use disorder:Having four to five of these symptoms in the last 12 monthsSevere substance use disorder:Having six or more of these symptoms in the last 12 months

Based on the number and severity of symptoms the person has, their healthcare provider will determine whether their substance use is a cause for concern and whether they have mild, moderate, or severe substance use disorder.

Thediagnostic criteriaare as follows:

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

Causes of Substance Use

Substance use often starts out in the following ways:

Causes of Substance Use Disorder

After a person has started using substances, they may be at risk of developing substance use disorder. These are some factors that can contribute to the risk of developing substance use disorder:

Cultural, social, religious, historical, and legal factors can also play a role in determining what forms of substance use are acceptable.For example, public laws determine which substances are legal or illegal, and how much of a substance can be legally consumed. Additionally, some cultures discourage the use of certain substances and permit others.

Why Mental Health Disorders Co-Exist With Substance Use

Professionalswho are certified or licensed in addiction medicine can determine whether a person’s substance use is a cause for concern, and diagnose and treat substance use disorder, says O’Neill. Your primary doctor can provide a reference to a specialist, if needed.

According to O’Neill, the diagnostic process involves a complete assessment, which often includes:

It’s important to be open and honest about your symptoms and substance use with your healthcare provider, so they can accurately determine whether or not your substance use is a cause for concern and if you have or are at risk of developing substance use disorder.“Proper diagnosis is critical to ensure you receive the most helpful level of care,” says O’Neill.

It’s important to be open and honest about your symptoms and substance use with your healthcare provider, so they can accurately determine whether or not your substance use is a cause for concern and if you have or are at risk of developing substance use disorder.

“Proper diagnosis is critical to ensure you receive the most helpful level of care,” says O’Neill.

If the person’s healthcare provider determines that their substance use is problematic and they have substance use disorder, they may require treatment.

Treatmentinvolves a professional assessment and treatment plan to meet the person’s individual needs for sustained recovery, says O’Neill. “The treatment plan can vary depending on several factors, such as severity of use and the person’s resources and sources of support.”

According to O’Neill, treatment for substance use disorder can involve:

Substance Use vs. Substance Abuse: What Are the Differences?

Below, O’Neill outlines some steps that can help prevent substance use and substance use disorder.

Preventing Substance Use

The best approach to prevent substance use is to provide comprehensive education and support at all opportunities.

Maeve O’Neill, MEd, LPC-S, CHC, CDTLFIt’s important to teach children, adolescents, and adults about the prevalence and dangers of substance use and help them develop resilience skills to avoid using substances.

It’s important to teach children, adolescents, and adults about the prevalence and dangers of substance use and help them develop resilience skills to avoid using substances.

Preventing Substance Use Disorder

Substance use disorder is preventable if we build systems of care that help us intervene at earlier stages of use. Schools and communities need to work collaboratively together to actively find and correct the conditions that lead to substance use disorder, in order to prevent it or mitigate its effects.

Substance use is a broad term that encompasses every instance of using harmful substances such as alcohol, drugs, nicotine,cannabis, or prescription medications. Substance use disorder, however, is a medical condition that refers specifically to problematic use of these substances, to the extent that the person experiences negative consequences to several areas of their life.

Trying a substance or using it occasionally is often the precursor to substance use disorder, particularly if someone is predisposed to it due to genetic, social, environmental, or individual factors. Therefore, it’s important to take steps to prevent substance use, particularly among young people, to help prevent substance use disorder.

A qualified healthcare professional can diagnose whether a person’s substance use 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 will work out a treatment plan for the person.

What This Means For YouIf you’re worried about your substance use and think you might be at risk for a substance use disorder, the best thing to do is to seek help and information, says O’Neill. “There are many counselors, coaches, andsupport group meetingsthat can help you understand and learn more about it. You are not alone and recovery is possible."

What This Means For You

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

How to Help an Addict: Resources and Treatment

8 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.McLellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.National Institute on Drug Abuse.Terms to use and avoid when talking about addiction.American Psychiatric Association.Substance-related and addictive disorders.NAMI.Substance Use Disorders.Hasin DS, O’Brien CP, Auriacombe M, et al.DSM-5 criteria for substance use disorders: Recommendations and rationale.Am J Psychiatry. 2013;170(8):834–851. doi:10.1176/appi.ajp.2013.12060782National Library of Medicine.Substance use disorder.Medline Plus.Robinson SM, Adinoff B.The classification of substance use disorders: historical, contextual, and conceptual considerations.Behav Sci (Basel). 2016;6(3):18. doi:10.3390/bs6030018National Library of Medicine.Drugs and young people.

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.McLellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.National Institute on Drug Abuse.Terms to use and avoid when talking about addiction.American Psychiatric Association.Substance-related and addictive disorders.NAMI.Substance Use Disorders.Hasin DS, O’Brien CP, Auriacombe M, et al.DSM-5 criteria for substance use disorders: Recommendations and rationale.Am J Psychiatry. 2013;170(8):834–851. doi:10.1176/appi.ajp.2013.12060782National Library of Medicine.Substance use disorder.Medline Plus.Robinson SM, Adinoff B.The classification of substance use disorders: historical, contextual, and conceptual considerations.Behav Sci (Basel). 2016;6(3):18. doi:10.3390/bs6030018National Library of Medicine.Drugs and young people.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

McLellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.National Institute on Drug Abuse.Terms to use and avoid when talking about addiction.American Psychiatric Association.Substance-related and addictive disorders.NAMI.Substance Use Disorders.Hasin DS, O’Brien CP, Auriacombe M, et al.DSM-5 criteria for substance use disorders: Recommendations and rationale.Am J Psychiatry. 2013;170(8):834–851. doi:10.1176/appi.ajp.2013.12060782National Library of Medicine.Substance use disorder.Medline Plus.Robinson SM, Adinoff B.The classification of substance use disorders: historical, contextual, and conceptual considerations.Behav Sci (Basel). 2016;6(3):18. doi:10.3390/bs6030018National Library of Medicine.Drugs and young people.

McLellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.

National Institute on Drug Abuse.Terms to use and avoid when talking about addiction.

American Psychiatric Association.Substance-related and addictive disorders.

NAMI.Substance Use Disorders.

Hasin DS, O’Brien CP, Auriacombe M, et al.DSM-5 criteria for substance use disorders: Recommendations and rationale.Am J Psychiatry. 2013;170(8):834–851. doi:10.1176/appi.ajp.2013.12060782

National Library of Medicine.Substance use disorder.Medline Plus.

Robinson SM, Adinoff B.The classification of substance use disorders: historical, contextual, and conceptual considerations.Behav Sci (Basel). 2016;6(3):18. doi:10.3390/bs6030018

National Library of Medicine.Drugs and young people.

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