Substance use and substance use disorder differ by the frequency of use and the effect on a person’s life. Substance use disorder is a mental health condition.
Substance use refers to using both legal and illegal substances.
Substance use disorder, a diagnosis that is the combination of what was previously called substance abuse and substance dependence, is a health condition in which a person experiences a pattern of symptoms surrounding compulsive substance use that occurs despite adverse effects on their life and daily functioning, including issues with:
- health
- work
- school
- home
- relationships
Substance use disorder can occur with legal and illegal substances as well as prescription and nonprescription medication.
However, not all people who engage in substance use develop substance use disorder.
Keep reading to learn more about what distinguishes substance use disorder from substance use, what factors might have an impact, and where to get help.
Why isn’t “substance abuse” used anymore?
The term “substance abuse” is no longer used.
This is because the word “abuse” carries and contributes to stigma and judgment.
The term “abuse” instead implies that it is an action a person is taking. While use of a substance may be voluntary at first, substance use disorder can impair a person’s judgment, decision making, memory, and behavior control over time.
Substance use disorder is a medical and mental health condition with identifiable causes and risk factors. The change in terminology reflects this. Like many other health conditions, substance use disorder disrupts the usual functioning of an organ in the body (the brain), has serious harmful effects, and may be preventable and treatable.
While substance use may have negative health consequences, it may not necessarily become substance use disorder.
Substance use disorder typically develops over time, with substance use increasing in frequency from:
- Experimental or prescription use: A person may try a substance once or take a prescription drug as directed by a doctor.
- Occasional use: A person may use the substance in certain situations or use a prescription drug in a way not directed by a doctor.
- Regular or heavy use: A person may take a substance habitually.
- Substance use disorder: A person may take the substance daily or multiple times daily. They may rarely not be using the substance.
People may be more likely to develop substance use disorder for many reasons, including:
- genetics (having specific genes
may increase your risk) - history of trauma, including physical, sexual, or emotional abuse
- mental health conditions, like depression and anxiety
- being around others who use the substance
- using substances at an early age
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), the criteria for substance use disorder include:
- Using more of a substance than you intend to or using it for longer than you’re meant to.
- Trying to cut down or stop using the substance but being unable to.
- Experiencing intense cravings or urges to use the substance.
- Needing more of the substance to get the desired effect (tolerance).
- Developing discontinuation symptoms when not using the substance.
- Spending more time getting and using the substance and recovering from use.
- Neglecting responsibilities at home, work, or school because of substance use.
- Continuing to use even when it causes relationship problems.
- Giving up important or desirable social and recreational activities due to substance use.
- Using substances in settings that put you in danger.
- Continuing to use despite the substance causing problems to your physical and mental health.
Substance use disorder can also range from mild to severe, depending on the number of criteria a person meets.
- One symptom could indicate a person is at risk of a substance use disorder.
- Two or three criteria point to a mild substance use disorder.
- Four or five symptoms show that someone has a moderate substance use disorder.
- Six or more criteria indicate a severe substance use disorder, which signals an addiction to that substance.
If you are trying to reduce or stop your substance use, help is available.
Depending on your level of use and the specific substance, stopping use abruptly after habitual use can be dangerous or life threatening. Some substances that cause withdrawal syndromes include:
It’s best to talk with a healthcare professional if you are trying to stop using a substance after heavy, habitual use. They may prescribe medication to reduce withdrawal symptoms or admit you for monitoring during the withdrawal period. They may also recommend tapering off, or slowly reducing your intake, under the guidance of a medical professional.
Stopping substance use can be difficult. The journey may not be linear, and setbacks are possible.
Resources for substance use disorder
- Above the Influence provides information targeted at youth and young adults regarding substance use, peer pressure, and treatment options.
- The Substance Abuse and Mental Health Services Administration (SAMHSA) offers free resources and referrals to treatment. If you have questions or need help, call the 24/7 helpline at 800-662-HELP (4357).
The National Institute on Drug Abuse provides information and research for teenagers and young adults about substance use disorders.- The National Association for Children of Alcoholics provides information and resources for children of parents with alcohol use disorder.
- Al-Anon provides confidential groups and meetings across the United States for adult friends and family members of people who misuse alcohol. Call 888-4AL-ANON (888-425-2666) for more meeting information.
- Alateen provides confidential groups and meetings across the United States to help teenagers and young adults cope with a friend or family member’s alcohol use. Try Alateen chat.
- Alcoholics Anonymous (AA) offers in-person and virtual meetings and support groups for people in recovery from alcohol addiction or misuse.
- Narcotics Anonymous (NA) offers in-person and virtual meetings and support groups for people in recovery from narcotic addiction or misuse.
Substance use and substance use disorder both involve substance use but differ in terms of their impact on your life and the associated symptoms.
Substance use disorder is a mental health condition that can range in severity.
Regardless of the substance, help is available to help reduce your intake or help you stop use altogether.