Substance Abuse vs Substance Dependence. What’s the difference?

When Mary was feeling down, she drank way too much.

Jim drank too much too, but his dependence on alcohol was so severe that it caused uncontrollable cravings and he made very unhealthy decisions.

What’s the difference between Jim and Mary?

Mary probably has a substance abuse problem – a serious issue, but maybe different from Jim's issue. Jim’s issue is might be something more serious though – substance use disorder, which is more commonly known as substance dependence.

Substance abuse may lead to dependency, which is a physical problem because the substance abuse has changed the way a brain works and limits its ability to function. A person with substance dependence has built up a tolerance to alcohol, drugs or some other substance and needs to increase the amount he/she is taking to achieve the same intoxication.

• Is unable to think clearly
• Has impaired judgment
• Has difficulty learning
• Is unable to control his/her behavior

The symptoms of a substance dependence often mirror those of mental health problems.

Some research suggests half of those with severe mental health issues also are abusing a substance. About 37 percent of those abusing alcohol and 53 percent of those with a drug addiction have at least one serious mental health illness, according to the National Alliance on Mental Illness.

The National Institute on Drug Abuse defines drug addiction as a mental illness because of those changes in the brain brought on by substance abuse.

Jim could exhibit physical, social and behavior changes with his condition, such as legal problems, unexplained weight loss or gain and sudden mood swings, according to Mental Health.Gov.

If you ask Jim about his problem, he will deny it. He will also show signs of withdrawal if unable to use the substance such as extreme anxiety or shakiness. He will also engage in dangerous behavior like abusing a substance while driving a car or at work.

Jim’s problem is serious and his physical and emotional well-being will not improve unless he gets treatment, which may include rehabilitation, counseling and support groups

Want to get Jim some help? Make an appointment with our Outpatient Center.