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Substance Abuse vs Dependence vs Addiction

Substance Abuse-Dependence-Addiction

As you know, the use, misuse and abuse of drugs and alcohol can have serious consequences. Did you know that substance abuse can lead to other health issues such as addiction and dependence, which are both considered diseases? The use of drugs affect the brain’s response and reaction, and scientific research by the National Institute on Drug Abuse (NIDA) shows that drug addiction and dependence are diseases that affects both brain and behavior. Let’s look at the nature and progression of substance use that leads to abuse, dependence and addiction.

Substance Abuse Defined

Substance abuse occurs with the excessive use or misuse of a drug beyond its intended purpose or prescription. The most commonly abused substances are alcohol and prescription drugs. All use of illegal drugs is considered substance abuse. The most common reason for drug and alcohl abuse is the desire to achieve a certain feeling or sensation. Substance abuse, if not treated, often leads to dependence.

Substance Dependence Defined

Drug dependence on a substance develops when the brain’s neurons adapt to repeated drug exposure and only function normally in the presence of the drug. When the drug is withdrawn, several physiologic reactions occur. These can be mild (e.g., for caffeine) or even life threatening (e.g., for alcohol). This is known as the withdrawal syndrome. In the case of illegal drugs or even medically administered drugs such as morphine, withdrawal can be very serious and the user will use the drug again to avoid the withdrawal syndrome. Dependence often leads to addiction.

Substance Addiction Defined

Addiction of any kind is the display of compulsive behavior. In the case of drug and alcohol abuse, this compulsive behavior is reinforcing or rewarding to the user, in spite of the negative consequences of their behavior. A major feature of addiction is the loss of control when it comes to abstaining from the substance. Scientists have learned a great deal about the biochemical, cellular, and molecular bases of addiction; it is clear that addiction is a disease of the brain. When a person is addicted to a substance, the use of that substance targets certain cells in the brain which triggers a feeling of reward or satisfaction.

The NIDA research shows that it is possible for someone to be dependent on a drug but not addicted. An example given in the research is of a patient who has been administered morphine who experiences withdrawal symptoms after treatment has ended. However, that person may not have an addiction that compels them to use or abuse the drug.

Can you see how the use of a substance can lead to the abuse and ultimately an addiction? Substances like alcohol are especially dangerous when you consider this because it takes several drinks before most people even realize they have had too much. At the heart of this matter is the role of substance abuse prevention and education. If discovered soon enough, the abuse of drugs and alcohol can be prevented by educating people about the consequences and health risks associated with their use and misuse. Through prevention, we lower the number of people who move beyond abuse into the more advanced stages of dependence and addiction.

[Source: The Neurobiology of Drug Addiction (NIDA)]

If you or someone you know struggles with substance abuse, here are some resources for education, prevention and treatment:

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