Definitions and differences between drug abuse/misuse/addiction/dependence in less than 5 minutes

Today I tried a new approach.

This is an article but more like slides…

The so-called addiction terminology (such as drug/substance abuse, drug misuse, drug addiction, drug dependence) needs clarity in our minds, there are key differences between them and its good to understand the difference.

I’ve tried to mention key points about these and in a way that’s meant for taking-home points… Recall is one of the goal of this article…

If you read this, you can get key definitions and differences between these terms in less than 5 minutes, at least that’s what I wish for..

Psst… They make excellent interview questions, takes less than 5 minutes.. so read on :)

Drug abuse:

• Persistent or sporadic, intentional excessive use of medicinal product, which is accompanied by harmful physical or psychological effects

• Intentional and excessive use that always leads to harm

• Taken to get high or inflict self-harm (the intent)

Drug misuse:

• Situations where the medicinal product is intentionally and inappropriately used not in accordance with the terms of the marketing authorization

• Here intentionally misuse occurs (like abuse)

• Difference is, misuse is not in accordance to term of MA but not necessarily excessive use

• May or may not lead to ADR

• Not associated with withdrawal, relapsing or chronicity

• Psychological and physical harm not necessary

• May or may not be excessive

• Drug misuse is generally associated with prescription medicines

• Prescription medicines are meant to be taken as directed by doctors

• Drug misuse happens when these substances are taken for a purpose that is not consistent with terms of market authorization (MA)

• Drug misuse is for treatment (the intent, not always but generally)

The six types of drug misuse:

1. How much → Incorrect dose- Taking the incorrect dose

2. When-> Wrong time- Taking the drug at the wrong time

3. Omission of dose à Forgetting to take a dose (missing doses)

4. Till when → Schedule → Stopping the use of a drug too soon

5. For what → Indication → Taking a drug for reasons other than why they were prescribed

6. What → Drug itself à Taking a drug that was not prescribed

The exact difference between drug abuse and drug misuse (intent):

• The key difference between a person who misuses drugs and a person who abuses drugs is their intent (treatment vs getting high/self-harm)

• In misuse à patient takes a drug to treat a specific ailment, whereas the latter uses a drug to elicit certain feelings (get high/ self-harm)

• An example of drug misuse is when a person who can’t fall asleep after taking a single sleeping pill takes another pill an hour later hoping that “it’ll do the job.” However, it’s drug abuse when a person consumes sleeping pills to manage their moods or acquire a “buzz,” or — in worst-case scenarios — to commit suicide.

Drug Addiction:

• Addiction: A chronic, relapsing disorder characterized by compulsive (or difficult to control) drug seeking and use despite harmful consequences, as well as long-lasting changes in the brain

• Uncontrollable use of a substance despite its consequences

Addiction implies:

• Chronic pattern

• Relapsing

• Compulsive

• Physical harm to the brain

• Harm to the body

• Withdrawal symptoms

• Drug seeking behavior becomes the central feature of life

Drug dependence/ Substance dependence

• When people use the term “dependence,” they are usually referring to a physical dependence on a substance.

• Dependence is characterized by the symptoms of tolerance and withdrawal

• Dependence can be mental or physical

• Mental dependence:

• Mental dependence is when use of a substance is a conditioned response to an event or feeling.

• These are known as “triggers.”

• Something as simple as the act of driving can trigger a desire to use.

• These triggers set off biochemical changes in a person’s brain that strongly influence addictive behavior

• Triggers can be emotional responses to events, certain people, places or anything a person associates with using a substance

Mental dependence:

• Use of a substance is a conditioned response to an event or feeling

• Deeply ingrained biochemical change in the brain by substance use

• However, the main characteristic that distinguishes addiction from dependence is the combination of mental and physical dependence with uncontrollable behavior in obtaining and using a substance

• Abuse and dependence are defined on a scale that measures the time and degree of substance use.

• Essentially, abuse is like the early stage of dependence.

• As substance abuse becomes more frequent, the likelihood of developing a dependence disorder becomes greater

How is drug abuse different from drug addiction?

• Drug addiction is a severe form of drug abuse (harm, withdrawal and relapse)

• The distinction between the two disorders lies in how much control the user can exercise over themselves (self-control).

• Since a person who abuses drugs still has control over their life, they don’t experience major disruption in their life.

• In contrast, those with an addiction have a disorder that affects most if not all aspects of their lives.

• They often miss work or school, endanger their families physically and/or financially, suffer health problems, get into legal trouble, and other serious issues because of their substance use.

• But despite these, they are unable to change their habits to improve their situation.

Drug dependence vs Drug addiction:

• When people use the term “dependence,” they are usually referring to a physical dependence on a substance

• Dependence is characterized by the symptoms of tolerance and withdrawal

• Addiction is marked by a change in behavior caused by the biochemical changes in the brain after continued substance abuse.

• Substance use becomes the main priority of the addict, regardless of the harm they may cause to themselves or others.

• An addiction causes people to act irrationally when they don’t have the substance they are addicted to in their system.

• Addiction encompasses both a mental and physical reliance on a given substance.

• So addiction both physical + mental, dependence more physical symptoms

• Abuse and dependence are defined on a scale that measures the time and degree of substance use

• Essentially, abuse is like the early stage of dependence. As substance abuse becomes more frequent, the likelihood of developing a dependence disorder becomes greater

So Abuse vs Misuse vs Addiction: the final word

• Misuse → use of drug to treat something intentionally, not as per MA terms patient has self-control, no self-harm intention, QOL can be normal, no relapse/withdrawal symptoms and physical or psychological harm

• Abuse → Intentional excessive use of a drug to get high or self-harm → patient has fair enough degree of self-control → QOL can be normal, harm may occur but relapse, withdrawal and psych harm not applicable

• Addiction →total lack of self-control → repeated intake of a substance despite obvious harm and adverse consequences → relapse and withdrawal symptoms → QOL severely impaired → Major disruption along all aspects of life

• Dependence → Highest degree of abuse → Tolerance (need for increased dose to get same effect), withdrawal symptoms, physical/mental, uncontrollable

• So explain this difference on the parameters of self-control, quantity, harm, QOL and life-disruption, psychological symptoms

I tried to simplify terminology that PVG professional would find useful, these all make good interview questions as well.

This is my understanding of these topics and a way to make it easy for you, my readers… If you feel like adding, agreeing or disagreeing, please write to me in comments or private messages..

Would love to discuss :)

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🏳️‍🌈 Aditi Sheth 🏳️‍🌈

🏳️‍🌈📚 Bookworm fueled by curiosity | 750+ Certificates | PBRER | Aggregate reports | Artificial Intelligence | Trained Psychologist | Introvert | ISFJ |MBBS