Substance Abuse vs. Addiction

The diagnostic criteria for Substance Abuse is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

  • Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (i.e. repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household).
  • Recurrent substance use in situations in which it is physically hazardous (i.e. driving an automobile or operating a machine when impaired by substance use).
  • Recurrent substance-related legal problems (i.e. arrests for substance -related disorderly conduct).
  • Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (i.e. arguments with spouse about consequences of intoxication, physical fights).
  • Absence of dependence has been established.

The diagnostic criteria for Addiction or Substance Dependence is defined as a pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

  • Tolerance as defined by either of the following: (1) The need for markedly increased amounts of the substance to achieve intoxication or the desired effect; or (2) A markedly diminished effect with continued use of the same amount of the substance.
  • Withdrawal, as manifested by either of the following: (1) The characteristic withdrawal syndrome for the substance; or (2) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
  • Substance is often taken in larger amounts or over a longer period of time than intended.
  • There is a persistent desire or unsuccessful efforts to cut down or control substance use.
  • A great deal of time is spent in activities necessary to obtain the substance, use the substance or recover from its effects.
  • Important social, occupational, or recreational activities are given up or reduced because of use.
  • The use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the use (i.e. continued drinking despite recognition that an ulcer was made worse by alcohol consumption).

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United States