Drug or substance abuse, dependence or addiction? Abuse and dependence (sometimes termed addiction) are formal psychiatric diagnoses with specified criteria. These criteria, which apply to all psychoactive substances, are provided in the DSM-IV used in the US and the International Classification of Diseases-10th revision used elsewhere in the world. The concepts, as well as the actual criteria, are actually quite similar.
Dependence refers to a loss of control over use of the drug. This results in continued use despite adverse consequences and inability to control how often or how much is used.
Drug abuse refers to continued drug use, even knowing the dangers and negative effects that are happening to the user. It is possible for people to be physically dependent on drugs without actually being addicted to them. Some blood pressure medications don’t cause addiction, for instance, but can cause a physical dependence. There are also other drugs, like cocaine, that cause addiction but don’t necessarily result in a physical dependence.
Drug tolerance, wherein people need higher doses of drugs to get the same effect, normally goes hand-in-hand with drug addiction.
Drug abuse may lead to drug addiction or dependence. People who take drugs in order to relieve pain might also become dependent on them. The exact causes of drug dependence and abuse are currently still debated. However, some of the factors that might lead to it include a person’s genes, peer pressure, the drug’s interaction with internal body systems, emotional distress, environmental stress, anxiety, and depression.
Although it is true that peer pressure might lead to drug abuse or use, most people who get addicted to drugs usually already suffer from a mental health condition, like depression, ADD, or post-traumatic stress disorder.
Children that live in environments where drugs are used illicitly might first watch their parents use various drugs. This could, in turn, place them at a high risk for getting addicted to drugs later on for either genetic or environmental reasons.
The people that are most likely to depend on or abuse drugs are usually those who:
The most commonly abused drugs today include:
There are various drug use stages that might eventually lead to dependence. In general, younger people tend to move much faster through these stages than adults do:
Experimentation — done recreationally and usually involves one’s peers; users might like the thought of defying authority figures, like their parents.
Regular use — users start missing more of school or of work; users start worrying about losing their sources of drugs; might use drugs to get rid of certain negative feelings; might start to avoid family members and friends; might find new friends who use more regularly; might show more tolerance and a professional ability at “handling” the drugs.
Daily preoccupation — users lose motivation; stop caring about school or work; have obviously different behaviors; drugs have become more important than everything else, including relationships; users become secretive; might start dealing drugs in order to support their own habits; might use more drugs or try out harder drugs; legal problems might increase.
Dependence — can’t bear thinking about life without any drugs in it; deny they have problems; physical conditions get worse; can’t control use anymore; might start thinking about suicide; legal and financial problems become worse; might completely break ties with friends or family members.
Some complications of drug dependence and abuse include: