Substance abuse is characterized by a pattern of repetitive use of mood and/or behavior-altering substance(s) in such a way as to result in adverse social consequences including failure to fulfill social or occupational obligations as they relate to work, family, interpersonal relationships, and the legal system. Substance abuse commonly leads to legal troubles in addition to physical or mental health issues for the substance abuser and in many cases endangers the social welfare of others i.e. passengers in a car driven by an alcohol abuser that wrecks and injures of kills the other occupants).

Commonly abuses substances include alcohol, anabolic steroids, amphetamines, cannabis (marijuana), cocaine, hallucinogens, inhalants, opiates, PCP, sedatives, hypnotics, and prescription drugs. Substance abuse differs from substance dependence in that substance dependence is defined in terms of physiological or behavioral symptoms and substance abuse deals more with the social consequences caused by substance abuse.

Substance abuse commonly is a precursor to substance dependence. In medical terms, substance dependence requires the development of a tolerance that leads to withdrawal symptoms in the absence of the substance being abused. Both substance abuse and substance dependence are distinct from addiction which is defined as the compulsive continuation of substance abuse despite the negative consequences which may or may not involve dependency. Individuals who suffer from substance dependence nearly always are substance abusers. On the other hand, substance abuse commonly occurs with no dependence.

Drug Abuse

Drug abuse, drug addiction, and chemical dependency are commonly used as synonyms for substance abuse. While there is no universally accepted definition of substance abuse, all use of illicit drugs outside of societal norms or as directed by a physician can be considered substance abuse.

History

As recently as the 1950s, alcohol and drug abuse were considered to be symptoms of moral weakness and deeper psychological disorders according to the first edition of the American Psychiatric Association's Diagnostic & Statistical Manual of Mental Disorders (DSM).

The opinion of the medical community has changed over time recognize substance abuse and substance dependence as involving social and cultural factors too. Substance abuse was defined as "problematic use with social or occupational impairment" but abuse involves no withdrawal or tolerance. Substance dependence is differentiated from substance abuse by the existence of withdrawal symptoms.

Definitions of substance abuse and dependence continue to evolve. Behavioral and physiological factors were given equal weight for the first time in 1987 when "psychoactive substance abuse" was defined as "a maladaptive pattern of use indicated by continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use or by recurrent use in situations in which it is physically hazardous."

Only a year later the DSM definition of substance dependence was "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is defined as "problematic use without compulsive use, significant tolerance, or withdrawal."

In 2010, the 5th edition of the DSM is scheduled for release and you can bet the definitions will reflect the latest research and findings in the field of substance abuse and dependence. Those involved are aware of the confusion caused by the constantly changing definitions not only in the general public but within the medical community as well.

Despite technicalities in the medical definitions, common sense says that if an individual uses (or more likely abuses) substances in such a manner is to be disruptive to his or her social or professional lives or causes legal troubles then that person has a substance problem. Whether that problem is abuse, dependence, or addiction is not nearly as important as acknowledgment of the issue and the sense to seek treatment. Unfortunately, many substance abusers won't acknowledge the reality of the situation and won't seek treatment. This pattern of substance abuse left unchecked can destroy lives but as is often said only those who truly want to be helped can be helped.