Drug use vs drug abuse

It is very important to recognize the difference between drug use and drug abuse. Here are a few terms and misconceptions on this topic as well as some information on the stigma around drug addiction and around non-harmful drug use.

Drug Use -
The use of any drug. This includes alcohol, tobacco, caffeine, and prescribed medication.

Drug Misuse -
Use of a legal or prescribed substance in a harmful and or unintended way. This can include taking more medication than prescribed to get high or forming harmful habits around alcohol, cigarettes, or caffeine.

Drug Abuse -
Recurrent substance use resulting in a failure to fulfill major role obligations in your school, work, home, or social life.

Addiction/dependence -
The term used to describe a situation in which a person would experience negative symptoms from immediately discontinuing use. This includes both psychological and physical repercussions. Addiction is assumed if the person has been using regularly (Once every 1-2 days) for longer than a week or two and is reluctant to stop. Addiction is also assumed if the person has gained a tolerance and needs to take more than they initially did to feel effects. It is important to note that a person does not have to be getting high to form a physical dependence on a drug. Also, psychological addiction is often co-morbid with physical addiction.

What is the difference between drug use and abuse?

 Drug use is not always unhealthy while, by definition, drug abuse is impairing your ability to lead a normal lifestyle. It is possible to use drugs in a healthy, non life-impairing way. This applies to both legal and illegal substances. Drug use turns into drug abuse when they begin to use as an addict would, whether or not addiction has yet to form.

What is the difference between misuse and abuse?

Misuse is when you use a substance in a way that it is not intended such as taking more medication than prescribed to get high or forming harmful habits around alcohol, cigarettes, or caffeine. This would turn into drug abuse if you began to experience an inability to live your life as you did before the drug use began due to the use of the substance. This could look like someone begins taking more anti-anxiety medication than prescribed and begins to ignore friends in favor of getting high.

What does physical addiction mean?

Addiction is the point at which you experience withdrawal from discontinuing use. This happens because your brain becomes accustomed to the altered chemical levels and when they suddenly return to normal it is very unpleasant.

Can addiction exist outside of physical dependence?

The answer I am sad to give to you is yes. Addiction does not always mean you are physically dependent. Psychological addiction exists and is just as harmful as physical addiction. Here are some examples of habits that aren’t physically addiction forming but CAN cause a psychological dependence:

- The use of many substances where, if all drugs had the same properties, it would form an -addiction.
- The use of a non-chemically addictive drug, such as marijuana, in a habitual and consistent way.
- Things like self-harm or purging

Is addiction always bad?

Drug addiction implies only that you are somehow dependent on the substance. There are people who smoke cigarettes and drink coffee every single day who would shake and have headaches if they stopped. These people are, in the most technical sense, addicted to drugs. Also, there are are people who are consistently taking opiates for pain and would experience withdrawal symptoms if they were to stop taking their medication. But we would not consider these people addicts in the same way we would someone smoking meth or heroin. This is the line that exists between addiction and abuse. Also, take a look at my post on misconceptions about addicts HERE to understand a bit more about the behavior of addicts.

A note before we get into this next section:

No one wants to be accused of encouraging risky behaviors so I will say this now: I am not telling you to use drugs. I do, however, very strongly believe in harm-reduction based education, especially in relation to substance use. I want to give you the all the facts you could need to stay safe, not just the ones that apply to legal behaviors.

The stigma around drug education

We teach drug use in the sad and ineffective way we used to teach sex education: abstinence only. (Just kidding we still use abstinence only sex-ed in 23% of public schools in the U.S.*) It is silly to tell someone not to ever use drugs because it is bad for them in the same way it is ineffective to tell teens not to have sex because they could get an STI or cause a pregnancy. Both these things feel good but have risks and people are scared to talk about safety or experience in fear of being accused of encouraging risky behavior. 

 Is there a difference between the use/abuse of legal and illegal substances?

Yes, absolutely. There are two main differences. The first is that most drugs that are illegal completely or only available as a prescription, have some danger of brain damage or death if used recklessly. The second, equally important difference, is there is less education on safe use. We will tell people “Don’t drink eight energy drinks in one sitting, you will get really tired and have lots of headaches and it could even be bad for your heart”. But we don’t tell people “Don’t do more than 1-2 points of ecstasy in a month because you run the risk of getting serotonin syndrome which can make life really tiring forever or even kill you”. The lack of availability of educational resources

Can the use of illegal substances ever be helpful?

Many illegal substances have positive cognitive effects such as helping with depression or anxiety. They can also help with relaxation, sleep, and self-awareness. Of course, these positives do not erase the risks.

For some ways to stay safe when using psychoactive substances, look HERE.