The simplest way to think about these diagnoses is that substance abuse is the less severe of the two. Both involve the repeated use of mind-altering/mood-altering substances in a manner that causes disruption and harm to a person’s life. As abuse progresses to dependence, additional symptoms of tolerance (needing to take more of something to achieve the same “high”) and physical and psychological dependence occur. Additionally, as more areas of a person’s life become negatively impacted by use (loss of job, loss of important relationships, and legal problems such as receiving a Driving under the Influence Citation DUI/DWI), the diagnosis will shift from abuse to dependence.
Substances of abuse and dependence include alcohol, some over the-counter drugs, nicotine, and many prescription medications, as well as illegal substances. Some consider all use of illegal drugs as meeting the criteria for substance abuse, as it places the individual at risk for being arrested.