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Substance Abuse Vs. Addiction: What’s The Difference?

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Medically Reviewed By: Diana Vo, LMFT

May 30, 2023 (Originally Published)

February 1, 2024 (Last Updated)

Table of Contents

Although often believed to be the same, there are many key differences between substance abuse vs. addiction.

Substance abuse refers to a recurring and compulsive pattern of using substances that results in significant adverse effects on various aspects of life. This may manifest as frequent absences from work or school, legal complications, and difficulties in personal relationships.

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Addiction, by contrast, is a chronic and progressive brain disorder that is characterized by a psychological and/or physical dependence on alcohol or illicit or prescription drugs. Addiction – clinically described as substance use disorder (not to be confused with substance abuse disorder) is a condition in which individuals become reliant on substances, leading to a state of dependency.

Addiction Vs. Substance Abuse

If you or a loved one are struggling with substance abuse or addiction, it’s important to understand the key differences so that you can find the proper help to overcome it. 

Substance Abuse 

Substance abuse (also called drug abuse), refers to the misuse or excessive use of drugs or substances, even when a person is aware of the harm it can cause to their health.

Common examples of substance abuse include:

  • Taking illicit drugs like heroin or cocaine
  • Exceeding prescribed doses of medications
  • Combining substances to enhance their effects despite the risks
  • Recreational use of prescription drugs to seek pleasurable experiences
  • Binge-drinking alcohol 

Substance abuse can have significant and long-term effects on physical and mental health. All forms of substance abuse increase the risk of overdosing, which occurs when someone takes more of a drug than their body can handle. Overdosing is extremely dangerous and can result in severe, life-threatening consequences. 


Addiction, on the other hand, is a more complex condition characterized by a psychological and/or physical dependence on substances. 

Addiction goes beyond choice, as individuals experience a compulsive need for drugs or alcohol, regardless of adverse outcomes. Those diagnosed with addictions experience a loss of control over substance use, with their primary focus being obtaining and using the substance, even at the expense of personal and professional obligations. 

Tolerance, withdrawal symptoms, and the inability to stop or reduce substance use are diagnostic criteria for addiction.

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Addiction Quiz 

Substance use disorder (not to be confused with substance abuse disorder) is the clinical term for addiction and it is diagnosed based on specific criteria outlined in DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders).

 The following criteria provide a framework for understanding the severity of the disorder:

  1. Taking the substance in larger amounts or for a longer duration than intended.
  2. Making unsuccessful efforts to cut down or control substance use.
  3. Spending a significant amount of time acquiring, using, and recovering from the substance.
  4. Experiencing intense cravings or a strong urge to use the substance.
  5. Failing to meet important responsibilities at work, school, or home due to substance use.
  6. Experiencing relationship problems as a result of substance use.
  7. Giving up or reducing participation in significant activities due to substance use.
  8. Engaging in risky behaviors, such as driving under the influence of drugs or alcohol.
  9. Continuing substance use despite being aware of physical or psychological problems caused by it.
  10. Developing tolerance, requiring increasing amounts of the substance to achieve the desired effects.
  11. Experiencing withdrawal symptoms specific to the substance in its absence.

Meeting two or three criteria in a one-year period indicates a mild addiction, four or five criteria indicate a moderate addiction, and six or more criteria indicate a severe addiction.

Many individuals may encounter substance use problems but are able to address them without progressing to addiction. They can successfully alter their substance use patterns or cease using altogether, demonstrating that interventions and support can make a significant impact in promoting positive change.

Key Differences

Here is a snapshot of the key differences between substance abuse and addiction:

  • Behavior vs. disease: Substance abuse refers to a pattern of excessive or problematic substance use that may be associated with negative consequences. It primarily focuses on the individual’s behavior and choices. Addiction, by contrast, is considered a chronic brain condition that is characterized by compulsive drug-seeking behavior and the inability to control or stop substance use despite negative consequences.
  • Severity and chronicity: Substance abuse can range from occasional and mild misuse to more frequent and severe episodes. It may not necessarily progress into an addiction. Addiction, however, represents a more severe stage of substance use disorder, where the brain’s reward system becomes fundamentally altered, leading to persistent drug cravings, tolerance, and withdrawal symptoms.
  • Psychological vs. physical dependence: Substance abuse often involves the misuse of drugs or alcohol to achieve a desired psychological effect – relaxation or euphoria, for instance. The abuse may or may not lead to physical dependence. On the other hand, addiction is characterized by psychological dependence (intense cravings and preoccupation with obtaining and using the substance) and physical dependence (tolerance and withdrawal symptoms when substance use is stopped or reduced).
  • Voluntary vs. compulsive use: Substance abuse is generally viewed as a voluntary behavior where individuals have some level of control over their substance use. They may engage in occasional or recreational use without experiencing the compulsive patterns associated with addiction. With addiction, the control over substance use is significantly impaired, and individuals may experience intense urges or cravings that drive them to continue using despite negative consequences.
  • Treatment approaches: Substance abuse may be addressed through interventions like counseling, education, and behavioral therapies that aim to reduce or eliminate problematic substance use patterns. Addiction, being a chronic and complex disease, often requires a more comprehensive treatment approach that may involve a combination of behavioral therapies, medications, support groups, and ongoing management to promote recovery and prevent relapse.
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What is the Treatment for Substance Abuse Vs. Addiction?

The treatment approaches for addiction and substance abuse may differ based on the severity and nature of the condition.

Substance Abuse Treatment

Substance abuse treatment is a comprehensive approach aimed at addressing the harmful patterns of substance use and mitigating their negative impact on individuals’ lives. It encompasses a range of interventions that target not only the behavior of substance abuse but also the underlying factors contributing to it. The primary goals of substance abuse treatment are to:

  • Promote healthier habits
  • Improve coping skills
  • Reduce risky behaviors associated with substance abuse

Counseling is a cornerstone of substance abuse treatment, providing individuals with a safe and supportive environment to explore their thoughts, feelings, and motivations related to substance use. Through counseling sessions, individuals can gain insight into the root causes of their substance abuse, develop strategies to manage cravings and triggers and work towards building a healthier and more fulfilling life. Therapists may utilize various therapeutic modalities, such as CBT (cognitive-behavioral therapy) or motivational interviewing, tailored to the specific needs and goals of each individual.

Psychoeducation plays a vital role in substance abuse treatment by equipping individuals with knowledge and understanding about the effects of substances on the body, brain, and overall well-being. It helps individuals comprehend the risks associated with substance abuse, including the potential health consequences, social and legal ramifications, and impact on relationships. Psychoeducation also focuses on enhancing awareness of triggers, relapse prevention strategies, and the benefits of adopting healthier alternatives to substance use.

Group therapy sessions allow individuals to connect with peers who are facing similar challenges, offering a supportive and empathetic environment where they can share their struggles, successes, and insights. Being surrounded by peers with lived experience of substance abuse or addiction can foster a sense of belonging and provide valuable encouragement and accountability on the journey to recovery.

In addition to counseling, psychoeducation, and support groups, behavioral therapies are frequently employed in substance abuse treatment. These therapies aim to modify unhealthy behaviors and develop healthier coping mechanisms. Techniques such as contingency management, which provides incentives for positive behaviors and abstinence, and DBT (dialectical behavior therapy), which focuses on emotional regulation and interpersonal effectiveness, can be beneficial in addressing substance abuse.

Addiction Treatment

Addiction treatment requires a more comprehensive and intensive approach due to the complex nature of this progressive and relapsing condition. Evidence-based addiction treatment aims to address both the physical and psychological aspects of addiction, with the ultimate goal of achieving long-term recovery and sustained sobriety. The treatment journey often begins with a process called detoxification (detox) where individuals safely withdraw from substances under medical supervision. This helps manage withdrawal symptoms and ensures a safe transition into the next phase of treatment.

Following detox, a combination of therapies is utilized to address the underlying causes and triggers of addiction. Individual counseling provides a one-on-one therapeutic environment where individuals can explore their thoughts, emotions, and behaviors related to substance use. This helps in developing insight, identifying triggers, and creating effective coping strategies. Group therapy brings individuals with similar struggles together in a supportive and empathetic setting, allowing them to share experiences, gain encouragement, and learn from one another. These group sessions provide a sense of community and foster a collective journey toward recovery.

MAT (medication-assisted treatment) may also be incorporated into addiction treatment, especially for those struggling with opioid or alcohol addiction. MAT involves the use of FDA-approved medications, in combination with behavioral interventions to manage withdrawal symptoms, minimize cravings, and support sustained recovery.

Holistic approaches are often integrated into addiction treatment to address the individual’s overall well-being. These may include practices such as mindfulness meditation, yoga, art therapy, and adventure therapy, which aim to promote self-reflection, self-care, stress reduction, and personal growth.

After completing the initial phase of treatment, individuals are often provided with aftercare support and relapse prevention planning. This may include ongoing therapy sessions, participation in support groups or alumni programs, and access to resources that help maintain sobriety and address any potential challenges that arise during the recovery journey.

By tailoring the treatment approach to the specific needs of individuals with substance abuse or addiction, healthcare professionals can provide effective interventions that support recovery, empower individuals to make positive changes in their lives, and help them build a foundation for lasting sobriety.

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Get Treatment for Drug and Alcohol Abuse at Renaissance Recovery

Renaissance Recovery Center is dedicated to providing comprehensive outpatient treatment for individuals struggling with substance abuse and addiction at our Huntington Beach rehab in you are looking for help in California or at our Lantana, FL rehab center if you are looking for help in Florida. Our specialized programs cater to drug addictions, alcohol addictions, and mental health conditions, offering integrated dual diagnosis treatment for those with co-occurring conditions like anxiety or depression.

Our outpatient treatment options provide the necessary support and structure to help you on your journey to recovery. Choose from the following programs tailored to your specific needs:

At Renaissance, we believe in individualized addiction treatment that encompasses a range of holistic and evidence-based interventions that may include:

To take the first vital step toward ongoing recovery from substance abuse or addiction, reach out to our admissions team at 866.330.9449. We are here to support you every step of the way.



At Renaissance Recovery our goal is to provide evidence-based treatment to as many individuals as possible. Give us a call today to verify your insurance coverage or to learn more about paying for addiction treatment.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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