What Are Substance Abuse and Addiction?

The difference between substance abuse and addiction is very slight. Substance abuse means using an illegal substance or using a legal substance in the wrong way. Addiction begins as abuse, or using a substance like marijuana or cocaine. You can abuse a drug (or alcohol) without having an addiction. For example, just because Sara smoked weed a few times doesn't mean that she has an addiction, but it does mean that she's abusing a drug — and that could lead to an addiction.

People can get addicted to all sorts of substances. When we think of addiction, we usually think of alcohol or illegal drugs. But people become addicted to medications, cigarettes, even glue! And some substances are more addictive than others: Drugs like crack or heroin are so addictive that they might only be used once or twice before the user loses control.

Addiction means a person has no control over whether he or she uses a drug or drinks. Someone who's addicted to cocaine has grown so used to the drug that he or she has to have it. Addiction can be physical, psychological, or both.

Physical addiction is when a person's body actually becomes dependent on a particular substance (even smoking is physically addictive). It also means building tolerance to that substance, so that a person needs a larger dose than ever before to get the same effects. Someone who is physically addicted and stops using a substance like drugs, alcohol, or cigarettes may experience withdrawal symptoms. Common symptoms of withdrawal are diarrhea, shaking, and generally feeling awful.

Psychological addiction happens when the cravings for a drug are psychological or emotional. People who are psychologically addicted feel overcome by the desire to have a drug. They may lie or steal to get it.

A person crosses the line between abuse and addiction when he or she is no longer trying the drug to have fun or get high, but has come to depend on it. His or her whole life centers around the need for the drug. An addicted person — whether it's a physical or psychological addiction or both — no longer feels like there is a choice in taking a substance.