The Difference Between Use and Abuse

by Alek Sabin

Substance abuse is a very hot topic in our country, right now. For the past two decades, addiction rates have continued to climb at unprecedented levels, driven in part by the sudden boom of prescription narcotics that have fueled the opioid epidemic that we find ourselves in, today.

For this reason, it’s important for the general population to have a clear idea of what addiction means, how it can affect their lives, and how to recognize the signs of substance abuse. In order to recognize addiction growing in someone we love, we need to understand the differences between use and abuse, and what each of those terms implies.

Use doesn’t always imply abuse

First of all, it’s important to note that use is something that all too often gets lumped in with abuse. Just because somebody takes a prescription opioid, this doesn’t equate with abuse. Likewise, a person who drinks alcohol in social situations isn’t necessarily abusing alcohol. Despite this fact, though, alcohol and prescription drugs are both substances with a high risk of abuse, which is why it is important to recognize when use becomes something far more destructive.

Abuse can lead to dependence

Another difference that needs to be acknowledged is the difference between abuse and addiction. A person who binge drinks in dangerous amounts is certainly abusing alcohol, but it doesn’t mean that they are addicted to it.

Alcoholism occurs once a person develops a dependence to alcohol. Dependence, whether mental or physical, is the qualifying ingredient to classify substance use as an addiction, regardless of the specific substance. Dependence is what makes addiction a behavioral disease, and creates a feeling of helplessness within addicts.

Using a substance outside of its intended purpose is abuse

With prescription medication, despite the potential dangers of many different painkillers, there are clear reasons why doctors prescribe them. For patients with extreme chronic pain, these drugs provide much needed relief.

The clear cut way that prescription medication gets abused is when it is used outside of its intended purpose, or beyond the scope of the instructions. For example, taking more than the specific amount your doctor told you to take qualifies as a form of abuse. Or, in another example, taking these drugs with alcohol, which can heighten the effects, qualifies as abuse. It should be noted, however, that there have even been

Many illicit substances qualify primarily as abuse

For many types of illicit substances, there isn’t really an area of engagement that is classified as use (at least not typically). For example, despite the fact that heroin used to serve a medical purpose, using street heroin in today’s world is an act that can be classified as abuse, even if it is only done once. Heroin isn’t a substance that can be used in moderation, due to the incredibly high risk of dependency. This is true for many hard substances. While certain substances, such as alcohol, can be done socially, the dangers of other substances negate the purpose of moderation.

Moderation can be a tricky word

The idea of moderation can be a tricky area to navigate, when it comes to defining use vs. abuse. While a person who only has a small glass of wine with dinner every day certainly isn’t abusing alcohol by doing so, moderation can become somewhat of a shield to justify increasingly risky behavior. To use alcohol as an example, alcoholics rarely started drinking in abusive patterns. Oftentimes, moderation enables a steadily increasing usage until we cross a line into progressively more dangerous abuse.

Abstinence is absolute, but not always realistic

For substances that have the capacity to be abused, the only surefire way to avoid abuse for sure is to engage in complete abstinence from that substance. However, as a strategy to deal with widespread addiction rates, abstinence isn’t really a realistic solution. There’s zero chance that everyone in the United States is going to stop drinking alcohol, and prohibition-like policies to support this behavior have failed miserably, in the past.

Likewise, with prescription drugs, there are substances that have clear medical purposes that shouldn’t necessarily be foregone. It’s for this reason that it’s important for people to navigate the boundaries between use and abuse within their own lives, and in the actions of their loved ones, so that addictive behavior can be identified and addressed before it is too late.

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