Addiction and Substance Abuse
Substance Abuse Disorder is the term we use to describe conditions where a person using drugs and/or alcohol suffers a sustained and adverse impact on their lives. The condition is progressive when untreated. Fortunately, it is manageable and people can recover fully with appropriate treatment
"Substance abuse" is the repeated use that causes significant impairment, such as disabilities, failure to meet responsibilities, health issues, impaired control, risky behavior, and social issues. Examples of this could be drinking enough to get frequent hangovers; using enough drugs that you miss work or school; smoking enough marijuana that you have lost friends, or often drink or use more than you intended to use.
"Addiction" simply means a physical dependency on a drug. Addiction (and "alcoholism" - physiological addiction to alcohol) is a medical term and falls in the high end of the spectrum of substance abuse disorders. For example, perhaps 95% of people being treated for alcohol abuse are not addicted or "alcoholics". The remaining people suffering from alcoholism face serious risks during withdrawal and treatment for them often requires hospitalization.
It is important to emphasize that the word "abuse" means only that use of a substance differs from what is intended. The term abuse should not ever be seen as a judgment of a person's behavior or character. The term "abuse" applies equally to the abuse of legal or illegal drugs. Substance abuse disorders are serious medical and mental health conditions - not character flaws.
When to seek help.
For many legal substances, the line between use and abuse is not clear. Is having a couple of drinks every day after work to unwind use or abuse? Is drinking two pots of coffee in the morning, to get your day started, use or abuse? Is smoking a pack of cigarettes a day substance abuse?
Generally, the question to ask is, "Is substance use causing harm?" If someone is worried about increasing use and has never discussed it with family, friends, or coworkers, chances are that people have noticed behavioral changes but decline to confront or intervene. The personal secrets of substance abuse are rarely a surprise to others. They see their choice not to mention their own concerns as being polite.
If you have concerns it is best to speak to a mental health practitioner. Abuse is often intertwined with other issues and the best way to address the abuse is to address all of the other concerns at the same time. The earlier this begins the easier and quicker all of these issues can be addressed.