What Are Three Differences Between Substance Abuse & Substance Dependence?

Substance abuse and dependence conjures up the image of a person who has lost control of his life. For that person the difference between abuse and dependence may be just an academic exercise. Substances that lead to abuse and dependence include alcohol, prescription medicines and illegal drugs such as cocaine. Differences do exist between the substance abuser and the person who is now dependent.

DSM

• The "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition," or DSM, is the standard reference book used by psychiatrists and other mental health professionals. It contains all the classifications of mental disorders and assigns each a number. According to "Psychology Today," in an article published in March 2010, changes are being proposed to combine the classifications that cover substance abuse and substance dependence. The new classification would be substance use disorder. The changes, if enacted, would appear in the DSM's revised fifth edition, scheduled for publication in May 2013.

Time of Use

• A substance abuser can be defined as a person who abuses some substance on an irregular basis. It may be a person who goes on a drinking binge for a day, misses work and gets arrested for driving while impaired. According to the DSM as reported in LifeTips, there must be some negative consequences from the substance to constitute abuse. Thus the person who consumes alcohol without any legal, work or home problems is not a substance abuser. The abuser may not have had any alcohol for a week or two prior to the binge and is able to not have alcohol following the binge. The difference in substance dependence, in the case of alcohol, manifests itself with the person who consumes the substance on a daily basis.

Freedom From Use

• Substance dependence by its name implies that the individual is dependent upon the substance and cannot function without it. According to an article in "Psychiatry and Wellness" that addresses prescription drug abuse, dependence is not addiction. Dependence is the result of sustained use of a substance that causes a person to have withdrawal symptoms if the substance is taken away. This physical dependence marks the difference from the substance abuser. A substance abuser can leave the substance alone anytime he desires. That does not mean he will never use the substance again. He will return to it, but the reuse is not based upon a physical need on a daily basis.

Physical Tolerance

• Physical tolerance refers to the concept that prolonged use of a substance leads to higher consumption. According to Healthy Place, with substance dependence, the amount ingested must be increased over time to obtain the same result. The body is not only dependent but requires higher dosages. The same effect does not occur in the occasional substance abuser. The amount of the substance used in each of his episodes will remain the same.