When Does Substance Use Turn into Addiction?

By Published On: March 2nd, 2021Categories: Alcohol Addiction, Drug Addiction

The terms “abuse” or, more properly, “misuse” and “addiction” are often used interchangeably, but contrary to popular belief, there is a difference. It is common knowledge that substance and alcohol use disorders are medical conditions that affect the brain, but did you know that simply using or misusing drugs and alcohol is not the same thing as being addicted? While misuse can lead to addiction, it’s important to know where they differ.

Abuse vs. Misuse

Our terminology for addiction-related language continues to evolve as we learn more about the science of addiction as well as the societal impact of certain terms. While substance “abuse” is still common in the vernacular, the addiction treatment field now favors “substance use” or “misuse.” These terms are both more accurate and have fewer negative connotations.

When identifying substance misuse, we are looking at a pattern of someone using substances or drugs for purposes for which they were not intended. For example, when someone is taking prescription or over-the-counter drugs not for the purposes of treating pain or illness, but to elicit the mood-altering effects of the drugs. Some of the symptoms of misuse include:

  • Performance at work or school begins to decline
  • Relationships start to become problematic
  • A person may begin taking dangerous and unnecessary risks as a result of their consumption
  • A person’s finances start to get tighter as they indulge more in their substance of choice

Someone misusing substances may still be able to stop before harming themselves or others or may choose to stop the use of the substances altogether rather easily. When someone is unable to break their pattern of using substances, typically measured within a 12-month period, that is when substance misuse has turned into addiction.


If someone has continued their pattern of substance misuse to the point where they are no longer able to stop using substances, even if they want to, then misuse has turned into addiction or substance use disorder (SUD). Prolonged exposure to addictive substances begins to have a lasting impact on the brain, actually altering how neurons function. Specifically, addictive substances alter the parts of the brain that regulate motivation and impulse control, causing a person to lose control over when and how much the substance is used. Some symptoms of addiction include:

  • Tolerance levels rise and substance use may be in larger amounts over a longer period than intended for the desired effect
  • It becomes increasingly difficult to stop using drugs or alcohol even after repeated attempts to quit
  • Cravings, or an intense desire to use the substance may be present
  • Severe withdrawal symptoms may appear such as nausea, sweating, shakiness, and extreme anxiety
  • Individuals become less interested in passions and hobbies outside of using drugs or alcohol
  • People may isolate themselves from loved ones due to shame and attempts to hide their addiction
  • Daily life revolves around obtaining the substance, getting high or drunk, and recovering from use
  • The individual may be unable to fulfill duties at work, school, or home due to substance use

The primary criteria by which we measure the difference between misuse and addiction is the significance of the impact on the individual’s functioning. If someone occasionally misuses substances but they are able to stop or curtail their use when they choose, then they likely haven’t developed an addiction yet. It is also important to note that addiction is a disease that often requires dedicated treatment to overcome. Someone using drugs and alcohol may be able to walk away, but someone with an addiction will likely need treatment and assistance to change their patterns of behavior.

The good news is that substance misuse, addiction, and alcohol, opioid, and substance use disorders, are indeed treatable! And the sooner someone recognizes that they are struggling and reaches out for help, the better.


If you or a loved one is struggling with substance misuse or addiction, call the New England Recovery Center Today at 1-877-MyRehab.

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