What’s the difference between a substance abuse disorder, addiction, and disease? That’s a good question, and one we set out to determine. Although there are some different aspects of each, the results of our findings might enlighten you. Read on for more information.

Substance abuse can lead to addiction, a disease that can affect anyone no matter their age, lifestyle, ethnic background, profession, or gender. People with substance abuse disorder cannot be categorized in any specific way. They can be rich or poor, educated or not. They can be white-collar professionals, blue-collar workers, or those who do not fit into those groups. They can have long or short hair or no hair at all.

People with substance abuse disorder can be short or tall or of average height.

They can be slim or heavy or of average weight. They don’t lack character or morals. All of these people have something in common, though.

The disease of addiction. Addiction is also called severe substance use disorder.

Substance Abuse Terminology

Here are some common terms used when discussing or reading about substance abuse:

Substance use: A less serious drug or alcohol use disorder in which substance use causes distress and problems. Addiction is a severe form of this. (Center on Addiction)

Addiction: A primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. (American Society of Addiction Medicine (ASAM))

Disease: A definite pathological process having a characteristic set of signs and symptoms. The disease is caused by extrinsic influences (e.g., virus, bacteria)

Is It Substance Abuse Disorder (SUD) Or Addiction?

You can have a substance use disorder (SUD) to drugs or alcohol that leads to addiction (severe SUD). Addiction is a chronic brain disease in which continued use of the substance changes the reward system in the brain. It is a disease due to the characteristic signs and symptoms it presents.

  • Two or three of the criteria met within a year indicates a mild substance abuse disorder
  • Four to five of the criteria met within the year indicates moderate substance abuse disorder
  • Six or more of the criteria met in this same amount of time indicates a severe substance abuse disorder, which also indicates addiction.

Types Of Addiction

Addiction affects a person’s brain and behavior when using drugs or alcohol that can lead to the inability to control drug or alcohol use to the detriment of the person and his or her life.

  •  Alcohol use disorder
  •  Tobacco use disorder
  •  Cannabis use disorder
  •  Stimulant use disorder
  •  Hallucinogen use disorder
  •  Opioid use disorder

Symptoms Of Addiction

Symptoms can only be experienced by the addicted person. Signs are what other people observe of the addicted person. These are usually the same in both instances. Not all of the below have to be felt or seen to notate addiction. Some can be indicative of other life situations and not necessarily substance abuse addiction.

The Most Common Signs And Symptoms Are:

  • Secretiveness
  • Lying
  • Stealing
  • Financially unpredictable, perhaps having large amounts of cash at times but no money at all at other times
  • Changes in social groups, new and unusual friends, odd phone conversations
  • Repeated unexplained outings, often with a sense of urgency
  • Drug paraphernalia such as unusual pipes, cigarette papers, small weighing scales, etc.
  • “Stashes” of drugs, usually in small plastic, paper, or foil packages
  • Tolerance, which is the need to engage in the addictive behavior more and more to get the desired effect
  • Withdrawal happens when the person does not take the substance or engage in the activity, and they experience unpleasant symptoms, which are often the opposite of the effects of the addictive behavior
  • Difficulty cutting down or controlling the addictive behavior
  • Social, occupational, or recreational activities becoming more focused on the addiction, and important social and occupational roles being jeopardized
  • The person becoming preoccupied with the addiction, spending a lot of time on planning, engaging in, and recovering from the addictive behavior
  • Extreme mood changes – happy, sad, excited, anxious, etc.
  • Sleeping a lot more or less than usual, or at different times of the day or night
  • Changes in energy – unexpectedly and extremely tired or energetic
  • Weight loss or weight gain
  • Unexpected and persistent coughs or sniffles
  • Seeming unwell at certain times and better at other times
  • Pupils of the eyes seeming smaller or larger than usual

Factors In Chronic Disease

Many different aspects of a person’s life factor in when engaging in the discussion if someone is addicted to substances. The most crucial thing to remember is that addiction is a chronic disease. It is chronic in the same way that diabetes and heart disease are – they are manageable, treatable, and need lifelong treatment that is adaptable.

The National Institute On Drug Abuse (NIDA) States:

  • Drug addiction is a chronic disease characterized by drug-seeking and uses that are compulsive, or difficult to control, despite harmful consequences.
  • Brain changes that occur over time with drug use challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. This is why drug addiction is also a relapsing disease.
  • Relapse is the return to drug use after an attempt to stop and indicates the need for more or different treatment.
  • Most drugs affect the brain’s reward circuit by flooding it with the chemical messenger dopamine. Surges of dopamine in the reward circuit cause the reinforcement of pleasurable but unhealthy activities, leading people to repeat the behavior again and again.
  • Over time, the brain adjusts to the excess dopamine, which reduces the high that the person feels compared to the high they felt when first taking the drug—an effect known as tolerance. They might take more of the drug, trying to achieve the same dopamine high.
  • No single factor can predict whether a person will become addicted to drugs. A combination of genetic, environmental, and developmental factors influences the risk for addiction. The more risk factors a person has, the greater the chance that taking drugs can lead to addiction.
  • Drug addiction is treatable and can be successfully managed.

Signs Of Addiction

The American Society for Addiction Medicine (ASAM) relays the “ABCDEs” of addiction:

  • Inability to consistently Abstain;
  • Impairment in Behavioral control;
  • Craving; or increased “hunger” for drugs or rewarding experiences;
  • Diminished recognition of significant problems with one’s behaviors and interpersonal relationships; and
  • A dysfunctional Emotional response


Is substance abuse a disease?

The answer is that it can be if someone shows signs of and experiences the symptoms of addiction. Addiction is a severe form of substance abuse disorder, and it is a chronic disease of the brain.

The good news is that substance abuse disorder and addiction can be treated and managed.

If you or a loved one is struggling with addiction, Delphi Behavioral Health Group can provide the necessary treatment and support that you or a loved one needs to get sober.

Tap to GET HELP NOW: (844) 899-5777