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What is the Difference Between Substance Abuse and Dependency?

Written by Shannon Weir, RN | Updated on Feb 18, 2023

shannon weir

Medically reviewed by Dr. Patrick J. Gallus, DO

Simply put, there is little difference between substance abuse and physical or psychological dependence. Both substance abuse and dependency are encompassed under the diagnostic material for substance use disorder (SUD). However, there are different severities of SUD that range from mild to severe. If an individual struggles with SUD, they will experience withdrawal symptoms when trying to stop using substances. Withdrawal can be uncomfortable, frightening, and even life-threatening and should be done in the presence of medical professionals.

What is the Diagnostic and Statistical Manual of Mental Disorders (DSM)?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to diagnosing mental disorders. DSM contains descriptions, symptoms, and other criteria for diagnosing. It has been periodically reviewed and revised since it was first published in 1952, with the most recent version being the DSM-Ⅴ.

The revisions proposed for DSM-Ⅴ aimed to overcome the problems identified with DSM-Ⅳ to provide an improved approach to SUD. The most significant question posed was whether or not to keep substance abuse and dependence as two separate disorders. In the DSM-Ⅳ criteria, the two were separated by the concept that “dependence syndrome” formed one dimension of substance problems, while social and interpersonal consequences of heavy use formed the other. It placed dependence above abuse in a hierarchy by stating that abuse should not be diagnosed when dependence was present. However, the publication of the DSM-Ⅴ concluded that abuse and dependence both fell under SUD.

Diagnosing Substance Use Disorder (SUD)

There are 11 criteria used for diagnosing SUD, including:

  1. Taking the substance in larger amounts or for longer than an individual is meant to
  2. Wanting to cut down or stop using the substance but not managing to
  3. Spending significant amounts of time getting, using, or recovering from the use of the substance
  4. Cravings and urges to use the substance
  5. Not managing to complete tasks at work, home, or school because of substance use
  6. Continuing to use, even when it causes problems in relationships
  7. Giving up important social, occupational, or recreational activities because of substance use
  8. Using the substance again and again, even when it puts the individual in danger
  9. Continuing to use, even when the individual knows they have a physical or psychological problem that could have been caused or worsened by the substance
  10. Needing more of the substance to get the desired effects (tolerance)
  11. Development of withdrawal symptoms

These criteria are divided into four categories: impaired control, social impairment, risky use, and pharmacological indicators (tolerance and withdrawal). The severity of the SUD depends on how many of the criteria are met by the individual. Two or three criteria indicates mild SUD, four or five criteria indicate a moderate SUD, and six or more criteria indicate a severe SUD.

The Risk Factors of Developing SUD

Vulnerability to SUD varies from person to person, and no single factor determines if someone will become addicted to drugs. However, the more risk factors a person has, the more likely it is that substance use will lead to SUD. Risk factors of SUD include:

  • Poor social skills
  • Drug experimentation
  • Community poverty
  • Home and family influence
  • Method of administration
  • Genetic inheritance from a family member with an addiction

Scientists estimate that 40-60% of a person’s vulnerability to addiction is due to genetic factors.

What Are Withdrawal Symptoms?

Withdrawals are a physical effect due to a lack of drugs or alcohol in the body. The body is attempting to reach a new state of homeostasis. Drug withdrawal can include mental, physical, and emotional symptoms. Withdrawal symptoms may include:

  • Trouble sleeping
  • Anxiety
  • Muscle and bone pain
  • Vomiting and diarrhea
  • Cold flashes
  • Seizures
  • Hallucinations
  • Depression
  • Mood swings

Depending on the substance used, withdrawal symptoms may vary. Symptoms often develop when quitting a substance abruptly or when substantially reducing the amount used. Withdrawal can even be fatal.

How Gallus Medical Detox Centers Can Help

At Gallus Medical Detox Centers, we provide you with addiction experts who can help you overcome uncomfortable withdrawal symptoms. We also provide our patients with a personalized, evidence-based treatment plan to meet their individualized needs and allow them to succeed. To do so, our centers use The Gallus Method. The Gallus Method is used to avoid fatal medical risks, psychological challenges, and unpleasant withdrawal symptoms.

What to Expect From Detox

Detox can be confusing, frightening, and overwhelming. At Gallus Medical Detox Centers, we emphasize your safety by providing professional expertise and efficiency without sacrificing any aspect of your dignity or comfort. Our program avoids leaving you feeling dehumanized by starting your recovery journey in a cold and sterile environment. That is why our detox provides a residential facility’s comfort with clinical expertise to ensure safe, effective, and personalized treatment. There is dignity in healing.

When using substances, there is the possibility of developing substance use disorder (SUD). Despite previous diagnostic criteria, both physical dependence and substance abuse are now diagnosed as one disorder. According to the DSM-Ⅴ, there are 11 criteria used when diagnosing SUD. The severity of SUD depends on how many criteria an individual meets. Along this criteria is the development of withdrawal symptoms when drug or alcohol use is suddenly stopped or use is significantly cut down. Withdrawal symptoms can be frightening, uncomfortable, and even life-threatening.

At Gallus Medical Detox Centers, we ensure a safe, effective, and comfortable detox. We use proprietary, evidence-based medical protocols that prioritize our patients’ comfort and safety to guide them through the detox process. At Gallus, we know detox can be overwhelming, and we wish to provide you with an environment and staff to ensure your success. For more information on diagnosing SUD, call Gallus Medical Detox Centers today at (720) 669-8178.

Shannon Weir, RN

Shannon Weir, RN is the Chief Nursing Officer at Gallus Medical Detox Centers. She has been a Registered Nurse for 30 years, Shannon’s experience ranges from critical care to flight nursing, medical detox, sexual assault exams, and SWAT nursing. Shannon has been with Gallus Medical Detox Centers since 2010 and is a vital part of our organization.

Last medically reviewed on January 14, 2021

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Dr. Patrick J. Gallus, DO
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Dr. Patrick J. Gallus, DO
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Dr. Patrick J. Gallus, DO
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If you or a loved one is struggling with substance use, call Gallus at
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