The words that we use and the meanings they have, greatly affect our thinking in any subject. Consider the following, and you may end up with clearer thinking about substance use problems which allows you to change your habits.
Substance Use:
is the simple act of using a substance. People freely choose to use substances, and like any other chosen behavior, people have their reasons for doing it – because they want pleasure, excitement, stress & anxiety relief, etc. Substance use isn’t mysterious – it’s a behavior people engage in because they get something out of it on some level.
Substance Abuse:
is the same behavior as substance use, the only difference is in the eye of the beholder. Technically, to abuse something is to use it to bad effect, or to use it improperly. So for example, if you’re using drugs to make yourself happy, yet it results in greater unhappiness – then you’re abusing drugs. Only you can be the judge of whether your substance use rises to the level of substance abuse though. There is no quantity of substances or frequency of use by which to measure substance abuse – there are only your personally gauged life needs and goals, and your personal assessment of whether the substance use promotes those, or impedes them. Again, this is still a voluntary act, the word ‘abuse’ is only used to denote that the pattern of use has been judged by you to create costs which outweigh the benefits.
[Author’s note as of 2021: the term “substance abuse” has fallen deeply out of fashion and regular use since this article was written 2011. That’s good news. When I wrote this piece I was trying to give alternative views on the terms of the day. I prefer “substance use problem” personally (as I originally wrote below), but I also find that “reckless substance use,” “chaotic substance use” or even “heavy substance use” are meaningful descriptions to some people. Your personal understanding of things is more important than the terms though. If you genuinely learn to think of your substance desire & use as something that you have the power to regulate, it won’t matter what term you use. You can then get to figuring out what level of use, if any at all, would make you happiest (with all that the term happiness includes).]
Addiction:
is still another level of both substance use and abuse. It is still voluntary, yet it may not feel so. This is because of an important added element: self-defeating beliefs. When we speak of addiction, we’re talking about an experience in which one is abusing substances, i.e. engaging in a pattern of voluntary substance use where the costs outweigh the benefits, and believes that for some reason they have no control, choice, or power to stop the behavior.
While the line between substance use and abuse is a matter of personal judgment about the balance between costs and benefits, the line between abuse and addiction goes far beyond such real world concerns as costs and benefits – addiction is purely a construct of the mind and is only experienced because one believes they “need” their substance, that they’re powerless over substances, that their genes are the sole cause of their behavior, that a disease is to blame for their choices, or even that substances possess some kind of other-worldly satanic lure. Addiction is a heightened level of substance abuse solely dependent on beliefs. If these self-defeating beliefs are properly analyzed, they fall apart, and you’re left with mere substance abuse – a straightforward problem which can be dealt with in a straightforward manner.
The use of the term “addiction” simply reinforces the negative beliefs on which it thrives. While I use the term throughout my writings for convenience sake, you should never refer to yourself as having an addiction, being an addict, or battling an addiction. The term historically referred to “bondage” or “slavery,” and it still carries that meaning today where one is somehow a slave to a disease which causes them to act compulsively. Instead, think or say “I’ve had a substance use problem,” it’s much more active, reinforcing that it’s a chosen behavior, and it promotes an internal locus of control which will empower you to change.
I am quite aware of the conventional definitions, concepts, and diagnostic criteria for Substance Abuse and Substance Dependency/Addiction, however, while the diagnostic criteria do a decent job of describing the experiences of people with substance use problems, I choose to throw these out in favor of definitions which I find to be more constructive and helpful with my students.
