Substance use can have serious consequences. Drug users may experience infections, paranoid delusions, brain damage, nerve damage or sudden death, depending on which drug they are using.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) listed several substance disorders, including drug dependency and drug abuse. So what is the difference between these two substance disorders?
The DSM-IV-TR has drug abuse and drug dependency disorders for several types of drugs, including alcohol, amphetamines, cannabis, cocaine, hallucinogens, inhalants, opioids, phencyclidine (PCP) and sedatives. The manual included diagnostic criteria for a dependency on nicotine and polysubstance, but not abuse criteria.
A section for other (or unknown) substance-related disorders is also in the manual, which allows for a diagnosis of drug abuse or dependency for drugs not otherwise listed, such nitrous oxide and prescription medications. If a person meets criteria for a drug dependency for a specific drug, such as cocaine, she cannot be diagnosed with drug abuse of that class of drug.
To be diagnosed with a substance abuse disorder, the person must have “a maladaptive pattern of substance use leading to clinically significant impairment or distress” within a 12 month period with one or more of the symptoms, according to the DSM-IV-TR.
Signs include failure to perform responsibilities at home, work or school; legal issues related to the substance use; continuing to use the substance even though there have been interpersonal or social issues caused or made worse by the substance; and using the substance in physically hazardous situations.
With a substance dependency disorder, the person also has a maladaptive pattern of substance use within a 12 month period, but meets three or more of the criteria. Two of the criteria are tolerance and withdrawal.
With tolerance, the person either has a decreased effect when using the same amount of the drug, or she needs to use more of the drug to get the level of intoxication desired.