Alcohol/Substance Use and Abuse

Distinguishing between Substance Use and Substance Misuse

Understanding the nature of alcohol and illicit drug use and misuse among ethnic minority groups must begin by distinguishing among substance use, substance misuse, substance abuse, and substance dependence (ordinarily referred to as addiction or chemical dependence). Clarification of the terminology is important because patients, researchers, policymakers, law enforcement, and the media often use these terms interchangeably, and the definitions may be at odds with those of the mental health and medical professionals who are responsible for diagnosing and treating alcohol and drug problems. For example, a man arrested for smoking marijuana at a concert may consider himself a substance user, but the criminal justice system may label him a substance abuser and him to drug treatment, where he may be diagnosed with a substance dependence disorder (such as a cannabis dependence) by a psychologist.

A person engaging in substance use can be described as using a substance without any identified problem associated with such use. For example, a teenager may experiment with marijuana, experience no adverse effects, and refrain from further use. The term substance misuse is a general term that describes people who suffer from either a substance abuse or substance dependence disorder.

Colloquially, the term substance abuse is used to refer to any degree of substance use, ranging from one-time use of an illicit drug to severe addiction. Its definition among medical and mental health professionals, however, and its use here, refers to a substance abuse disorder marked by habitual use of a substance in a manner that is harmful to self or others but without strong signs of physical dependence or significant psychosocial negative consequences. For example, a man may drink heavily at bars on some weekends and then drive home in a state of intoxication. His behavior is dangerous because he is placing himself and others at risk of injury or death, but the role of alcohol in his life may not be so central as to reach the level of addiction.

...