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What Do Substance Abuse and Addiction Mean?

The difference between substance abuse and addiction is very slight. Substance abuse means using an illegal substance or misusing a legal substance. Addiction begins as abuse, or using a substance like marijuana or cocaine.

You can abuse a drug (or alcohol) without having an addiction. For example, just because someone smoked pot a few times doesn't mean that they have an addiction, but it could lead to one.

People can get addicted to all sorts of substances. When we think of addiction, we usually think of alcohol or street drugs. But people become addicted to prescription medicines, cigarettes, even sniffing glue.

Some substances are more addictive than others: Drugs like crack or heroin are so addictive that they might only be used once or twice before the user loses control.

Addiction means a person needs a drug, even if they know it has bad consequences. Addiction can be physical, psychological, or both.

Physical Addiction

Being physically addicted means a person's body becomes dependent on a particular substance (even vaping is physically addictive). It also means building tolerance to that substance, so that a person needs a larger dose than before to get the same effects.

Someone who is physically addicted and stops using a substance like drugs, alcohol, or nicotine may have withdrawal symptoms. Common symptoms of withdrawal are diarrhea, shaking, and generally feeling awful.

Psychological Addiction

Psychological addiction happens when the cravings for a drug are psychological or emotional. People who are psychologically addicted feel overcome by the desire to have a drug. They may lie or steal to get it.

A person crosses the line from abuse to addiction when they aren't just using the drug to have fun or get high, but have come to depend on it. Their whole life centers around the need for the drug. An addicted person — whether they have a physical addiction, psychological addiction, or both — no longer feels like they have a choice about using a substance.

What Are the Signs of Addiction?

The most obvious sign of an addiction is the need to have a particular drug or substance. But many other signs can suggest a possible addiction, such as changes in mood or weight loss or gain. (These also are signs of other conditions too, though, such as depression or eating disorders.)

Someone may have a drug or alcohol addiction if they:

  • Use drugs or alcohol to help forget problems or to relax.
  • Spend a lot of time figuring out how to get drugs.
  • Steal or sell belongings to be able to afford drugs.
  • Tried and failed to stop taking drugs or drinking.
  • Feel shaky or sick when trying to stop.
  • Need to take more of the substance to get the same effect.
  • Have changes in their sleeping habits, eating habits (including weight loss or gain), or mood (including mood swings, anxiety, anger, or depression).
  • Develop problems in their relationships with family and friends.
  • Lose interest in activities that used to be important.
  • Do worse at school.

How Can Someone Get Help With a Substance Abuse Problem or Addiction?

If you think that you or someone you care about is addicted to drugs or alcohol, recognizing the problem is the first step in getting help.

Call SAMHSA's National Helpline at 1-800-662-HELP (4357). This free and confidential service is available in English and Spanish.

Many people think they can kick the problem on their own, but that rarely works. Find someone you trust to talk to. It may help to talk to a friend or someone your own age at first, but a supportive and understanding adult is your best option for getting help. If you can't talk to your parents, you might want to approach a school counselor, relative, doctor, favorite teacher, or religious leader.

Overcoming addiction is not easy. Quitting drugs or drinking is probably going to be one of the hardest things you or your friend do. It's not a sign of weakness if you need professional help from a trained drug counselor or therapist. Most people who try to kick a drug or alcohol problem need professional help or a treatment program to do so.

What Can Help With Addiction Recovery?

After you start a treatment program, try these tips to make the road to recovery less bumpy:

  • Tell your friends about your decision to stop using drugs. True friends will respect your decision. This might mean that you need to find a new group of friends who will be 100% supportive. Unless everyone decides to kick their drug habit at once, you probably won't be able to hang out with the friends you did drugs with.
  • Ask your friends or family to be ready to support you when you need them. You might need to call someone in the middle of the night just to talk. If you're going through a tough time, don't try to handle things on your own — accept the help your family and friends offer.
  • Accept invitations only to events that you know won't involve drugs or alcohol. Going to the movies is probably safe, but you may want to skip a Friday night party until you're feeling more secure. Plan activities that don't involve drugs. Go to the movies, try bowling, or take an art class with a friend.
  • Have a plan about what you'll do if you find yourself in a situation with drugs or alcohol. The temptation will be there sometimes. If you know how you're going to handle it, you'll be OK. Establish a plan with your parents, siblings, or other supportive friends and adults so that if you call or text using a code, they'll know you need a ride out of there.
  • Remind yourself that having an addiction doesn't make a person bad or weak. If you fall back into old patterns (backslide) a bit, talk to an adult as soon as possible. It's nothing to be ashamed about, but it's important to get help soon so that all the hard work you put into your recovery is not lost.

How Can I Help a Friend With Addiction?

If you're worried about a friend who has an addiction, you can use these same tips to help them. For example, let your friend know that you are available to talk or offer your support. If you notice a friend backsliding, talk about it openly and ask what you can do to help.

If your friend is going back to drugs or drinking and won't accept your help, don't be afraid to talk to a nonthreatening, understanding adult, like your parent or school counselor. Getting your friend help is the best support you can offer.

Above all, offer a friend who's battling an addiction lots of encouragement and praise. Hearing that you care is exactly the kind of motivation your friend needs.

What Helps With Staying Sober?

Recovering from a drug or alcohol addiction doesn't end with a 6-week treatment program. It's a lifelong process. Many people find that joining a support group can help them stay clean. There are support groups specifically for teens and younger people. You'll meet people who have gone through the same experiences, and you can have real-life discussions about drugs that you won't hear in your school's health class.

Many people find that helping others is also the best way to help themselves. Your understanding of how hard the recovery process can be will help you to support others who are battling an addiction.

If you do have a relapse, recognizing the problem as soon as possible is critical. Get help right away so that you don't undo the hard work you put into your initial recovery. And if you do have a relapse, don't ever be afraid to ask for help!

Medically reviewed by: Larissa Hirsch, MD
Date reviewed: August 2023