Substance abuse (drug abuse) differs from substance dependence (drug addiction) in that it does not include an extremely strong craving, loss of control, or physical dependence. A definition of substance abuse that is frequently cited is from DSM-IV-TR, the fourth edition text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association. The DSM-IV-TR says that the symptoms specified below must have occurred repeatedly over a one-year period of time. And it specifically says that substance abuse differs from substance dependence in that substance abuse does not include tolerance or withdrawal symptoms (DSM-IV-TR, p. 198). The specific diagnostic criteria outlined in DSM-IV-TR are:

• “A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)

2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)

3. Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)

4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)

• B. The symptoms have never met the criteria for Substance Dependence for this class of substance” (DSM-IV-TR, p. 199).

http://www.nida.nih.gov/

http://www.niaaa.nih.gov/FAQs/General-English/default.htm#whatis

Diagnostic and Statistical Manual of Mental Disorders, fourth edition text revision (DSM-IV-TR). (2000). Arlington, VA.: American Psychiatric Association.