Use, misuse and abuse – what is the difference?

Words matter. And in the case of talking about or documenting sensitive information, it’s much more necessary. As patient advocates and providers of unbiased care, it is vital that we use the proper terminology related to substance use and addiction. Here is a glossary of terms you need to know; it is vital that we use them appropriately and encourage others to do the identical. It must be noted that the American Psychological Association has seen a change within the language used to explain addiction, using the words “substance use disorder” as a substitute of “abuse” and “addiction.”

Addiction

Addiction is a disease that affects complex interactions between biological and environmental aspects. Recent evidence suggests that addiction is less about physical dependence and withdrawal than about compulsive repetition of activities despite life-damaging consequences. The behavior enhances feelings of delight from the substance and causes a lack of control in limiting its use (Murphy, 2018). Addiction may be known as a substance use disorder.

Alcohol use disorder

In alcohol use disorder (AUD), the consequences of alcohol consumption on various neurotransmitters may cause changes in emotion, motivation, and cognitive processing. Repeated exposure to alcohol affects the effectiveness of neurotransmitters, leading to the necessity to eat larger amounts of alcohol to provide similar effects (Walters, 2021).

Abuse

The term misuse often refers to pharmaceuticals. Means taking a drugs in a way or at a unique dose than prescribed; taking another person’s prescription, even whether it is a legitimate medical criticism; or shooting up to feel euphoric (National Institute on Drug Abuse, 2020).

Opioid use disorder

Opioid use disorder is defined because the chronic use of opioids to a level that causes clinically significant distress or impairment (Dydyk et al., 2021).

Substance abuse

As mentioned above, it’s preferable to make use of the phrase “substance use disorder” since the word “abuse” suggests that the person has selection and control over their behavior (Burda, 2020).

Substance use disorder

Substance use disorder (SUD) is a brain disorder that alters the circuitry of the basal ganglia, prolonged amygdala, and prefrontal cortex. These changes affect reward, self-control and stress processes (Walters, 2021).

• Substance Abuse and Mental Health Services Administration (SAMHSA)
• American Psychiatric Association: Addiction and Substance Use Disorders

Burda, C. (2020). Substance use disorders: Semantics and stigma. (1), 14-17. https://doi.org/10.1097/01.NPR.0000586060.78573.ab

Dydyk AM, Jain NK and Gupta M. Opioid use disorders. [Updated 2021 Jul 12]. In: StatPearls [Internet]. Treasure Island (Florida): StatPearls Publishing; 2021 January-. https://www.ncbi.nlm.nih.gov/books/NBK553166/

Murphy, K. (2018). The science of addiction. (3), 38-45. https://www.doi.org/10.1097/01.NME.0000531870.46498.da

National Institute on Drug Abuse. (2020, June). Prescription Drug Misuse Investigation Report. https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/overview

Walters, M. (2021). Using SBIRT for substance use relapse. (3), 63-66. https://www.doi.org/10.1097/01.NURSE.0000724424.00301.19