What’s the difference between substance use and addiction?

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Author: Canadian Mental Health Association, BC Division

 

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People tend to use the word “addiction” to mean very different things. “I am addicted to shopping” might mean only that the speaker likes to shop. On the other hand, “He is addicted” might mean the speaker thinks the other person is completely unable to control his own behaviour. When people use the word about psychoactive (mind-altering) substances like alcohol, tobacco, or other drugs, they often assume these drugs are dangerous and have the power to control human behaviour.

The evidence, however, suggests a quite different picture. While substance use can clearly contribute to health and social problems, substances can be beneficial for some people in some situations. Many people celebrate a special occasion with a nice glass of wine, for example. Some people use tobacco as a powerful symbol in cultural and spiritual ceremonies. In fact, substances have been used by humans throughout history for many reasons: to feel good, to feel better, to improve performance, for cultural/spiritual reasons, and to have new experiences.

Substance use is more complicated than just “good” or “bad.” It’s helpful to think of substance use along a continuum, from beneficial use to harmful use. Along the middle of the continuum, substance use may be both beneficial and harmful. You have an enjoyable night out with friends, but feel a little ill the next day. At the far end of the continuum, some people develop dependence—they need to continually use the drug in order to feel normal and will keep using even when that leads to financial difficulties, problems at home or at work, health problems, or legal problems.

In general, substance use is a problem when it causes problems for you or others—and how much use causes problems will be different for different people in different situations. The reason a person uses a substance influences the risk of developing problems. For instance, if a person uses a substance to have fun, only occasional social use may follow. But when a person uses a substance to cope with a long-term problem such as social anxiety, then more long lasting and intense use may follow. Managing our risk involves being aware of why we are using and what impacts our use is having on ourselves and those around us. The wisdom of our ancestors suggests a guiding principle—not too much, not too often, and only in safe contexts.

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The Canadian Mental Health Association promotes the mental health of all and supports the resilience and recovery of people experiencing a mental illness through public education, community-based research, advocacy, and direct services. Visit www.cmha.bc.ca.

 
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