When it comes to drug and alcohol misuse, terms like addiction and substance use disorder are often used interchangeably. While they are closely related, they aren’t exactly the same, which many people may not know. Understanding the difference can help reduce stigma, promote better treatment decisions, and support individuals on the path to recovery.

What Is Substance Use Disorder (SUD)?

Substance Use Disorder (SUD) is the clinical term used by medical professionals to diagnose a pattern of substance use that leads to significant impairment or distress. It’s defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)  and can range from mild to severe depending on how many symptoms are present.

Common signs and symptoms of SUD include:

• Using more of a substance than intended
  
• Unsuccessful efforts to cut down or stop
  
• Cravings and urges to use
  
• Neglecting responsibilities at work, school, or home
  
• Continuing use despite social or health problems
  
• Withdrawal

SUD is an umbrella diagnosis that applies to a wide range of substances including alcohol, opioids, stimulants, and more.

What Is Addiction?

Addiction is a more general and often more stigmatized term that refers to the compulsive use of a substance despite harmful consequences. It’s not an official diagnosis in the DSM-5, but it’s widely used in both medical and public settings to describe the more severe end of the spectrum of substance misuse.

Addiction usually implies:

• Loss of control over substance use
  
• An overwhelming psychological or physical dependence
  
• Ongoing use even when the user is fully aware of the damage it’s causing
  

While all addictions fall under the category of substance use disorder, not all SUDs involve addiction. For instance, someone with a mild SUD may still retain some control and function relatively well in day-to-day life.

So, What’s the Key Difference?

• Terminology: SUD is a clinical diagnosis; addiction is a term often used to describe severe SUD.
  
• Stigma: SUD is preferred in medical settings to avoid judgment and promote compassionate care.
  
• Severity: Addiction typically refers to a more advanced, chronic form of substance use disorder.

Diagnostic Criteria: Substance Use Disorder vs. Addiction

Substance Use Disorder (SUD) – Clinical Diagnosis

Substance Use Disorder is diagnosed based on criteria outlined in the DSM-5. A healthcare professional evaluates whether a person meets at least 2 of the following 11 criteria within a specific time period:

1. Using the substance in larger amounts or for longer than intended
   
2. Wanting to cut down or stop using the substance but not managing to
   
3. Spending a lot of time getting, using, or recovering from use
   
4. Cravings and urges to use the substance
   
5. Failing to fulfill responsibilities at work, school, or home
   
6. Continuing use despite relationship problems
   
7. Giving up important social, occupational, or recreational activities
   
8. Using substances in risky situations (e.g., driving, operating machinery)
   
9. Continuing use despite physical or mental health problems caused or worsened by use
   
10. Developing tolerance (needing more to get the same effect)
    
11. Experiencing withdrawal symptoms when not using
    

The severity of SUD is determined by the number of symptoms present:

• Mild: 2–3 criteria
  
• Moderate: 4–5 criteria
  
• Severe: 6 or more criteria

This framework allows clinicians to treat SUD as a spectrum, recognizing that not everyone who struggles with substances is experiencing the same level of impairment.

Addiction – A Descriptive Term, Not a Diagnosis

The term “addiction” does not have a formal diagnostic checklist in the DSM-5. Instead, it’s used more descriptively to refer to someone experiencing severe SUD, especially when there’s:

• A loss of control over substance use
• Compulsive behavior despite harmful consequences
• Strong psychological or physical dependence
  
• Inability to stop despite repeated attempts

While professionals may use the term “addiction” when speaking informally or explaining the condition to patients, formal diagnosis and treatment planning are based on SUD criteria.

Why This Matters

Understanding that addiction is typically a severe form of SUD helps people recognize that you don’t have to “hit rock bottom” to seek help. Even mild or moderate SUDs are treatable and early intervention can prevent the condition from worsening.

Why Language Matters

Using accurate, non-stigmatizing language like “substance use disorder” helps reduce shame and makes it easier for people to seek help. At the same time, many in recovery identify with the term “addiction” because it captures the intensity of their experience. Both terms have value, depending on context.

Finding the Right Support with Revive Recovery Centers

Whether someone has a mild substance use disorder or is battling a severe addiction, what matters most is getting the right help. Treatment options vary and may include detox, inpatient or outpatient care, medication-assisted treatment, therapy, and long-term aftercare planning.

Recovery is possible—and it starts with understanding. Call Revive Recovery Center today to learn your recovery options. 

Sources:

American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

https://www.co.door.wi.gov/DocumentCenter/View/2533/Criteria-for-Substance-Use-Disorders-PDF