❝ a useful overarching term which includes substance use, dependence, psychological and social wellbeing ❞


Addiction is more than drinking too much, smoking or taking too many drugs. It is about experiencing difficulty in controlling the amount of alcohol, tobacco or drugs consumed and the consequences, usually negative, that follow.


Addiction is a term commonly used to cover all of the many aspects of substance misuse and dependence. Essentially addiction includes dependence, use of the substance and all of the associated problems which include: physical and mental ill-health, family disruption, poor work performance, criminal activity, financial difficulties, neglect of child care responsibilities and so on. Some behaviours, notably sex, exercise, gambling, are considered to have similar addictive potential to psychoactive substances. 

Kurzgesagt – In a Nutshell Addiction (5.43) is a cartoon derived from Johann Hari's New York Times best-selling book 'Chasing The Scream: The First and Last Days of the War on Drugs.' It is a very good description of current thinking about the nature of addiction...


Dependence is seen by many to be at the heart of addiction. It can be thought of as a 'strong habit' that is difficult to control. It is a psychological state which can be recognised when an individual becomes more preoccupied with substance use, spending more time drinking, smoking or taking other drugs, often at the expense of other important activities. Typically more severe dependence is associated with, but not the same as, frequent substance use, leading to tolerance (needing more of the drug to get the same effect) and withdrawal symptoms (physical symptoms such as shakiness and sweating when the drug wears off). Dependent drinkers and drug takers often want to be abstinent or at least in more control of their substance use but find the immediate rewards of alcohol and other drugs too powerful to resist. The rewards people experience can be very different ranging from simply liking the effect, being intoxicated, to something utilitarian such as mood change.

In this next video Robert West, Psychologist and Editor of Addiction (3.43), gives an explanation of how different terms have been used to describe addiction and what they mean...

What is USE, MISUSE and HARMFUL USE of a substance?

Use and misuse have no precise meaning. The word 'use' implies consumption which is mainly without problems, whereas 'misuse' suggests something that is problematic - it is less judgemental than 'abuse'. Misuse could mean a whole range of things from occasional intoxication to severe dependence. 'Harmful Use' is defined by the World Health Organisation as use that causes actual physical or mental health, whereas 'hazardous use' refers to use that has the potential to cause harm, be that ill-health or social in nature.

AVAILABILITY, dependence and use

The way people use drugs, the substances they use, and the places they use are changing all the time. In recent years there has been a huge increase in new drugs coming available. Fashion partly dictates patterns of use but most of all it is to do with availability. To a lesser or greater extent availability is affected by government policy, albeit some policies are more effective than others.