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is substance use abuse dependence or addiction when you talk about addiction dependence abuse and misuse of substances is it all semantics do they all mean the same thing not quite yes itamp;#39;s a bit about semantics but mostly is about the relationship you have with drugs the diagnostic and statistical manual of mental disorders or dsm-5 is the holy grail of disorder descriptions and symptoms the manual doesnamp;#39;t specify addiction to drugs as a diagnosis but addiction has primarily been a synonymous term for drug dependence when a person has a substance dependence they may develop a tolerance for the drug and experience withdrawal symptoms without it there is also a noticeable decline in their daily function the addiction brings about mental and behavioral impairments and slows down emotional reaction and physical movements another marked trait is how a person compulsively needs to have the drug despite harmful consequences the misuse or abusive substances manifest a little d