Substance abuse and behavioral addictions are closely related mental health challenges, but several key differences set them apart. Learning these differences can help you understand what the best treatment options are and how you can break free from your addiction once and for all.

Understanding Substance Abuse

Substance use disorders are exceptionally common in the United States. According to the 2023 National Survey on Drug Use and Health:

• 18.0% of adults in the United States have a substance use disorder
• 24.9% of adults report using illicit drugs in the past year
• 67.1% of adults report drinking alcohol in the past year

Someone who develops a substance use disorder may experience debilitating mental and physical health symptoms. They might struggle to stop or cut down their substance use without professional help. 

Some of the most common signs of a substance use disorder include:

• Cravings
• Withdrawal symptoms
• Loss of interest in hobbies
• Not being able to stop on one’s own
• Using more than intended or for longer than intended
• Continued use despite mounting personal consequences

A substance use disorder can devastate someone’s life. It can lead to an overdose or contribute to the development of a lasting medical or mental health condition.

Understanding Behavioral Addiction

Not all addictions are to substances. Many people show similar patterns of addictive behavior without ingesting drugs or alcohol. These behavioral addictions include:

• Pornography addiction
• Sex addiction
• Internet addiction
• Gaming addiction
• Social media addiction
• Food addiction
• Exercise addiction
• Shopping addiction
• Gambling addiction

The number of people living with behavioral addictions is unknown, though there has been substantial scientific interest in the subject in recent years.

Unlike substance use disorders, most behavioral addictions are not included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the primary resource that clinicians use to diagnose mental health conditions. As of now, only gambling addiction is specifically named as a disorder.

[Pullquote: “Still, researchers have discovered that behavioral addictions and substance use disorders have much more in common than you might expect.”]

The Connection Between Substance Abuse and Behavioral Addictions

The difference between substance use disorders and behavioral addictions, at first, seems apparent: One is a physiological and psychological dependence on an addictive substance, while the other is a compulsive pattern of behavior unrelated to substance use. 

Still, researchers have discovered that behavioral addictions and substance use disorders have much more in common than you might expect.

Substance Use and the Brain

Someone with a substance use disorder ingests addictive chemicals that affect their brain. While opioids, cocaine, alcohol, amphetamines, and hallucinogens each have unique effects, all of them involve a large release of the neurotransmitter dopamine.

Dopamine is the brain’s primary reward neurotransmitter. It encourages people to repeat pleasurable activities over and over again and plays a key role in motivation and memory. In an unaddicted brain, dopamine is released during activities such as sex, sports, achieving a personal goal, or eating great food.

When someone uses addictive drugs, however, their brain is flooded with dopamine far above what is typically released during everyday activities. This spike of dopamine plays a key role in the development of addiction by rewarding the user for returning to the behavior.

In time, people who use addictive drugs become accustomed to these dopamine spikes. Their brains begin to change to accommodate higher levels of dopamine, leading to lasting changes in reward processing. 

These changes make it difficult for people with substance use disorders to find motivation to do other activities, leading them to return to substance use over and over again.

Behavioral Addictions and the Brain

Behavioral addictions involve processes similar to substance-related dopamine spikes. Activities such as sex, gambling, viewing pornography, playing video games, or scrolling social media provide some of the highest natural dopamine releases. 

Just as in a substance use disorder, the brain of someone who engages repeatedly in certain behaviors can begin to change. Their brain’s reward network adjusts, and they can feel a sense of reward only through the highly dopaminergic behavior. It becomes difficult for them to enjoy activities outside of their addiction.

Unsurprisingly, this leads to many of the same signs that people with substance use disorders experience, such as:

• Craving the behavior
• Withdrawal symptoms from cutting down on or stopping the behavior
• Loss of interest in other activities
• An inability to cut down or stop on their own
• Continuing the behavior despite mounting consequences

These symptoms are why certain behaviors are labeled as “addictions.”

What Is the Difference Between Substance Abuse and Behavioral Addiction?

The primary difference between substance abuse and behavioral addiction is that one is driven by addictive chemicals, while the other is driven by addictive behaviors. Both disorders affect the same regions of the brain in similar ways. 

People with substance use disorders tend to experience more substantial changes due to the powerful addictive effects of drugs such as heroin or methamphetamine, but both types of disorders can have varying degrees of severity.

Find Addiction Treatment at Never Alone Recovery

No matter what type of addiction you’re living with, Never Alone Recovery is here to help. Never Alone Recovery focuses on connecting you with the best facilities that provide evidence-based treatment approaches to help you overcome challenges with addiction and achieve lasting recovery.

You can break free from addiction, and Never Alone Recovery can support you on your recovery journey. To get started, call us at 866-788-8335 and speak to one of our addiction recovery consultants.