Mental health providers may describe drug problems as substance abuse (misuse or problematic use) or substance dependence, with the latter being more severe and disruptive to the person’s life. Substance dependence is the mental health diagnosis that corresponds with what is commonly called addiction. Addiction is commonly summarized as “continued use despite adverse consequences.” In other words, even though a behavior or activity is wreaking havoc in someone’s life, he/she keeps doing it. Though traditionally associated with the use of alcohol and drugs, some use the term addiction more widely to describe problematic, compulsive engagement in behaviors such as sex, gambling and overeating.

There are two different ways of thinking of addiction. Some see it as the drug or problematic behavior having hijacked the person’s brain chemistry. Others see addiction as the result of the person attempting to “self-medicate” symptoms of some baseline mental illness such as depression, bipolar disorder, PTSD or another anxiety disorder. However one conceptualizes it, it is clear that the stakes for those with problematic substance use, which are high, are exceptionally so for Blacks. Though national survey data suggest that the use and selling of illegal substances is similar in Blacks and whites, when it comes to incarceration for the use and selling of illegal substances, Blacks are grossly overrepresented.