What distinguishes drug abuse from drug dependence?

The distinction between drug abuse and drug dependence is primarily based on the presence of physical signs related to substance use, specifically tolerance and withdrawal symptoms. Drug dependence indicates a physiological adaptation to a substance, resulting in the need for increased amounts of the drug (tolerance) to achieve the same effects, and withdrawal symptoms that occur when the substance is reduced or stopped.

Drug abuse, on the other hand, typically refers to the maladaptive pattern of substance use leading to significant impairment or distress, but it does not necessarily involve the physiological aspects of dependence. Not every instance of drug abuse results in physical dependence, as one can abuse substances without developing tolerance or experiencing withdrawal.

This is why the option regarding tolerance and withdrawal symptoms effectively captures the essence of what distinguishes dependence from abuse. Other options incorrectly imply that abuse always involves dependence or suggest limitations to their impact on social relationships that do not align with the clinical definitions of these terms.