Substance abuse refers to the use of drugs or alcohol in a way that causes significant problems or distress. It can lead to negative consequences in various areas of life, such as work, relationships, and health. Substance dependence, on the other hand, is characterized by a physical and psychological dependence on drugs or alcohol, including withdrawal symptoms when the substance is discontinued. Substance misuse refers to the use of drugs or alcohol in a way that is not consistent with medical or social norms, but does not necessarily meet the criteria for substance abuse or dependence.