Some would argue that if you use any substance for a non-therapeutic or illegal use, it's immediately called “abuse”. Now we're getting into taxonomy, definitional issues. But the point is that you don't necessarily need to be dependent to have immediate harms from the use of a drug. We see that in people who drink too much and kill themselves driving home. There's a variety of ways of looking at it.
I'm sorry if it's less than a full answer, but I think the point made by Paula is really trying to focus on what we know are the issues flowing from non-therapeutic use and therapeutic use that is not consistent with what best practices are called for, either in prescribing for or in terms of treating specific conditions.