Dependence and addiction are often conflated when talking about substance abuse. Sometimes the terms are used interchangeably or not used at all. Substance abuse disorder is the more preferred clinical term.
However, there is a difference between dependence and addiction. Usually, the former term refers to physical dependence on drugs or alcohol. Having a physical dependence means that you will experience tolerance and withdrawal symptoms. It is possible to have a physical dependence on drugs or alcohol without addiction, but addiction is usually not far away if you are dependent.
What Is the Difference Between Dependence and Addiction?
Addiction is more than just dependence on alcohol or drugs. It’s characterized by significant behavior changes, which are the result of biochemical rewiring in the brain. A period of sustained substance abuse eventually causes this rewiring. Addiction causes a person to prioritize using drugs or alcohol over all else, even if this use leads to negative changes in their lives. Addiction can also be described as psychological dependence. Many of the symptoms displayed by addicted people are psychological. Addiction causes an uncontrollable need to use, and the person may act irrationally if they can’t get the substance that they are addicted to.
Dependence, on the other hand, is simply developing a tolerance to drugs or alcohol as a result of continued, chronic use. This means that you may need more of the substance in order to achieve the same effect. Your body will also experience uncomfortable symptoms if you reduce your use of whatever substance you’re dependent on. You can think of dependence as the earliest stage of addiction. A dependence is required for addiction, but it’s not addiction by itself.
Whether you have addiction or dependence, you’re likely to see a number of negative effects in your life. If you’re addicted, then your whole life is ruled by the desire and urge to get and use a particular substance. However, dependence isn’t much better. If you’re dependent physically on a substance, then it means you’ll experience withdrawal symptoms when you don’t get enough. That can make it hard to participate in certain things if you can’t use your chosen substance.
Physical vs. Mental Dependence
Mental dependence happens when you use a substance in response to certain triggers. Triggers can be feelings or situations or events. Feeling stressed can be a trigger. Certain actions, like coming home from work, can also be triggers. After a person goes through addiction treatment, they have to be very cognizant of triggers. Relapse often occurs in response to triggers.
Trigger symptoms might include any or all of the following:
• Feeling of tightness in the stomach
• Intense desire or urge to use drugs or alcohol
• Anxiety or nervousness
If you have both physical and mental dependence symptoms, then it’s likely that addiction is present. However, the main factor that shows the difference between addiction and dependence is a combination of uncontrollable drug-seeking behavior with both physical and mental dependence.
What’s the Difference Between Substance Abuse and Substance Dependence?
According to the Diagnostic and Statistical Manual of Mental Disorders, there is a difference between substance abuse and substance dependence. Newer versions of the DSM consider both to be the same disorder. However, in general, abuse is the earliest stage of dependence. If you’re abusing a substance, you’re likely using it more than recommended or prescribed. If you continue to abuse the substance, you most likely will develop a dependence. Once the dependence becomes mental as well as physical, and you develop uncontrollable drug-seeking behaviors, then you have reached the stage of addiction.
What Is Drug Dependence?
Also known as chemical dependency, drug dependence is when you need one or more drugs to feel normal and function normally. Chemical dependency was once considered a more severe form of abuse. However, both now fall under a substance use disorder classification. Chemical dependency doesn’t have to be related to illicit drugs, which is part of why it’s different from addiction.
For example, if you take drugs for diabetes or high blood pressure, you will likely form a chemical dependency after a prolonged period of taking the drugs. If you stop using these drugs, you may experience serious side effects. However, since these drugs are not considered addictive, it’s unlikely that you will have a progression of symptoms that includes uncontrollable drug-seeking behavior.
On the other hand, if you take drugs like opiate painkillers, a chemical dependency can put you at risk for addiction. You’re more at risk if you have any of the following:
• A family history of addiction
• A history of anxiety or depression
• Another mental health condition
• You live in an environment where people use drugs and drugs are easy to access
Chemical dependency often progresses to addiction as you build tolerance, develop a concern about losing access to drugs, and begin taking them in a recreational way. Prescription drugs that often cause chemical dependency in the user include the following:
• Opiate painkillers
• Drugs used for anxiety and insomnia such as valium
• Focus drugs such as Adderall
• Drugs that provide a high or a buzz such as marijuana and alcohol
What Are Some Signs of Addiction?
As mentioned previously, the biggest sign of addiction is an uncontrollable need to use drugs or alcohol. This need is so strong that it often engulfs a person’s entire life. Their waking hours revolve around when they can get their next fix. They often worry excessively about running out of drugs. Work, school and other life responsibilities quickly fall by the wayside as they pursue drug use. They will lose interest in any previous hobbies or activities that they enjoyed.
If you’re observing a loved one spiral into addiction, you may notice the following signs as an outsider:
• Drastic mood and behavior changes
• Sudden lack of interest in anything they liked before
• Decreased hygiene
• Financial problems (they may ask you for money often)
• Legal problems
• Drug paraphernalia in their car or house (empty alcohol bottles, syringes, lighters, spoons, etc.)
• Losing their job or dropping out of school
If you ask them about addiction, they will often deny it or get defensive. They may downplay how much they use or deny it outright.
The good news is that addiction can be treated with a combination of medication and therapy. Working with an addiction therapist is a good first step in fighting back. You might also consider addiction rehab for comprehensive treatment. Addiction is a mental disorder, and people who struggle with it may have to work towards sobriety their entire lives.
As an Addiction Therapist in Los Angeles, Doctor Howard Samuels offers behavioral counseling for people struggling with substance abuse. Whether you have a dependence or an addiction, it will take time and work to get free and rediscover sobriety. Start on that path today by contacting Doctor Samuels.