Addiction vs. Dependence

Understanding the distinction between addiction and dependence is important.

Dependence means there is a physical and/or mental reliance on a substance. It is defined as a state in which an organism functions normally only in the presence of a drug per the National Institute on Drug Abuse. Also, dependence affects the thalamus and brain stem, while addiction affects the pleasure centers of the brain.

Addiction is more behavioral in nature fueled by the rewarding feeling achieved from consuming drugs or alcohol, in spite of the detrimental consequences to oneself and others.

It is possible to possess a dependence without an addiction. Drugs that are not addictive can produce a natural dependence. Use of prednisone, a type of cortisone used to treat inflammation, is a good example of when a dependence can be present without an addiction. If consistent use is stopped abruptly it can produce physical withdrawal symptoms such as fatigue, weakness, and joint pain. However, this drug is only used for medical reasons and there is no way to get a “high” from it, which eliminates the risk to become addicted to that particular substance.

Although it is possible to be dependent but not addicted to a given drug, dependence is commonly a precursor to addiction.

History of Terms

The confusion centered on the difference between addiction and dependence can be attributed to the previous American Psychiatric Association’s definitions. Abuse and dependence used to be considered the two levels of severity of a substance use disorder. Abuse was considered a mild form of addiction and dependence was considered to be a much more extreme addiction. This was perplexing in the study of biology, as dependence is defined as a physical adaptation to a substance.

Current definitions have become much clearer creating mild, moderate, or severe as the different tiers of a substance use disorder, eliminating the use of the words “dependence” and “addiction” to characterize severity.

What is addiction?

Addiction is the compulsive behavior and uncontrollable feeling associated with continued use of a substance despite harmful consequences. It can be a lifetime struggle to conquer these behaviors and feelings that can commonly return even after recovery.

While it was previously believed that addiction was a conscious choice an individual was making, it is now believed that is exists due to biological changes created in the brain from substance use. When the pleasure centers of the brain are stimulated, the means to continue to achieve that feeling can take priority over someone’s daily activities. Addiction is characterized by two behaviors:

1. The inability to quit using

2. The continued desire to use regardless of the consequences

The susceptibility to having an addiction is associated with someone’s genetic makeup, their accessibility to drugs and alcohol, their socioeconomic status, and environment.

Types of Dependence

There are two types of dependence: physical and mental. A physical dependence can take shape when someone experiences physical impairments or withdrawal symptoms in the absence of a substance. Consuming drugs or alcohol in large quantities can create a physical dependence, as the body will begin to rely on those substances to fulfill normal daily activities.

Physical dependence is rooted in an individual developing a tolerance to a drug. The body becomes accustomed to and less sensitive to substances over time. After continued use, an increased amount of a certain substance is necessary to achieve the same effects.

Alcohol, heroin, and methamphetamine are a few examples of substances that can create the greatest risk in developing a physical dependence. Additionally, a substance that is injected or snorted is much more likely to create a strong physical dependence when compared to something that is consumed orally.

A mental dependence can be defined as the psychological or emotional of process of dealing with a substance use disorder. It can generally be fueled by triggers, or certain activities that might create associations with use. Symptoms can include:

• Cravings

• Mental disorders such as anxiety or depression that appear as a result of lack of substance use

• Effects on appetite

• Issues with sleep

While physical and mental dependencies are different, an individual generally does not suffer from one type without the other.

Withdrawal

An individual who has continued to consume a substance will notice adverse withdrawal symptoms once that substance is no longer present in the body. Symptoms can vary depending upon the type of substance and severity of use. Some might be physical, some mental and symptoms can also be life-threatening.

Understanding the differences between addiction and dependence is important. While similar, and often used interchangeably, the correct use of these terms is valuable during addiction recovery treatment and beyond.

Are you or a loved one suffering from drug or alcohol addiction? We are here for you and we are here to help.