The words “dependence” and “addiction” are often thrown around in today’s substance abuse-conscious society. That the public is aware of such terms is a step in the right direction, and shows that as a culture we are no longer as willing to sweep such issues under the rug.
However, a lack of clear education on the topic and the similarity between the words can lead to confusion. If you are unsure about the difference between the two, it may hinder your efforts to decide on an appropriate course of treatment.
Humans can form dependence on many drugs, pharmaceuticals and alcohol included. The National Institute on Drug Abuse defines physical dependence as the bodily adaptation to a certain drug, “requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal)” (2012). This definition points to a few important characteristics.
First, drugs do not necessarily need to bring us recreational reward in order for us to depend on them – although they frequently do. Rather, the human body can easily form a dependence on a variety of medications or substances, including sleep aids, antidepressants or antianxieties, needing them in order to perform certain tasks such as remaining calm or falling asleep.
Going into Withdrawal
Second, over time, a physical dependence is often characterized by needing higher amounts of the drug to feel the same effect. When the drug is removed, the body will go into withdrawal, because it has become so accustomed to having that drug in the system and made physical adjustments to accommodate it.
According to Addictions and Recovery, withdrawal can take various forms depending on the drug (2015). With alcohol, opiates and tranquilizers (including many drugs frequently prescribed pharmaceutically), the symptoms of withdrawal can be severe. With recreational drugs such as cocaine, marijuana or ecstasy, the withdrawal may be more emotional in nature, and point to addiction rather than dependence.
Psychological addiction may have a physical dependence component, but goes beyond that to include several other specific traits as well. According to the National Alliance of Advocates for Buprenorphine Treatment, while physical dependence is normal and can be treated with alternative medications and slowly tapering off the chemical on which the body is dependent, addiction is not normal (2014).
Cravings are the basis of the problem, causing and mind (and often the body) to want the drug, sometimes desperately. This results in compulsive and uncontrollable substance use and abuse, doing harm to oneself and others; failure to fulfill responsibilities; and changing mental states that prioritize the substance over other values or people.
Addiction is often very destructive, causing ruined relationships and failed employment opportunities, and can even cause affected individuals to become homeless. Serious addiction can result in death.
Telling the Difference
Before deciding on treatment, it is important to distinguish between dependence and psychological addiction. For dependence, a treatment plan that weans the body off the substance slowly to avoid withdrawal is the best course of action. For addiction, however, more serious treatment that addresses the emotional component is required.
Most people need to undergo some form of therapy and learn to control cravings, often by replacing formerly destructive behaviors with new, healthier ones.
The good news is that both dependence and addiction are fully treatable, and by choosing the right option for you, you can overcome the problem.
- National Institutes of Health, Is there a difference between physical dependence and addiction?, National Institute of Drug Abuse, 2012, http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence.
- Addictions and Recovery, Withdrawal, AddicitonsandRecovery.org, http://www.addictionsandrecovery.org/withdrawal.htm, 2015.
- National Alliance of Advocates for Buprenorphine Treatment, Physical dependence and addiction, National Alliance of Advocates for Buprenorphine Treatment, 2014, http://www.naabt.org/addiction_physical-dependence.cfm.