Dependency Vs. Addiction

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Last Edited: January 4, 2021
Patricia Howard, LMFT, CADC
Clinically Reviewed
Jim Brown, CDCA
All of the information on this page has been reviewed and certified by an addiction professional.

Physiological & Physical Dependence on Drugs or Alcohol

Distinguishing the key difference between addiction and dependence isn’t straightforward. Many people use the terms interchangeably, but it’s important to understand the nuances that set them apart. 

This knowledge can help you better understand your or your loved one’s condition. Let’s get into what you need to know. 

What Is Physical Dependence?

When people talk about drug dependence, they are usually discussing the physical effects of drug use. These effects consist of tolerance and withdrawal.

Understanding Tolerance 

Tolerance can happen when you continue taking the same substance for an extended period. Over time, your body habituates to the drug. It requires more and more of it to achieve the desired effect. Likewise, in some cases, the body depends on it to function appropriately. 

When someone has an increased tolerance, they may use the drug more frequently, in higher doses, and through more dangerous routes of administration. For example, someone who begins using prescription opioids may eventually progress into using heroin intravenously.

Of course, most people don’t intend to use heroin. But if their body becomes so dependent on the prescription drugs, they require more of them to “feel normal.” Over time, this pattern can cause financial or logistical issues, resulting in the desire to use cheaper, more potent drugs.

Understanding Withdrawal 

Withdrawal refers to the physiological effects that happen after reducing or abstaining from the substance. Withdrawal effects vary in severity, and they largely depend on the type of drug used. Common withdrawal symptoms include:

  • Increased cravings.
  • Depression or persistent sadness.
  • Heightened anxiety or paranoia.
  • Body aches and muscle pain.
  • Sleep disturbances.
  • Hallucinations.
  • Extreme thirst or hunger.
  • Fatigue.
  • Problems with concentration.

Withdrawal symptoms often peak within the first few days after stopping drug use. In some cases, however, symptoms may persist for several weeks or months. This phenomenon is known as protracted withdrawal or post-acute withdrawal syndrome

In extreme cases, such as severe alcohol use disorder, withdrawal can be fatal. Most of the time, the symptoms aren’t life-threatening, but they can be so distressing that they invariably trigger a relapse.

This is why it’s so important that people seek medical attention when cutting back or stopping drug use. It’s impossible to predict how your body will cope with withdrawal. Keep in mind that the following variables may complicate your withdrawal process:

  • Co-occurring mental health issues, like depression or anxiety.
  • Previous histories of withdrawal.
  • Age.
  • Physical health and any preexisting medical conditions.
  • Types of drugs used, especially if there is polysubstance use. 

What Is Addiction?

Addiction is an umbrella term associated with substance use disorders. Not everyone who is physically dependent on drugs meets the criteria for a substance use disorder. Over time, however, most dependence leads to addiction.

Addiction includes dependence, but it also includes numerous other symptoms like:

  • Spending excess time obtaining, using, or recovering from a drug.
  • Lying about drug use.
  • Using the drug despite relationship problems.
  • Using the drug despite problems at school, work, or with law enforcement.
  • Suffering medical consequences as a result of drug use.
  • Using the drug in physically hazardous situations (such as while driving).
  • Wanting to cut back or stop drug use, but feeling unable to do so.

In other words, addiction can affect all areas of someone’s functioning. Many people consider it a disease of both the mind and body. 

Addiction typically requires a combination of detox and long-term clinical treatment with appropriate aftercare planning. Recovery is possible, but it’s essential to learn the right tools to mitigate the chance for a relapse. 

Commonly Abused Substances

Addiction vs Physical Dependence

What About Substance Use Disorders?

In 2013, the Diagnostic and Statistical Manual (DSM-5) revised their definitions for substance abuse and substance dependence into one term: substance use disorder

This is now the clinical term for describing addiction, and it’s a simplified way to resolve the ongoing confusion about the differences between substance abuse vs. dependence. 

Substance use disorders can be mild, moderate, or severe. When left untreated, most disorders progressively worsen. 

Final Thoughts 

People can become both physically and emotionally dependent on their drugs of choice. Addiction is insidious- it’s easy to rationalize or deny a problem until it becomes so immense that you aren’t sure how to cope.

If you believe that you or someone you know suffers from addiction or dependence, please contact one of our addiction specialists and call (866) 578-7471.