Addiction vs. dependence

Frequently in the context of drug and alcohol abuse, addiction, and dependence are used interchangeably. However, there are different guidelines for what constitutes addiction and what constitutes dependence—physical dependence is often a sign of addiction, not the addiction itself. Knowing the difference between the two can be essential in determining when and if treatment is necessary.

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The confusion between the terms has to do with the history of how they have been defined. The American Psychiatric Association used to use addiction and dependence as two different levels of severity of substance abuse—addiction was milder, and dependence was more severe.

However, current definitions separate addiction and dependence from the current medical diagnosis of substance use disorder, which can be characterized as mild, moderate, or severe.

Understanding the General Differences

The definitions of addiction and dependence in the context of substance use disorders are different. Substance dependence includes physical or physiological symptoms, such as increased tolerance and withdrawal symptoms. Dependence is almost purely physical; it has to do with how the body responds to repeated drug or alcohol use. Rather than your brain telling you that you need more of the substance in their system, your body tells you it will not feel normal without alcohol or drugs. Dependence can be mental as well, but differently than addiction.

Despite the difference in their definitions, dependence and addiction are not always mutually exclusive. It is possible to have a physical dependence on a substance without being addicted, but dependence is almost always an addiction factor. While a dependent person is not yet addicted, it is possible they will be.

Addiction is not as clear-cut as the definition of dependence, but the main difference is that addiction has to do with changes in the brain. When the brain’s biochemistry adapts to substance use so that a person is compulsively using despite harmful consequences, a person is considered addicted. No matter what they do or what harm their substance abuse can cause themselves or others, they cannot stop using the drug.

Addiction is not a conscious choice—when substances take control of the brain’s pleasure centers and dopamine transmitters, it slowly unlearns how to produce those feelings independently. Therefore, substance use becomes essential to brain functioning in a way out of the individual’s control. While dependence constitutes a physical reaction to substance abuse, addiction will change behavior. The substance becomes the number one priority; a person’s thoughts will revolve around obtaining the substance. Addiction encompasses the mental aspect of substance abuse disorder that dependence does not.

Physical vs. Mental Dependence

As described before, physical dependence has to do with the levels of tolerance and withdrawal symptoms present in the individual struggling with a substance use disorder. The body will rely on the substance to feel normal. However, the idea of mental dependence has gained credibility more recently as symptoms of addiction, such as triggers and cravings, begin physically but slowly work their way into the individual’s psyche. Some signs of mental dependency include:

  • Cravings
  • Mental disorders such as anxiety and depression that appear as a result of lack of substance use
  • Effects on appetite
  • Issues with sleep

These symptoms do not necessarily have to do with the individual being unable to resist the substance, as addiction does; instead, they can become physical symptoms caused by mental dependency. Like addiction and dependence, psychological and physical addiction are not mutually exclusive as one usually does not occur without the other.

Do you believe that you or a loved one are suffering from a substance use disorder? Talk to our experienced addiction professionals by calling: (844) 978-1524

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