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Addiction and Dependence: Understanding Basic Differences

Many people who take prescription medications are warned by their doctors about addiction. Drugs like anti-anxiety medications and opioid painkillers can be highly addictive. Sometimes doctors also talk about dependence and developing a tolerance. Both things can happen when taking medication. However, it’s easy to confuse the terms. Addiction and dependence are related concepts, but they have distinct meanings and characteristics. There are many drugs that people develop a dependence on, but not all of them are addictive and dependence is not always "bad", sometimes it's a natural course in treatment. However, when a person misuses a drug, tolerance can lead to addiction.

Addiction and Substance Use Disorders

Addiction is a complex, chronic brain disease characterized by compulsive drug-seeking and use. People who struggle with addiction, also sometimes called substance use disorder, tend to use it no matter what, even despite harmful consequences. They usually experience a psychological craving for the drug, a physical craving, and a loss of control over its consumption.

Addiction has both physical and psychological characteristics. Someone addicted to opioids like heroin or prescription painkillers may experience intense physical and emotional cravings. When they’re addicted, they probably prioritize drug use over personal responsibilities and engage in risky behaviors to obtain or use the drug.

People addicted to stimulants like cocaine or amphetamines may exhibit a strong desire to repeatedly use the drug, often leading to neglect of work, relationships, and health.

People can become addicted to drugs without experiencing physical withdrawal symptoms, but highly addictive drugs like opioids or stimulants, they usually experience a plethora of issues that go away after withdrawal.

What Is Dependence?

Dependence, also called physical dependence, occurs when a person’s body adapts to the presence of a drug and requires it to function normally. This is a normal thing in medicine and doctors typically adjust dosages for it. People on different drugs can develop a tolerance, needing more of the drug to achieve the same effect. If they stop using the drug abruptly, they may experience withdrawal symptoms.

People with a substance use disorder have a tolerance to the drug. They are not usually taking it as prescribed, however, and may be using the drug in harmful amounts. A person who has developed a tolerance to a non-addictive drug, such as an antidepressant, will need more of it to continue getting benefits.

Illicit drug use and recreational drug use can also lead to dependence but are part of a broader pattern of substance use. Chronic alcohol consumption, for example, can lead to physical dependence. When a person who is dependent on alcohol abruptly stops drinking, they may experience withdrawal symptoms such as tremors, anxiety, and even seizures.

When a person takes anti-anxiety medications, like Xanax or Valium, they also may develop physical dependence. When someone who is dependent on benzodiazepines stops taking them suddenly, they may experience withdrawal symptoms like anxiety, insomnia, and seizures. These drugs are highly addictive and withdrawal is not uncommon.

Telling The Difference

A person who continues to use a substance despite negative consequences probably has a substance use disorder. Dependence, drug-seeking behavior, changes in personality, and personal and financial problems are also part of the bigger picture when it comes to addiction. Eventually, a person who uses drugs may not be able to focus on much else but the getting and using of that drug. (Alcohol is a drug, too.)

While addiction is primarily a behavioral and psychological condition characterized by compulsive drug use and a lack of control, dependence is a physical adaptation to a drug. This can happen when people use a drug as intended and even when a drug is not addictive. This can result in tolerance and withdrawal symptoms when the drug is discontinued.

Addiction and dependence often co-occur, especially with substances that have a high potential for abuse, but they are not synonymous. Treatment for addiction includes behavioral therapy, peer support groups, Medication-Assisted Treatment, and other therapeutic methods to help break the cycle of addiction and pursue recovery. Staying sober is also a part of ongoing recovery.

Getting Help for Addiction

Addiction is a disease of the brain that can’t get better without abstinence and treatment. We’re here to help you start the journey to sober living and recovery, and we’re happy to answer any questions. Please give us a call, it’s 100% confidential.



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Mark G
Mark Gladden brings both personal and professional experience to his role as co-founder of Present Moments Recovery. Now in long-term recovery himself after struggling with addiction for years, Mark understands firsthand the challenges men face in achieving and maintaining sobriety. It was this insight, combined with a desire to help others, that led Mark to establish Present Moments Recovery.

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