Addiction VS Dependence

What Is Substance Addiction?

Substance addiction refers to a complex mental health condition where an individual struggles to stop or control their behavior towards a particular substance. In many cases, individuals may be diagnosed with substance use disorder.

Substance use disorder (SUD) is described in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, fifth edition) as a pattern of symptoms and behaviors caused by an uncontrollable urge to abuse a particular substance.

The most common types of substance addiction are drug addiction and alcohol addiction. People with substance addiction issues often continue abusing a substance despite the harmful consequences it has on their lives.

People with a substance addiction may wish to quit but find it difficult to manage physical symptoms such as intense cravings or withdrawal symptoms. For individuals with severe addiction, substance abuse treatment that includes therapy and medications may be necessary.

Common symptoms of addiction include:

• Being unable to stop alcohol or drug use, even despite wanting to cut down or control use
• Repeatedly trying and failing to quit or control drug or alcohol abuse
• Continuing to abuse substances despite the negative consequences to health and quality of life
• Engaging in secretive or dishonest behavior to hide drug or alcohol use
• Neglecting roles and responsibilities such as work, school, or home obligations
• Withdrawing from social groups and activities in favor of seeking out and abusing substances
• Requiring larger amounts or higher doses of the substance to achieve the desired effect

What Is Substance Dependence?

Substance dependence refers to the physical or mental dependence on drugs or alcohol. Dependence is often divided into two categories: physical and psychological dependency. Physical dependency refers to the body developing a physical reliance on the substance.

For example, someone prescribed benzodiazepines may begin to develop a physical dependence on the drug and experience withdrawal symptoms when not taking it regularly.

Psychological dependency, on the other hand, relates to the reliance on substances for mental and emotional well-being.

People who only have substance dependence typically do not crave or desire the substance’s effect but feel compelled to use it to curb unwanted emotional or physical symptoms, such as symptoms of withdrawal.

Addiction and dependence are often confused with each other. However, they can and often do exist simultaneously.

Where someone with dependence may not have the strong urge to take a substance for its effect, patterns of addiction may develop over time.

Common symptoms of dependence include:

• Developing a tolerance to certain substances and requiring more for similar effects
• Needing to continue a drug to avoid adverse effects
• Experiencing physical or psychological withdrawal symptoms when not using the substance, such as:
  • Anxiety
  • Depression
  • Nightmares
  • Sweating
  • Muscle weakness
  • Body aches
  • Nausea
  • Vomiting

How Are Addiction and Dependence Related?

Although addiction and dependence are different, their symptoms can look somewhat similar to friends and family.

Understanding how these two conditions relate helps increase awareness of the risk for severe addiction and health problems, as people experiencing substance dependence are at greater risk of developing addiction and SUDs.

Differences Between Addiction and Dependence

One of the biggest differences between addiction and dependence is that addiction is a disease, and tolerance is a condition. While addiction and dependence frequently co-occur, they describe two separate issues.

People with addiction have difficulty stopping themselves from using substances, even when they want to stop. Addiction affects the addict’s thoughts and behaviors, causing patterns of drug-seeking behavior that may be destructive or dangerous.

Individuals with dependence (and not addiction) typically do not struggle to stop themselves from using substances. However, they may continue using due to physical or mental symptoms caused by stopping the substance.

People with dependence may not enjoy the effects of the substance but still feel trapped in using it due to withdrawal symptoms. Individuals with addiction actively crave and seek the effects of substances. However, given enough time, people with dependence may develop an addiction.

Similarities Between Addiction and Dependence

Addiction and dependence do have several similarities, hence why many confuse the two. For both groups, they may have lost control over their substance use.

While this loss of control may be for different reasons, addiction and dependence may appear the same to a loved one or outside observer.

Both addiction and dependence can cause an individual’s tolerance for the substance to increase. When this occurs, the person will require larger amounts of the substance to achieve the same effect.

In addition, both conditions frequently cause withdrawal symptoms when the user attempts to stop using the substance. These withdrawal symptoms may be unpleasant or even dangerous, causing the user to continue using the substance to avoid these negative effects.

There is also the risk of accidental overdose, especially when people with addiction or dependence find themselves needing higher doses. Regardless of the cause, an overdose is a serious medical emergency that requires immediate intervention.

How Does Substance Abuse Become Dependence and Addiction?

Although dependence and addiction are different, they often co-occur. People with dependence on a substance are much more likely to develop an addiction or SUD later on. Dependence can become an addiction the longer the individual uses or abuses the substance for its effects.

Over time, an individual with dependence may begin to enjoy the effects of a substance. Repeated use of drugs and alcohol over a long period of time can cause changes in the brain, especially related to the brain’s reward center.

The reward center in the brain is primarily found along the dopamine pathways. Dopamine is a chemical associated with pleasure and reward.

Each time a substance is taken, a flood of dopamine is released in this part of the brain. Eventually, the brain may depend on this flood of dopamine to function.

Once a person begins to crave the pleasurable feelings caused by dopamine, they may begin to develop addictive behaviors they slowly lose control over. For this reason, it’s important that individuals with dependence on a substance seek help before they develop an addiction.

Treatment for Substance Dependence and Addiction

Some treatments are effective for both dependence and addiction, while others are not. In the case of dependence, behavioral treatments like therapy may not be necessary.

Treatment for dependence varies, depending on the substance, but typically can be handled by a general physician.

Withdrawal symptoms are often the biggest risk for psychological or physical dependence. Healthcare providers can help by slowly weening the patient off the substance and/or prescribing medication to help ease withdrawal symptoms.

These solutions are also used in the treatment of addiction. However, addiction treatment typically includes behavioral therapy to help the patient address the problematic behaviors around substance use.

Because addiction is a mental health disorder, several treatment options may be necessary.

Medical detoxification can help addicts safely stop using drugs or alcohol under medical supervision. After detox, addicts typically enter inpatient or outpatient treatment centers, which include behavioral health treatments like addiction therapy and medication-assisted treatments (MATs).

Find Dependence or Addiction Treatment Near You

Living with substance dependence or addiction can be incredibly challenging. Thankfully, there are many treatment programs and options to help you or a loved one address dependence issues or enter addiction recovery.

If you or someone you love has a dependence on a substance or is showing signs of addiction, talk to your doctor about these symptoms. They can help you determine whether it’s dependence or addiction and help you determine the best treatment option for you.

You can also check out SAMHSA’s online treatment locator or call their helpline at 1-800-662-4357 to learn what treatment options are available in your area.