Addiction vs. Dependence

Addiction vs Dependence: Where Are You at in Your Substance Use?

Addiction and dependence are terms that people often use interchangeably. However, there is a difference between the two. The sooner you can recognize the signs of each one, the sooner you can seek help. Here at Sana Lake Recovery Center, we’re here to guide you through those differences.

What is Dependence?

The National Institute on Drug Abuse states that dependence is “a state in which an organism functions normally only in the presence of a drug.” Drugs alter the balance of chemicals in the brain. Consequently, the brain has to adapt by changing its natural chemical production. The adaptation then leads to tolerance to the substance.

Through consistent use, the brain starts to depend on the presence of the drug in order to function. If you’re dependent on a drug or alcohol and you stop using the substance, it will affect the chemical balance in your body and withdrawal symptoms will occur.

Dependence can be a sign that addiction is right around the corner. In other cases, dependence can be a side effect of drug and alcohol addiction.

What is Addiction?

Addiction is the compulsive use of a substance despite negative consequences. Similarly to dependence, addiction is caused by chemical changes that occur in the brain. These changes affect the reward and motivation parts of the brain. Your brain starts to correlate using the drug with intense relief and joy after an extended time.

Unlike dependence, a combination of genetic and environmental factors impacts one’s risk of developing an addiction. For example, let’s say a daughter has grown up with a mother that has a heroin addiction. In this case, the daughter will be more likely to experiment with drugs and develop an addiction.

The Difference Between Dependence and Addiction

The World Health Organization states how dependence describes a collection of different characteristics that grow to become a much higher priority in a person’s life than other previous behaviors that were more important at one time. In other words, your priorities change and the substance you’re using becomes your main focal point. Thus, leading to drug or alcohol addiction.

Addiction is characterized by an inability to stop using a drug; failure to meet work, social, or family obligations; and oftentimes tolerance and withdrawal. On the other hand, physical dependence is the adaptation of your body to the drug, requiring more of it to achieve a certain effect (tolerance).

Dependence also elicits drug-specific physical or mental symptoms if the individual drops the substance “cold-turkey” (withdrawal). 

The National Alliance of Advocates for Buprenorphine Treatment believes that the discussion of addiction vs dependence is an important one. They state that it is “the single most important concept to understand when learning about addiction and evidence-based treatment” 

In his opening statement to Congress, Dr. Gottlieb (commissioner) explained, “Someone who requires long-term treatment for opioid addiction with medications – including those that cause a physical dependence – is not addicted to those medications,” and that the stigma surrounding MAT, because of this misunderstanding, “serves to keep many Americans who are seeking a life of sobriety from reaching their goal.

In this case, in the setting of a public health crisis, we need to take a more active role in challenging these conventions around medical therapy.”

Insight Into Tolerance

It’s important to note that there are three main types of tolerance. Tolerance to a drug is often a result of dependence. The more of the drug that your body is exposed to, the harder it is to achieve the same effects without increasing dosage. This is why overdosing is such a dangerous effect of developing a tolerance to any substance.

The three main types of tolerance are:

  1. Acute or short-term, tolerance occurs after repeated exposure to a drug over a fairly short period. For example, cocaine use often results in acute tolerance. 
  2. Chronic, or long-term, tolerance begins when a person’s body adapts to constant exposure to a drug over weeks or months. For example, individuals who consistently misuse prescription opioids build up chronic tolerance to the intense, euphoric effects. This can consequently lead to an increase in the dosage taken.
  3. Learned tolerance can result from frequent exposure to certain drugs. For example, people who misuse alcohol for a long time often do not appear intoxicated to others. 

How Do I Know If I Have a Dependence on Drugs or Alcohol?

Drug or alcohol dependence occurs when you need drugs to function daily. Looking at behavioral patterns is key when diagnosing a dependence on drugs or alcohol versus an addiction. This dependence will also result in withdrawal symptoms when the drug isn’t used. 

Physical symptoms of withdrawal are a result of the body becoming stressed without the drug. These symptoms may include the following:

  • Anxiety
  • Depression
  • Muscle weakness
  • Nightmares
  • Body aches
  • Sweating
  • Nausea
  • Vomiting

How Do I Know If I Have an Addiction to Drugs or Alcohol?

Drug and alcohol addiction is a severe brain disease that impacts people of every race, age group, nationality, and socioeconomic background. Recognizing toxic habits and being-self aware is key to conquering this disease. It’s important, to be honest with yourself about where you’re at.

Some signs can help you determine if you’re experiencing drug or alcohol addiction. Problems with relationships, your job or school, and even legal issues stemming from substance use can be a warning sign that you’re suffering from addiction. There are certain questions you can ask yourself to help determine whether it’s a dependence or an addiction to drugs or alcohol. 

Some of the many questions include:

  • Has your substance use negatively impacted the relationships in your life?
  • Do you continue to use substances despite negative consequences?
  • Have you ever lied to a doctor to attain prescription drugs?
  • Have you ever used substances without knowing what they were or what they would do to you?
  • Do you think about drugs or alcohol often?
  • Have you ever attempted to stop or reduce your substance use but weren’t able to?

The Statistics of Drug and Alcohol Addiction/Dependence

Although addiction and dependence are two different obstacles, they often intertwine. A dependence on substances to alleviate pain can lead to addiction. In other cases, making substance use a habit can chemically alter your brain and body, thus leading to an addiction

It’s important to address the statistics behind drug and alcohol use in the United States. Ignoring the issue will only cause further pain to people and communities nationwide. Did you know the National Survey on Drug Use and Health (NSDUH) states that 19.7 million American adults (aged 12 and older) battled a substance use disorder in 2017?

Nearly 74% of adults struggling from drug and alcohol addiction struggled with an alcohol use disorder in 2017 as well. But it doesn’t stop there. In 2017, 8.5 million American adults suffered from both a mental health disorder and a substance use disorder, or co-occurring disorders.

Whether you’re suffering from addiction or dependence, you can choose to seek help today. No matter how lost you feel, there is always a chance to improve and learn from your mistakes. Although it may seem overwhelming, we encourage you to make that first step towards a lasting change in your life.

Treatment for Addiction and Dependence of Drugs or Alcohol

Based on your unique circumstances, a treatment program can be tailored to meet your needs. We believe in personalizing treatment for each person. If each addiction and person is unique, treatment should be too.

However, it’s important to understand that all treatment lies under the umbrella of the levels of care rehab provides. There are very intensive programs and then there are those with more flexibility. Keep reading to learn more about the levels of care for addiction and dependence on drugs or alcohol.

Drug and Alcohol Detox

Detoxification helps people safely withdraw from drugs or alcohol until their system is clear. Detox is typically the first step of any treatment plan. In certain situations, detoxing from certain drugs requires medication-assisted therapy to alleviate the severity of withdrawal symptoms. Medications prescribed during detox are often tapered down until the individual is no longer physically dependent on the addictive substance.

Detox must be done under medical supervision. Withdrawal symptoms can be difficult, and even deadly to undergo. That’s why our medical team provides 24/7 supervision and care during detox.

Inpatient Rehab/Residential Treatment

Inpatient rehabs, also referred to as residential treatment, is the highest level of care we offer. These treatment programs are structured to address all aspects of an individual’s addiction. During residential treatment, patients reside in a substance-free facility and receive around-the-clock medical care and therapeutic support.

If you’re struggling with chronic addiction, as well as a co-occurring mental or behavioral disorder, then residential treatment may be best suited for your needs.

Outpatient Rehab

Outpatient rehab programs are another level of care when it comes to comprehensive addiction treatment. Outpatient rehab offers many of the same kinds of effective treatments and therapies as residential treatment does. However, outpatient rehab allows patients to live at home during the recovery process.

Patients travel to the facility for scheduled treatment sessions throughout the week.

Outpatient treatment is best suited for those with mild forms of addiction and a committed, disciplined approach to recovery. In other cases, individuals choose to complete an outpatient program after completing a more intensive level of care. 

Start the Road to Recovery Today for Drug or Alcohol Addiction/Dependence

Addiction vs dependence is a discussion that must happen for you to realize where you’re at. Substance misuse can lead to many consequences. Addiction doesn’t deserve to rob you of another day. Dependence can also be conquered. 

We encourage you to give us a call today if you have any questions, comments, or concerns. We’re here to guide you through the entire process. 

You can contact us at Sana Lake Recovery Center here. Our caring staff can help you make the final decision in choosing the right rehab center for you. 

References:

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence

https://www.samhsa.gov/data/report/2017-nsduh-annual-national-report

https://www.centeronaddiction.org/the-buzz-blog/understanding-difference-between-physical-dependence-and-addiction

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.