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According to the Merriam-Webster dictionary, addiction is “a compulsive, chronic, physiological or psychological need for a habit-forming substance, behavior, or activity having harmful physical, psychological, or social effects.” When addicted to a substance, a person cannot stop using it despite the negative consequences.
Addiction also leads to missed work, neglected relationships, failure to attend family obligations, and dependency.
Dependence, on the other hand, includes physical symptoms associated with using or not using a substance. When someone is dependent, his or her body adapts to a drug and requires more of it to achieve the same effect. The body also experiences withdrawal if an individual abruptly stops taking the substance.
Though dependence and addiction are often used to mean the same thing, they are not. Dependence is a physical condition that occurs once the body adapts to functioning with the drug. No longer taking that drug produces measurable symptoms, including withdrawal syndrome. This is not the case with addiction.
You can be addicted without being dependent and be dependent without having an addiction. However, it’s common for physical dependence to accompany addiction.
It’s possible to be both physically dependent and psychologically dependent on a substance. Psychological dependence is another way of saying a person is addicted to something. They might not experience physical withdrawal symptoms when they stop using, but their brain processes have changed.
There are some drugs you can be addicted to without developing physical dependence. For example, cocaine doesn’t trigger physical withdrawal symptoms in most people, but addiction is possible.
Some argue that all substances trigger a physical withdrawal, but it’s not always the flu-like symptoms that accompany certain drugs.
Symptoms of withdrawal might also include:
These all indicate that the body is out of balance and is struggling to adjust to life without the substance.
It’s also possible to abuse a substance without ever becoming physically dependent on or addicted to the substance. However, misusing a substance always puts someone at a higher risk for developing an addiction or physical dependence.
You can misuse substances and not be dependent. You can also be dependent on substances without misusing it or being addicted to it. However, prevention from dependence must occur at the substance abuse stage.
When a person misuses a drug, he or she can become physically dependent on it. This means he or she develops a tolerance to the substance and needs higher doses over time to achieve the same effect.
A physically dependent person also experiences withdrawal when the use of the drug is suddenly stopped. Withdrawal occurs because the body is trying to counteract the lack of the drug.
Certain prescribed medications and illicit drugs increase the amount of dopamine in the brain. As a result, the brain needs to produce less dopamine naturally. When the intake of the substance stops, the brain isn’t immediately able to return to producing dopamine as it once did. And since dopamine is one of the neurotransmitters responsible for pleasure, the person can’t experience pleasure, at least while the brain is healing, without the drug.
It’s obvious when someone is physically dependent on a drug. When you stop taking the drug you experience withdrawal symptoms.
It’s not as easy to know if you are addicted. It’s even possible to be dependent on a drug without being addicted to it. A good example is someone managing cancer-related pain with opioids. That person might be dependent on the drug and experience withdrawal symptoms if they suddenly stop taking it. However, it’s not an addiction because there is no compulsion to use the drug despite harm.
The line between physical dependence vs. addiction blurs when someone is dependent on a drug because of pain. He or she seeks the substance to relieve the pain, but is it caused by addiction? In most cases, the presence of an addiction is determined by noticeable negative consequences.
If the use of a substance is hurting you, damaging your relationships, interfering with school or work, or causing legal problems, and you continue to seek the drug, it might be an addiction. On the other hand, if you crave the drug or experience withdrawal when not using it (dependence), but you can prevent yourself from taking it, it’s probably not an addiction.
Substance abuse treatment can help with the misuse of and dependence and addiction to a drug.
Treatment can be two-fold:
Even if someone is not physically dependent, treatment is helpful for coping with the addiction.
Treatment programs occur in a variety of settings for different lengths of time. They are based on different theories and incorporate different philosophies. Treatment might include behavioral therapy, medication, or a combination of the two. It could also include support for dealing with addiction to prescription medications, illicit drugs, or alcohol.
Many treatment programs also address co-occurring issues, such as multiple addictions or mental health disorders. There might be individual and group therapy, and the loved ones of the addicted person might attend counseling. Finding a treatment program that is right for you is an important part of recovery.
It’s also important to realize that addiction is a chronic disorder that can result in relapse. Short-term or one-time treatment options are rarely effective. Treatment must address withdrawal if it occurs, addiction, relapse, and other issues. Success is most often experienced when a person opts for a long-term treatment program with ongoing support.
“Definition of ADDICTION.” Merriam-Webster.Com, 2019, https://www.merriam-webster.com/dictionary/addiction
National Institute on Drug Abuse. “Is There a Difference between Physical Dependence and Addiction?” Drugabuse.Gov, 2019, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence
“Physical Addiction or Psychological Addiction – Is There a Real Difference?” Psychology Today, https://www.psychologytoday.com/us/blog/all-about-addiction/201007/physical-addiction-or-psychological-addiction-is-there-real
National Institute on Drug Abuse. “What Is Drug Addiction Treatment?” Drugabuse.Gov, 2019, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/what-drug-addiction-treatment