#1stresponders... What is Addiction vs. Dependence

By Great Oaks Recovery Center

When I was faced with being labeled an “addict” I felt defeated. To me, being an addict meant that I’d lost control and needed drugs to function. It also meant that I would be limited to two possible outcomes: quitting for good or going to an early grave. As I tried desperately to find another way to explain my chronic condition, I remembered hearing the term “dependence” and somehow it had a nicer ring to it.

Being physically dependent made my problem sound more manageable than being dubbed a drug addict. But when I was asked to differentiate between the two I was stumped. What is addiction versus dependence?

Addiction versus Dependence: Let’s Define Dependence First

The word dependence is typically used when referring to a reliance on something. That something can be any number of things, such as a person, a system, an object or a substance. Dependence can be psychological and/ or physical. In this discussion on addiction versus dependence, it is physical dependence that is being referenced.

In this context, physical dependence means that the body is reliant on a substance to function normally and if the substance is not ingested, the body will react by exhibiting withdrawal symptoms. Common substances that can cause physical dependence are alcohol, opiates, benzodiazepines, and amphetamines. Some substances, like opiates, can cause physical dependence after only a few uses while others may take longer to develop. Typically what happens is that a person will take the substance regularly enough that the body becomes accustomed to having it in the system and a tolerance is formed. Once a physical dependence is developed, if the substance is suddenly absent from the system it is unable to function normally, so to speak, and withdrawal symptoms will occur. Withdrawal symptoms vary depending upon the substance. Here is some more information on alcohol withdrawal symptoms and heroin withdrawal symptoms.

Physical dependence does not necessarily mean the individual is an addict. For example, physical dependence can develop in a person who is taking painkillers as prescribed by a doctor. Conversely, an addict may not yet be physically dependent on a substance. However, these two things are often related and once a physical dependence has developed, a full-blown addiction may not be far behind, and visa versa.

Addiction versus Dependence: What is the Difference?

Addiction is a disease and, as such, has diagnosable characteristics. An addiction includes intense and uncontrollable cravings, an inability to control how much or how often a substance is used, and continued use despite negative consequences. In the previous example of a person who has become physically dependent on painkillers, a non-addict wouldn’t experience cravings to keep using no matter what. The real addict would experience strong cravings and would likely return to using at some point, without some form of recovery support.

Addiction versus dependence can be a confusing subject. The word dependence is sometimes used interchangeably with the word addiction and although the two are often related, there are distinct differences. Seeking help from professionals and other people with experience in this area can be useful when trying to decide if one’s behaviors have led to addiction, dependence or both.

Sources

Defining addiction, dependence and abuse. (n.d.). Retrieved June 25, 2015, from http://knowledgex.camh.net/primary_care/guidelines_materials/Pregnancy_Lactation/Pages/defining_addiction

The National Alliance of Advocates for Buprenorphine Treatment. (2014, October 31). Retrieved June 25, 2015, from http://www.naabt.org/addiction_physical-dependence.cfm