The terms “addiction” and “dependence” can seem similar, but they are different. Dependence occurs when the body physically relies on a drug. Addiction involves changes in behavior.
A person with an addiction has difficulty not using substances or doing rewarding activities, even if it is harming them.
A person can have an addiction without necessarily having a physical dependence. Similarly, a person can have a physical dependence on a drug without feeling compelled to use it. However, they may still experience withdrawal symptoms if they stop taking it.
In this article, we look at the differences between addiction and dependence and explore definitions, examples, and differences in treatment.
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Addiction is a chronic health condition. It occurs when a person has difficulty stopping substance use or engaging in a behavior that provides some type of benefit.
Addiction causes cravings, compulsive behavior, and changes in the brain.
Physical dependence is when the body adapts to a substance’s presence. It
Unlike addiction, dependence does not necessarily involve difficulty controlling behavior.
A person may feel indifferent toward the drug they are taking. But because the body has adapted to its presence, a person may experience negative effects if they lower the dosage or stop taking it altogether.
Dependence can happen with many drugs, even when a person takes them as per their doctor’s instructions.
Addiction can involve a wide range of substances and behaviors.
Addiction can occur with the following substances:
When addiction to a substance develops, it is called substance use disorder. It can be mild, moderate, or severe. Addiction is the severe form.
There are also behavioral addictions. These involve activities rather than substances. There is some debate around which types of behavior can constitute a clinical addiction. Some examples include:
The International Classification of Diseases (ICD-11) also recognizes gaming disorder.
Various substances, both legal and illegal, can cause physical dependence. Some examples of substances that can cause dependence include:
Many people who use the term “dependence” are referring to physical dependence. Mental or psychological dependence is also possible.
Mental dependence is when a person relies on a substance or behavior to cope with emotional challenges. For example, a person may drink alcohol when they feel stressed but otherwise feel no compulsion to drink.
This is not the same as addiction. With alcohol addiction, or severe alcohol use disorder, a person finds it difficult to stop drinking much of the time, not only in certain situations.
Tolerance is when the body’s response to a substance diminishes over time. A person may require higher doses to get the same effect. A person may develop tolerance to a drug if they use it for a long time.
While tolerance is common with dependence, it is not the same thing. Dependence involves the body needing to take a substance to avoid withdrawal symptoms, while tolerance can be present without dependence.
Recognizing the differences between dependence and addiction is crucial for tailoring effective treatment and recovery strategies.
What these strategies are depends on the substance or behavior a person wants to stop.
Treatment plans are not always necessary for physical dependence. For example, a person with a caffeine dependence who stops drinking coffee may have withdrawal symptoms for a few days but then feel better.
However, other forms of drug dependence can cause significant withdrawal symptoms. For some substances, such as alcohol, suddenly stopping it can be dangerous. In these cases, treatment involves gradually tapering off the drug over a set period to reduce withdrawal effects.
Depending on the situation, doctors may also recommend additional interventions to ease withdrawal symptoms,
- resting or sleeping more
- drinking plenty of water
- practicing calm, peaceful activities
- taking certain vitamins
- temporarily taking medications to improve sleep, nausea, or other symptoms
- taking medications to prevent severe complications, such as seizures
Sometimes, severe withdrawal symptoms require monitoring from doctors in a hospital setting.
Addiction treatment and recovery
Treatment for addiction involves a more comprehensive approach that addresses both physical and psychological aspects. Treatment may include:
- behavioral therapies
- support groups
Doctors may also prescribe certain medications to manage dependence and addiction. The specific medication depends on the substance use disorder.
For example, a doctor may recommend:
- buprenorphine or methadone for opioid addiction
- naltrexone, disulfiram, or acamprosate for alcohol addiction
- nicotine replacement products, bupropion, or varenicline (Tyrvaya) for nicotine addiction
In severe cases of intoxication or overdose, a person may require emergency care.
Addiction and dependence are different concepts, each with their own unique characteristics.
Addiction involves compulsive, harmful substance use or behaviors. Dependence is when the body physically relies on a substance.
People can have just a physical dependence, addiction, or both at the same time. Mental dependence is also possible. This is when a person depends on a substance or behavior emotionally, such as when stressed.
Distinguishing between these concepts is essential in recommending the right treatments. Physical dependence can require a careful tapering process. Addiction recovery can involve addressing both physical and psychological health.