Addiction Vs. Dependence: What Is the Difference?

What Is Addiction?

Addiction is a pervasive repetition of behavior that continues despite associated consequences.⁴ Individuals struggling with addiction experience uncontrollable urges or cravings to engage in problematic substance use or behaviors (e.g., gambling, stealing, spending, sex, etc.).³ Thoughts become obsessive, ultimately leading toward compulsions to satisfy them.

The DSM-5 classifies addiction as a disease, including those of substance-related (i.e., drugs, alcohol) and other addictive disorders.⁶ Treatment is ongoing and adaptable as one progresses through recovery.

Symptoms of addiction include:⁶

• Consuming a substance in larger amounts over a longer period than intended
• Persistent desire or unsuccessful attempts to cut down or control consumption
• Spending a lot of time obtaining and consuming the substance
• Cravings or strong urges to use the substance
• Recurrent use, resulting in a failure to fulfill major role obligations
• Continued use despite persistent or recurrent social or interpersonal problems caused or exacerbated by the addiction
• Important social, occupational, or recreational activities are given up or reduced
• Recurrent use in physically hazardous situations
• Continuing use despite knowledge of having a persistent or recurrent physical or psychological problem

What Is Dependence?

Experts define dependence as a physical dependence on a substance that occurs naturally after continued use.^1,2,3,4,5 Dependence may develop whether one uses a substance as recommended or misuses. Neurophysiological changes occur in the brain, resulting in tolerance and withdrawal symptoms when individuals stop consuming the substance.³

Dependence is not unique to drugs and alcohol. People can become physically dependent on everyday substances like sugar and caffeine. Physical dependence may prove more substantial depending on substance strength, method of consumption, frequency of use, and overall health.

Symptoms of dependence include:⁶

• Tolerance: Individuals require increased amounts of a substance to experience desired effects. With increased tolerance, the body struggles to maintain equilibrium and relies on the external source.³
• Withdrawal: Withdrawal symptoms occur when someone stops using a substance due to physiological dependence.

Differences Between Addiction & Dependence

Dependence and addiction are related but distinct concepts in the substance abuse realm. While addiction refers to a compulsive and uncontrollable need to use a substance despite associated consequences, dependence occurs as the body adapts to the drug. In other words, addiction is primarily a psychological disorder, whereas dependence pertains to the physical need for a substance to maintain normal functioning.

Physical Dependence Vs. Addiction

Physical dependence is marked by the reliance on a substance to function normally. The body becomes accustomed to the presence of the drug and adapts to its effects, leading to withdrawal symptoms if the individual cuts back on the substance or quits altogether. This physical need for the substance is the fundamental characteristic of dependence.

Addiction goes beyond physical dependence and encompasses a complex psychological component. Addiction is a compulsive, uncontrollable urge to use a substance, even when consumption produces various negative impacts. It involves a psychological craving and a loss of control over drug use. A range of behavioral, emotional, and social issues often accompany addiction.

Physical Dependence Vs. Mental Dependence

Physical and mental dependence are interrelated yet distinct concepts that contribute to addiction. As mentioned, physical dependence relates to bodily reliance on substances. Conversely, mental dependence is the psychological need for a substance often driven by cravings, emotional distress, or other underlying psychological conditions. Both physical and mental dependence can co-exist, reinforcing each other in a vicious cycle.

Substance Abuse Vs. Substance Dependence

The main difference between abuse and dependence lies in the severity and behavioral patterns related to drug or alcohol use. Substance abuse is the excessive, harmful, or inappropriate use of substances, often resulting in negative consequences. For example, individuals may use drugs in dangerous situations, neglect responsibilities, or experience legal or interpersonal problems due to substance use.

On the other hand, substance dependence, also known as addiction, is a more severe and chronic condition. While substance abuse implies problematic patterns of use, substance dependence includes both the harmful behaviors associated with abuse and the physical and psychological reliance on the substance.

Treatment for Addiction & Dependence

The first step in getting help for addiction and dependence is identifying the problem. Addiction and dependence can escalate quickly, becoming increasingly difficult to manage. The earlier you seek treatment, the greater the likelihood of positive outcomes.

Inpatient & Rehab Treatment

Inpatient and rehab treatments involve staying at a specialized facility, typically from a few weeks to several months. This treatment provides a structured, supportive environment with round-the-clock care and supervision. Inpatient treatment offers a highly focused approach, providing individualized treatment plans, therapy sessions, group support, and access to various therapeutic interventions. Programs allow individuals to fully immerse themselves in recovery and promote a holistic approach to address physical, psychological, and social factors.

Intensive Outpatient Therapy

Intensive outpatient therapy provides a comprehensive treatment approach tailored to individual needs. These programs typically include individual therapy, group therapy, family therapy, and educational sessions on addiction and recovery. Sessions focus on addressing the underlying causes of addiction, developing coping skills, and providing support to navigate challenges.

Intensive outpatient is ideal for individuals requiring more support than traditional outpatient care without the 24-hour care provided by inpatient treatment. Individuals can benefit from intensive treatment while maintaining their work, school, or family commitments, making it a more flexible option when treating addiction.

Medications

Medications play an essential role in the treatment of substance abuse and addiction. Medication-assisted treatment (MAT) is not a standalone solution but can significantly improve the chances of a successful recovery by addressing the physical and psychological aspects of addiction.

MAT involves medications to alleviate withdrawal symptoms, reduce drug cravings, and minimize the risk of relapse. These medications may be part of an outpatient or inpatient treatment program, often alongside behavioral therapy and counseling. Certain medications, such as methadone, naltrexone, and buprenorphine, can be especially beneficial for treating opioid addiction.

Other medications, including acamprosate and disulfiram, help curb alcohol cravings and decrease the risk of relapse for alcohol misuse and addiction. Managing physical dependence and cravings with medications can significantly boost recovery efforts and improve the chances of long-term success.

How to Find Treatment

Consult with a professional–preferably specializing in addiction and dependence–to receive an assessment and a formal diagnosis. Be open-minded to suggestions, as professionals are trained and experienced in determining treatment plans.

Consider that the more severe the condition, the more invasive the treatment. Even in minor cases of addiction or dependence, treatment is appropriate for additional support. Positive social support is also a leading factor in recovery. Finding the right therapist can seem challenging, but an online therapist directory can help you locate a provider who fits your unique needs.

Final Thoughts

Substance abuse and addiction are complex issues requiring a comprehensive approach to treatment. Whether one chooses inpatient treatment, rehab, intensive outpatient therapy, or a combination, the key is to seek help and support. Treatment options provide the tools, guidance, and resources to overcome addiction, address underlying issues, and build a foundation for a healthier, more fulfilling life. It is important to remember that recovery is a journey, and seeking professional help is an important step toward a brighter future.