Maybe you’ve just discovered that someone you care about abuses drugs or alcohol. It can be hard to understand why they couldn’t just give it up—especially if it is causing harm to their close relationships and to their own life. Why can’t they stop cold turkey? Today, we’re going to find out why, which begins with a look at the difference between addiction vs. dependence.
“Addiction” and “dependence” are often interchanged terms that can be difficult to keep straight, even for the medical community. In 1964, the World Health Organization wanted to replace “addiction” with “dependence.”
After that, The Diagnostic and Statistical Manual of Mental Health Disorders (DSM) used to consider addiction and dependence as separate disorders. Now, they use a more exact term: substance use disorder. Substance use disorder is considered a mental disease that affects behavior and the inability for a user to control their use of alcohol or drugs—whether it’s prescription or not.
However, there are still important differences when it comes to understanding addiction vs. dependence.
What is addiction?
Addiction used to be treated as a choice that addicts made on their own. Today, addiction is understood as a process that changes the chemistry of the brain after continued substance abuse. When someone is addicted to drugs, alcohol, or even other habits such as gambling, it can become all-consuming. They may choose the drug or activity over family occasions. They may miss appointments and skip work or school.
If an addict tries to quit their addiction, they may have extreme cravings or obsessive thoughts about the drug that their body is lacking in withdrawal. They may resort to doing anything to get drugs or alcohol, including spending time talking someone into giving them money for it, stealing, or selling all their belongings. Addicts easily find themselves in financial trouble because their addiction may make them unable to maintain a job.
Because addiction changes brain chemistry, addiction isn’t a choice. It’s a result of drug abuse, and addicts need help that they won’t be able to get on their own.
What is dependence?
Dependence happens when the body adapts to a drug. In this case, a user will need more and more of it each time to achieve the same high they received when they first used the drug. This is called a tolerance to the drug. They may experience physical or mental symptoms during withdrawal because their body has become dependent on the substance.
Dependence commonly occurs with prescription drugs, even when the drugs are taken as instructed. Patients may not even know that they are dependent on their drugs until they visit their doctor again and tell them that the medication isn’t working. This is common with prescription painkillers and anti-anxiety medication, such as Vicodin and Xanax respectively, which can also be addictive.
Addiction vs. Dependence
Like with caffeine, you may notice that you have a headache if you don’t have your daily dose of coffee. Maybe you notice you’ve increased your intake from one cup of coffee to two cups. That is considered dependence. The body demands an increased dose for the same effect, and it has a physical withdrawal symptom if it doesn’t receive the dose.
However, in this case of dependence, you can choose not to drink coffee for the rest of the week, and choose to deal with the headache with the assistance of aspirin. The headache will eventually go away on its own as your body normalizes itself without caffeine.
If you were addicted to caffeine, you wouldn’t be able to make the decision to stop your daily regimen of drinking coffee. You would feel compelled to get caffeine no matter what, even if it meant begging outside of a coffee shop to get it.
The U.S. government considers addiction to be a disease of the brain. The good news is that if you or your loved one is struggling with the terrible effects of addiction, they can receive help. Because it’s recognized as a disease in the brain, help is often covered by insurance. Insurance plans will clarify if they cover treatments on your policy that can help: detox, inpatient rehab, and medications.
Detox treatments provide a medically supervised space for addicts to get rid of the drugs in their body naturally with time. Mental and physical withdrawal symptoms will appear, some of which can be as intense as seizures or suicidal thoughts. But under professional care, these symptoms can be managed and medicated safely.
After detox, you or your loved one can attend inpatient rehab at an addiction treatment center. This is where you’ll receive ongoing care for your withdrawal symptoms, and you’ll attend therapy for mental symptoms. You’ll also have access to a support circle of other detoxed addicts aiming for the same goal of lifelong recovery.
Some prescribed medications can help dull withdrawal symptoms. Other medications can even make the drug that you or your loved one are addicted to less appealing, or blocked by certain receptors in the brain. Coming up with a recovery plan isn’t as simple as taking pills—medical staff can help determine which medication you need based on your duration of drug or alcohol abuse and your possible co-occurring mental disorders.
Addiction vs. dependence can be a tricky distinction to make. In short, addiction means that the brain has chemically changed as a reaction to substance abuse. Addiction is widely considered a disease, and there are plenty of treatment plans available that insurance policies cover.
Dependence means that the body is reliant upon the drug and can build a tolerance to the drug. Dependency is also treatable, and it’s commonly treated by reducing dosage slowly over time. You may also receive medication to help with the physical side effects of lowering your dosage. Whether you or your loved one is addicted or dependent, there are treatment options for the umbrella term: substance use disorder.