Drug dependence vs. drug addiction: Is there really a difference? Yes, there is. Understanding the difference between mental or physical dependence vs. addiction can help customize effective treatment and recovery programs better suited to the individual. The right treatment provides a more compassionate recovery journey, one less likely to result in a relapse.

Dependence means a person is physically or mentally reliant on a substance to feel “normal.” Without the substance, they go through a process called withdrawal, which can cause distressing symptoms. In fact, going through withdrawal without professional support can be so distressing that is causes individuals to give up and return to the substances they were depending on.

Addiction is a change in brain chemistry that drives someone to seek a repeat of an experience. This could involve drinking or taking drugs. The individual usually associates the substance with positive feelings, and their brain craves these feelings over and over. Addiction and dependency can both be present, or someone can have one but not the other.

Drug Dependence vs. Drug Addiction: A Brief History of Medical Terms

There is often confusion between the terms addiction and dependence. That’s primarily thanks to older definitions that we no longer use but that some professionals still refer to. Definitions from reputable sources can pass quickly into regular usage, even though they have since been updated or corrected.

An example of this is the American Psychiatric Association’s1 previous definitions of the terms abuse and dependence. They had deemed both terms an addiction without considering addiction as a separate state of mind and body. They defined abuse as a severe addiction and dependence as a milder addiction. Those definitions don’t match up to what we scientifically understand addiction to be, and their definitions have now been updated.

Similarly, the American Psychological Association2 (APA) updated its terminology and definitions in 2013. This has led to less use of terms like abuse, which has a number of negative connotations. Referring to addiction or dependency is not only more in line with science but also more compassionate and less likely to lead to judgment.

History has been recording instances of addiction in humans for at least 12,000 years3, all across the world. But it’s only since the 1950s that we’ve been studying the science behind addiction and dependence. Both cause changes within the brain or body that make quitting incredibly difficult without the right support or treatment. Quitting drugs or alcohol isn’t just about having a “strong will.” It’s about dealing with physiological or psychological changes caused by the repeated use of substances.

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Someone can depend on a substance without being addicted to it, and vice versa. It is much more useful to focus on individuals and their relationship to substances — and which treatment options will best suit their unique situation.

Related: How Family Can Help Recovery

What Is Addiction?

Addiction is a brain disorder, sometimes called a disease. Basically, an individual has an intense desire to repeat an action. In terms of drug or alcohol addiction, this means that the individual enjoys the experience of taking drugs or drinking. It brings them pleasure or fulfills a mental or physical need. They want to do it again, and that desire is so strong it becomes a compulsion that’s hard to ignore.

The science behind addiction looks at a range of factors including:

  • Genetics
  • Environmental factors
  • Social factors
  • Biological predisposition
  • Psychological factors

Addiction can come about because of loss or trauma. It is a way to replenish positive feelings in a life that feels lacking in daily joy. Addiction could also occur due to peer pressure or a desire to fit in. Or it may simply result from trying a substance once and then feeling the need to keep doing it.

Addiction causes changes in the brain, particularly in the prefrontal cortex and the limbic system. These areas of the brain deal with:

  • Rewards and motivation
  • Judgement
  • Impulse control
  • Memory
  • Motivation

An individual addicted to a substance may feel highly motivated to seek the experience of taking drugs or drinking. Conversely, their ability to deal with day-to-day life may become impaired and lead them to make poor choices. Changes in behavior typically accompany addiction.

What Is Dependence?

Dependence is not the same as addiction. Dependence happens when the body or the brain requires a particular substance for a person to feel normal. Without the substance, whether that’s a type of drug or alcohol, the body suffers from withdrawal symptoms.

Dependence can occur because of prolonged use of prescription medication. It isn’t always the choice of the individual to be in a position that causes them to suffer from drug dependence. Doctors often prescribe opioids for pain. If an individual takes these for more than six months, it’s likely they will become dependent on them.

In situations like this, a doctor may be able to wean patients off the drugs by gradually decreasing the dosage. This helps reduce the impact of withdrawal. Drug users who have experienced a very negative withdrawal period may choose to keep taking the drugs rather than go through this again. Professional, compassionate support for substance dependence is critical for a thorough recovery.

Withdrawal Effects and Symptoms

Withdrawal means the body or brain is craving a substance that it is being denied. The withdrawal experience is different for everyone, but there are many common symptoms. Someone going through opioid withdrawal may experience:

  • Gut cramps
  • Anxiety
  • Stomach upset
  • Runny nose or eyes
  • Sleeplessness or restlessness
  • Fever and shakes
  • Changes in blood pressure
  • Seizures

The severity of these symptoms may depend on the intensity of the body’s dependence on the opioids. Some of these symptoms may also occur in those going through alcohol withdrawal. Additional symptoms of alcohol withdrawal include:

  • Nausea
  • Vomiting
  • Delirium tremens, a recognized symptom of alcohol withdrawal involving shakes, disorientation, and even hallucinations
  • Palpitations

These symptoms can be frightening. They can also make an individual struggling with alcohol or drug use feel like they can’t go through with quitting. Those affected may feel like it’s just too hard. That’s why it’s so crucial to have professional support. Compassion and a full understanding of what these people are going through can help them keep going.

Related: Alcohol Withdrawal

Physical and Mental Dependence Explained

You may have heard substances described as either mentally addictive or physically addictive. These terms are misnomers, as they imply that if the body physically depends on something, then the individual has a dependence, not an addiction.

However, the person may also be an addict. Their behavior may have changed. They may enjoy taking the substance. As far as physical dependence vs. addiction goes, the two are not mutually exclusive.

Physical dependence often refers to a substance that will cause a physical response once removed. If you look at the list of withdrawal symptoms above, you can see that there are many physical symptoms. These range from nausea to palpitations. The lack of substance literally changes the person physiologically. They have to go through these changes to get back to a substance-free state. This promotes health and overall well-being.

Mental dependence indicates that it’s the brain that’s primarily affected by the substance — or lack of it. In truth, most substances cause physical and mental responses. Recovery specialists usually look at the body and brain holistically, making sure they treat both with respect and compassion.

Substances linked to mental dependency could cause depression, anxiety, or even hallucinations. It’s most likely that individuals will always experience a combination of physical and mental effects when getting clean.

Mental dependence can also refer to an individual’s reliance on a substance to help them feel a certain way. A very anxious person may use alcohol to calm their nerves. They may start off by doing this only in highly stressful situations, such as a date or a school reunion. Because alcohol makes them feel relaxed and happy, they keep doing it.

Before they know it, they’re using alcohol to deal with every social situation. They’re not necessarily physically dependent. They may not suffer any physical withdrawal symptoms. But without the alcohol, they feel low and lacking in confidence, and may even avoid social situations. This type of addiction can quickly lead to dependency if left untreated. Effective recovery helps alcohol users regain their confidence and deal with these situations while sober.

Alcohol Dependence vs. Addiction

Alcohol provides a clear example of how dependence and addiction are not exactly the same. When the body physically depends on alcohol, it relies on it to feel normal. Without the alcohol, withdrawal symptoms like the ones highlighted above begin.

However, someone can be addicted to alcohol without depending on it. If someone needs to feel a “beer buzz” constantly to take their mind off their problems, this could be an addiction. If someone spends all their spare money on cheap wine or spirits, this could also be a sign of an addiction. That’s not to say that everyone who drinks regularly is an addict. Things to look for include:

  • Forgetting or ignoring responsibilities in favor of drinking
  • Not being able to go a night without a drink
  • Planning to not drink, then always drinking
  • Feelings of shame and regret after drinking
  • The inability to control the amount of alcohol consumed
  • Changes in behavior — becoming aggressive or hostile, or depressed and anxious
  • Changes in personality — an addicted person may feel like they are “only fun” when they’ve had a drink and use alcohol as a social crutch
  • Maintaining a distance from those who discourage their drinking or disapprove

Part of alcohol addiction recovery is reminding the person they don’t need alcohol to complete them. It’s about helping them remember the brilliant person they are, even without alcohol in their life.

Alcohol addiction and dependence can cause family problems and relationship breakdowns. If you think you’re struggling with drinking too much and know it’s time to stop, call Cardinal Recovery at (855) 928-1987 for advice on the best alcohol addiction or dependence treatment, tailored to you and your needs.

Drug Dependence vs. Addiction

In much the same way as alcohol addiction, drug addiction doesn’t always mean the individual physically depends on the substance. We’ve already looked at the opioids problem. Individuals can end up with a dependence despite never having had any desire to “take drugs.” It’s important to remove the stigma of dependence and addiction so people can get the help they need.

Drug use can be social, such as when friends take cocaine together. The cocaine makes the user feel good, or confident. They feel like they need it to navigate their social circle. It helps them talk to people.

But drug users also make poor choices. They may spend all their money on these nights out. They could miss a rent payment. They might even forget to wash sometimes. The drug use affects their life negatively. Yet they can’t resist the compulsion to take the drug.

This is drug dependence vs. addiction. The two may often go hand in hand, but recovery specialists must carefully assess each individual’s needs to understand what their experiences may be during treatment and recovery.

Physical Dependence vs. Addiction: How to Help

When it comes to treatment and recovery, professionals know the difference between mental and physical dependence vs. addiction. This helps them determine the right course of treatment.

Treatment and recovery plans should always focus on the individual, their support circle, and their needs. There is no point in trying to implement a one-size-fits-all approach to addiction. People become addicted or dependent for different reasons.

If you know someone who displays some of the signs of dependence or addiction outlined above, we want to help. Perhaps you yourself have become dependent on a particular substance or need help with an addiction that’s gotten out of hand.

We offer a 15-minute assessment by phone, during which one of our friendly team members can talk you through your situation without judgement. Call Cardinal Recovery at (855) 928-1987 and start your journey to recovery today.


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