“Addiction” and “dependence” are often used interchangeably to mean someone can’t stop using a substance. Sometimes “dependence” is used when a term with a more clinical sound than “addiction” is needed, but now the preferred term is “substance use disorder.” While addiction and dependence are closely related, they are not quite the same. “Dependence” or “physical dependence” is the more limited term. It refers to the physical changes your body makes to accommodate the presence of the drug. So, for example, cocaine reduces the number of proteins available to clear dopamine away from the synapses between brain cells. In the short term, you experience this as more confidence, energy, and focus. In the long term, however, your brain just produces less dopamine. When this happens, you build a tolerance to the drug, and if you don’t take it, you feel tired, unmotivated, and unfocused. This is the development of physical dependence. You can become dependent on a substance when using it as prescribed for a long enough time. Being dependent on a substance doesn’t necessarily mean you’re addicted. For example, you might become physically dependent on opioid painkillers without becoming addicted. In this case, you can quit relatively easily by tapering down the dose, although you may have to find alternative ways of managing pain. Addiction includes a larger set of behavioral changes. Typically, physical dependence is just one aspect of addiction. It’s the physical dependence that makes it difficult to stop using because of needing the drug to feel normal and experiencing withdrawal symptoms without it. However, addiction also includes preoccupation with the drug, or thinking it about using even while doing other things. Addiction also usually means prioritizing substance use over more important things, including friends, family, school, and work. It may also lead to secretive behavior, lying, or stealing. Typically, addiction also includes escalating use. The distinction between dependence and addiction is subtle but important. Patients who are merely dependent on a substance can usually quit pretty easily, while people who have developed addictions usually need more comprehensive treatment. The distinction is also important because opioid addiction is often treated with medication such as methadone or buprenorphine. This medication assisted treatment is often mischaracterized as replacing one addiction with another. While it’s true that patients become dependent on methadone or buprenorphine, they rarely become addicted. The medication allows them to live more normal lives without succumbing to the dangers of addiction. However, if this dependence were mistaken for addiction, it could prevent many people with opioid use disorders from getting the treatment they need.
If you or someone you love is struggling with addiction or mental illness, we can help. Recovery Ways is a premier drug and alcohol addiction treatment facility located in Salt Lake City, Utah. We have the resources to effectively treat a dual diagnosis. Our mission is to provide the most cost-effective, accessible substance abuse treatment to as many people as possible. Request information online or call us today at 1-888-986-7848.
