Substance Addiction vs. Dependence: What's the Difference?

substance addiction treatment in connecticut

When a person is struggling with substance abuse, loved ones might describe them as being “dependent” on drugs, or as having an “addiction.” But are these one in the same?

Addiction and dependence are two separate conditions relating to substance abuse. Yet because the terms are used interchangeably, the line between them often gets blurred. 

You may have a friend that smokes marijuana every morning before school, and wonder if he has a problem. You may have a daughter who drinks excessively with friends when she is home for college break, and wonder if you should be concerned. Maybe your loved one is taking painkillers for longer than prescribed, for an injury that happened months ago. Would this be classified as a dependence or an addiction? And most importantly, when does it require professional intervention and care?

Substance Addiction vs. Dependence: An Overview

When people talk about addiction, they are usually referring to the harmful effects that drugs and alcohol have on a person’s behavior. When they talk about dependence, they are typically inferring that the person is reliant on drugs and alcohol, despite the negative consequences. However, are those the true definitions? And don’t they overlap?

The differences between substance addiction and substance dependence are slight, as many of their signs and symptoms intersect.

Addiction is characterized by an inability to stop using a substance, despite the harmful consequences. A person who is addicted typically struggles to meet work, social, and/or family obligations. Generally, this person will also have built a tolerance to their drug of choice, and experience painful withdrawal symptoms (mental or physical) upon stopping use of it. Addiction is caused by chronic substance use.

Dependence is typically a physical reliance on a drug, also characterized by symptoms of tolerance and withdrawal. An individual who is dependent on a drug may have a high tolerance, and needs to ingest higher dosages to feel the drug’s effects. If this person stops use abruptly, they will also experience acute withdrawal symptoms, as their body craves more of the drug. Like addiction, dependence happens with chronic drug use.

So, what is the difference? Dependence is exhibited by physical symptoms. Addiction manifests as a combination of physical, mental, and behavioral symptoms. A person who is addicted is also dependent. However, a person who is dependent on a drug may not addicted to it. Keep in mind, a physical dependence is usually a precursor to addiction, so it is important to recognize the signs of both.

Today, most clinicians avoid the terms “dependence” and “addiction” altogether, and instead use “substance use disorder.” In fact, substance use disorder became the scientific term for these conditions in 2013, when the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was released. In this, the definitions of “substance abuse” (which referenced a mild form of addiction) and “substance dependence” (which represented more severe cases) were both replaced.

A substance use disorder, or SUD, is a mental health disorder that develops after prolonged substance abuse. It can be both physical and mental. It changes how the brain functions and impairs how a person behaves as a result. A person who has a substance use disorder prioritizes seeking and using the drug above all else, and may act irrationally when they do not have the drug in their system.

According to the latest version of the DSM, substance use disorders can be mild, moderate, or severe, depending on the number of symptoms. Symptoms include:

  • Failed attempts to quit using or drinking
  • Compulsive cravings to use the substance
  • Reduced physical health
  • Increased dosages of a drug, or taking it longer than intended
  • Time lost to seeking, using, and recovering from the substance use
  • Loss of priorities and obligations (such as work and school) in place of drug use
  • Continued use, despite the problems it’s caused in relationships
  • Continued use, despite being put in dangerous situations
  • High tolerance (i.e. needing more of the substance to get the desired effect)
  • Development of withdrawal symptoms

If a person is exhibiting two or more of the above symptoms, professional substance use treatment is recommended. This indicates the presence of at least a mild substance use disorder.

Substance Addiction vs. Dependence: When Treatment is Needed

Untreated substance use disorders – whether they are mild or severe – can be detrimental to a person’s mental, physical, emotional, social, and even financial health. These disorders can also be fatal. That is why professional treatment is always recommended, no matter whether a person is dependent on a drug or has a full-blown addiction to it. It is never too early to seek treatment, but it can be too late.

Generally, those who are physically dependent on a drug will benefit from detoxification. This is a supervised clinical environment where one can safely work through the withdrawal period that accompanies a SUD, to rid their body of the toxins from drugs and alcohol. Withdrawal symptoms from certain drugs can be fatal, so it is important that detox is done professionally, in a safe and controlled medical facility.

Detoxification is not always needed—this depends on the extent of the withdrawal symptoms upon stopping drug abuse. In near every case of substance use disorders, however, therapy and education is an important step towards recovery.

Therapy can be in the form of counseling, behavioral therapy, self-help groups, group therapy, mindfulness, or a combination of modalities. Education is learning how to overcome and cope with the effects of addiction, such as compulsive cravings, and how to establish a healthier lifestyle. Together, therapy and education teach individuals how to get to the root of their addiction, defeat difficult emotions and cravings, establish healthful routines, and discover their best possible selves.

Sometimes, drug dependence and addiction are accompanied by underlying mental health issues, such as depression, anxiety, eating, trauma, and stress-related disorders. In these cases, integrated treatment for co-occurring disorders is required, no matter the severity of the dependence and/or addiction.

If you are concerned your loved one is addicted to or dependent on drugs, do not hesitate to seek professional help. While it is never too early to treat a substance use disorder, it can be too late. Contact Turnbridge today at 877-581-1793 to learn about our treatment programs for young men and women. For further reading about the different types of substance use disorder treatment available, check out the articles below.