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Drug Dependence vs. Drug Addiction

There are many terms thrown around in relation to drug abuse, and it can be difficult to discern what they mean. Drug addiction is an already misunderstood disease, and the confusion regarding terminology only adds to the problem. While drug dependence and drug addiction are often related, they do not mean the same thing.

What is drug dependence?

Drug dependence involves a physical condition. Repeated exposure to a drug or frequent usage causes the body to adapt to the drug. The easiest way to identify drug dependence is through withdrawal symptoms when the drug is no longer used.

Dependence directly impacts the brain, including the thalamus and brain stem. The brain and body only function normally when the drug is present because the drug has disrupted the brain’s chemical balance. Over time, chemical production is altered to build a tolerance to the drug. That tolerance can shift to dependence, messing with a person’s chemical balance when they stop taking the drug.

Mental Dependence

Mental dependence is a type of substance dependence characterized by triggers. Biochemical changes can occur in the brain when a trigger is present, and those chemicals influence behavior. Common triggers include emotional responses, enablers, certain places, or things associated with a drug.

Physical Dependence

Drug dependence most commonly refers to a physical dependence on a substance. A tolerance is built up to a drug, and withdrawal symptoms occur when the drug is not used. Dependence is easily identifiable because the body reacts to the lack of the substance.


Withdrawal occurs during the drug detox process. When someone who is dependent on a substance stops taking it or cuts back, the body and mind react. Withdrawal symptoms can range from mild to severe or even life-threatening depending on the severity of substance abuse. Symptoms vary by person and substance, but it is important to seek medical treatment to avoid fatal withdrawal symptoms.

What is drug addiction?

Repeated exposure to a substance does not always result in addiction. Addiction is a compulsion and can be identified by behavioral changes due to biochemical changes. With addiction, the substance is the priority despite any potential harm it may cause the addict. Addiction is often characterized by irrational thinking and behavior if the substance is not present. Reliance on the drug is not just physical, but mental as well.

Substance Abuse Disorder

In recent years, the term “substance abuse disorder” is more commonly used as the medical term for addiction. Substance use disorders can be classified as mild, moderate, or severe. The change was made to lessen the confusion around the word “addiction.” Substance use disorder is also considered more inclusive. The hope is that by changing the terminology and removing some of the stigma associated with drug addiction, more people with a substance abuse disorder will seek treatment.

Is there a difference between drug dependence and addiction?

It is possible to be dependent on a substance without having an addiction. For example, someone can drink heavily for multiple days in a row. Their brain adapts to the presence of alcohol in the body and they form a dependence on alcohol. When they stop drinking, they may experience withdrawal symptoms, but they are not necessarily addicted. However, if that person is unable to stop drinking, they may have an alcohol addiction.

Developing a high tolerance for a substance and forming a dependency on it are considered warning signs for addiction. Many substances, including illicit drugs and prescription medication, can cause dependency and withdrawal. But, a person is considered to be addicted to a substance if they compulsively seek it out, disregarding the consequences. Addiction often leads to observable problems like the loss of a job, issues within the family, or trouble with law enforcement.

Is the difference important?

Identifying the proper term can help someone seek the proper treatment. For dependence, a lot of the focus is on treating withdrawal symptoms and overcoming the cravings for a substance. For addiction, treatment is both physical and mental. Addicts deal with a frequent struggle to stay away from a substance, even after they experience detox and withdrawal. Addiction is also characterized by relapses.

What is tolerance?

With repeated use over time, a person’s response to a drug is diminished. Developing a tolerance to prescription or illicit drugs requires more of the drug to achieve the same effect. Tolerance does not necessarily lead to an addiction, however it can be part of the early stages of addiction.

The three types of drug tolerance include:

  • acute tolerance
  • chronic tolerance
  • learned tolerance.

Acute Tolerance

Acute tolerance is characterized by tolerance built in a short period of time. Repeated use of a drug can lead to short-term tolerance. For example, cocaine results in acute tolerance because the high experienced from the first dose is usually felt more than the high from a subsequent dose in a short period.

Chronic Tolerance

Chronic tolerance occurs when a substance is regularly abused over a long period of time. The prolonged exposure can occur over weeks or months and causes the body to adapt to the drug. For example, a chronic tolerance can be developed for prescription opioids. People who abuse opioids often have to increase the dosage or change the method of using the drug to achieve a similar euphoric effect.

Learned Tolerance

Learned tolerance can occur when someone does not appear intoxicated because they have learned to conceal the effects of drugs. For example, people who drink heavily may not seem drunk. By practicing tasks under the influence of alcohol, they are able to compensate for the effects of drinking.

What factors impact the severity of dependence?

Dependence is typically worsened the longer a person consumes an addictive substance. However, there are several other factors that can impact the severity of dependence outside of the time of use. How someone abuses a drug can potentially increase their dependence. Injecting a drug or snorting it can lead to a higher severity of dependence than taking a drug by swallowing or drinking it. The drug impacts the brain quicker when snorted or injected, so it may take less time to become addicted or dependent.

The type of drug being used also impacts the severity of dependence. For some drugs, tolerance and dependency can build much faster than others. Crystal meth and cocaine are two drugs that build up dependency quickly, especially since people typically increase the dose with each bender. While tolerance for alcohol or benzos can build quickly, dependency on these substances typically takes longer to form.

Can you identify if you are you dependent or addicted?

Recognizing a drug dependence is fairly uncomplicated. If someone stops using the drug and experiences withdrawal symptoms, they have a dependency. Identifying a drug addiction is not as straightforward. It can be difficult to seek help for substance abuse or dependency, and the differences between dependency and addiction can make the process feel more complicated.

Seeking professional medical help can ensure that a person receives the proper diagnoses and treatment. A doctor can examine a patient to determine if symptoms of dependency or withdrawal are present. A mental evaluation can also help determine the presence of an addiction. If you are concerned that you may have a drug dependency or drug addiction, it is crucial that you speak to a medical professional as soon as possible.

With drug dependency, there are many treatment options including inpatient drug detox programs. Medical staff can help lessen withdrawal symptoms and keep a person comfortable as their body rids itself of toxins. For drug addictions, detox and withdrawal are the first steps towards recovery. Ongoing care, including support groups and individual counseling, can help determine the factors that influence addiction. With the proper medical care and support, a person can receive the help they need to stop abusing a substance and prevent a subsequent relapse.