Drug dependence is not addiction and it matters PMC

The distinction is essential for patients and caregivers to understand. This is why recent evidence-based literature clearly defines the difference between addiction and physical dependence in drug use. Detoxification treatment may need to be administered to those with substance dependence due to the dangerous nature of some withdrawal symptoms. As with substance abuse, research suggests that no treatment method is superior, but that social support is very important and that organizations such as AA and NA have better than average success rates in reducing relapse.

The brain continues to develop into adulthood and undergoes dramatic changes during adolescence.

• Dependence refers to the body’s adaptation to a drug, leading to withdrawal symptoms, while addiction involves compulsive drug use despite negative consequences.
• But large-scale studies during the last two decades revealed a population of people who were having problems because they took drugs and drank too much alcohol.
• However, these recent changes mean that “dependence” now includes both physical and physiological dependence (in terms of tolerance and withdrawal symptoms).
• People can have just a physical dependence, addiction, or both at the same time.
• Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning and memory, and behavior control.12 These changes help explain the compulsive nature of addiction.

In this edition, the definitions revolving around addiction were changed once again. The APA ditched both “substance abuse” and “substance dependence” in favor of “substance use disorder.” Substance use disorder is now the medical term for addiction. Previously, abuse was a mild form of addiction, and dependence was a moderate or severe form of addiction. That terminology was problematic because in biology — the study of organisms — dependence refers to a physical adaptation to a substance. In the case of drug and alcohol abuse, this compulsive behavior is reinforcing or rewarding to the user, in spite of the negative consequences of their behavior.

Mental Dependence Vs. Physical Dependence

Withdrawal – Alcohol is taken to relieve symptoms of withdrawal, which include (among others) depression, fatigue, mood swings, anxiety, and irritability. Use Despite Understanding of Consequences – Alcohol use persists despite the patient’s knowledge of a physical or psychological problem that’s likely caused by alcohol. Physical Harm – The patient has consumed alcohol in situations that are dangerous or that pose a threat to physical health. Use Continues Despite Conflicts – The patient has experienced ongoing social problems that are exacerbated by alcohol use, but continues his or her pattern of use, regardless. By Buddy TBuddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism.

How To Know If I Am Addicted?

The most common reason for drug and alcohl abuse is the desire to achieve a certain feeling or sensation. According to these guidelines, the presence of two or three symptoms suggests a mild substance use disorder, while four or five symptoms indicate a moderate disorder. If a person exhibits six or more symptoms, it is classified as a severe substance use disorder, commonly referred to as addiction. Understanding the distinctions between addiction, tolerance, and dependence is crucial for accurate diagnosis and effective treatment.

Substance use is a broad term that encompasses every instance of using harmful substances such as alcohol, drugs, nicotine, cannabis, or prescription medications. Substance use disorder, however, is a medical condition that refers specifically to problematic use of these substances, to the extent that the person experiences negative consequences to several areas of their life. Alcohol dependence and addiction vs dependence alcohol abuse were two designations previously recognized in the DSM-IV. Today, they have been combined and are known as alcohol use disorder.

Brady reported that although Hispanic men in the United States use and abuse alcohol at a high rate, almost 50 percent of Hispanic women do not drink at all. She also cited a 1990 report issued by the National Institute on Alcohol Abuse and Alcoholism noting that the alcohol-related death rate among Native Americans in 1988 was 5.4 times higher than it was for any other race. Regardless of what term you use to describe a substance misuse issue, Mr. Kump emphasizes that the key is to understand that treatment is available. He sees some people who took just a few weeks to develop an addiction to opioids, while others had a slower journey to their addiction.

• In addition, symptoms must not meet the criteria for substance dependence for the class of substance.
• In medical practice, to get a diagnosis of a substance use disorder, there first needs to be a careful diagnostic interview conducted by a mental health professional.
• While the choice to initially try drugs or alcohol is voluntary, over time, it becomes harder to stop.
• Mental dependence is when a person relies on a substance or behavior to cope with emotional challenges.
• When addiction is related to drugs or alcohol, the condition is also called a substance use disorder.

Many drugs cause dependence but not addiction, for example, paroxetine 10 and clonidine 11. But when people withdraw from these medications, they do not crave them and once successfully tapered, they do not have recurrent use. In contrast, craving and recurrent use are common symptoms of addiction, particularly during early stages of recovery. …resulted in confusion among clinicians regarding the difference between “dependence” in a DSM (IV) sense, which is really “addiction,” and “dependence” as a normal physiological adaptation to repeated dosing of a medication.

What Is Moderate Drinking?

In fact, for some people, trying a substance or using it occasionally can be the first step of developing substance use disorder. If you’ve heard the terms “substance use” and “substance abuse,” you may wonder whether they mean the same thing or whether there’s any difference between them. Dependence situations demand the need for skilled therapists, counselors, and medical practitioners.

Let’s examine how the world views addiction versus dependence in relation to substance abuse disorders. When they first use a drug, people may perceive what seem to be positive effects. Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. In contrast, with SUD, a patient’s actions are directed primarily by an overwhelming need to accommodate the brain’s reward center, and the part of the brain that guides self-control and decision making is directly impeded.

• We know opioids, for example, can be highly addictive, and that addiction can develop quickly.
• Misunderstanding these terms can lead to inappropriate patient management.
• TracyOrleans, JoanHollendonner, MarilynAguirre-Molina, and MarjorieGutman, “Behavioral Determinants of Health” (report prepared by Robert Wood Johnson Foundation staff, Princeton, N.J., April1996).

Dependence refers to the body’s adaptation to a drug, leading to withdrawal symptoms, while addiction involves compulsive drug use despite negative consequences. Tolerance and dependence are essential indicators of drug use, but it’s a misconception that they only develop after long-term, chronic use. These symptoms, including withdrawal, define physical dependence, which can occur even with short-term use in some cases. It’s crucial to differentiate between addiction and physical dependence to avoid real-life severe consequences. Unlike addiction, dependence is primarily a biological response to the presence of a drug.