Dependence is defined as a psychological and physical reliance on a substance and losing control of substance abuse. The biggest difference between addiction and dependence is functionality. While a person who is dependent on a drug needs it to feel normal, it’s not creating a lot of chaos in their lives. But an addicted individual will start experiencing problems due to their drug abuse.

  • Individuals with SUD often experience health issues, legal problems, and job loss due to their substance abuse.
  • For a long time, addiction meant an uncontrollable habit of using alcohol or other drugs.
  • In addition, stress, trauma, and hardship are also known ‘risk factors’ that make addiction more likely.

At the same time, the distinction between addiction and dependence is not trivial. Medical professionals are ethically required to get the diagnosis right so that they can get the treatment right. Treatment must address withdrawal symptoms and potential relapses if it occurs. Success is most likely when a person has access to long-term treatment and ongoing support. It’s important to realize that addiction is a chronic disorder that can result in relapse. In most cases, addiction is determined by noticeable negative consequences to one’s life.

Get Professional Help

Dependence is characterized by tolerance or withdrawal symptoms and can be a consequence of many drugs, such as pain medications, stimulants, and antidepressants. Herbert D. Kleber, M.D., will lead off with a discussion of the nature of addiction, developments in the treatment field, and reasons the public lacks faith in treatment as a method of combating substance abuse. He is executive vice president and medical director of the Center on Addiction and Substance Abuse at Columbia University. He is also professor of psychiatry at the Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute and heads a new division on substance abuse within the psychiatry department. Against the backdrop of the presidential campaign, the prevention of substance abuse has recently become a politically charged issue. Quoting Bob Dole, the Republican nominee, newspaper accounts blame the Clinton administration’s “silence on the matter” for the recent increase in substance abuse among adolescents.

  • Whether it’s prescription medications, smoking, or illicit street drugs, it can be difficult to manage your substance use and to know whether you’re heading towards addiction.
  • They deliver a double punch — they don’t just increase the feel-good dopamine in the brain, but there’s also a need to take them consistently to avoid painful withdrawal symptoms.
  • The term substance use disorder (SUD) is the preferred way of saying it in the scientific community.
  • For individuals who are seeking intensive treatment but still prefer to live at home, partial hospitalization (PHP) or day treatment programs are also available.
  • And sometimes it takes more than one type of treatment to be successful.

Detox programs are available at certain clinics and medical facilities, where they supervise a person’s drug withdrawal and provide supportive medications, where necessary. These clinics are usually staffed with a team of doctors and nurses who have experience with addiction and drug withdrawal. The advantage of going to a detox center is that medical assistance is readily available.


The public sees substance abuse treatment as a “surgical procedure” that should end in a cure, Kleber said. The therapist’s goal for the patient may be abstinence, Kleber noted, but the patient’s goal, at least initially, is usually “controlled use.” Relapse occurs frequently until the patient learns this is not usually a viable goal. Drugs, alcohol, and tobacco all exert certain effects on the brain and its reward system. The pleasurable feelings that come from smoking, drinking, and taking drugs can reinforce the desire for those substances. 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.

Many patients are often confused as to how they can be dependent on a drug, such as an opioid, but not be addicted to it. The distinction is essential for patients and caregivers to understand. This is why recent evidence-based literature clearly defines the difference between addiction addiction vs dependence and physical dependence in drug use. Mark eventually develops a physical dependence on alcohol, as it’s an addictive substance. He decides to cut out this bad habit, but he soon starts drinking again. Now he drinks ten or fifteen beers every night, and he sometimes blacks out.

Determining Whether You’re Dependent or Addicted

We know opioids, for example, can be highly addictive, and that addiction can develop quickly. They deliver a double punch — they don’t just increase the feel-good dopamine in the brain, but there’s also a need to take them consistently to avoid painful withdrawal symptoms. The solution in the DSM-5 was to combine the categories of “substance dependence” and “substance abuse” into one category called “substance use disorder” under a chapter heading called Substance-Related and Addictive Disorders. The purposeful use of the term “Addictive Disorders” in the naming of this chapter was primarily due to the addition of “gambling disorder” to the DSM, a non-substance-related disorder.

  • Dependence, on the other hand, is characterized by a physical and psychological loss of control due to substance abuse.
  • Like your brain, your body can quickly get used to any drugs8 you take.
  • In most cases, addiction is determined by noticeable negative consequences to one’s life.
  • Being physically dependent on a substance means a person’s brain and body have come to rely on the drug, and that a person will experience physical withdrawals when cutting back or stopping.
  • Medical and substance abuse communities have found that there are neurochemical differences between a normal brain and an addict’s brain.
  • Not only are millions of Americans struggling with substance use disorder, but in 2014 alone, there were more than 45,000 overdose deaths, over half of which involved prescription opioids and heroin.

According to the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there’s not really a distinction between dependence and abuse anymore. Rather, the manual defines substance abuse disorders as mild, moderate, or severe. Addiction indicates more of a substance use disorder, while dependence is the physical body’s buildup of tolerance to a drug. Someone who’s dependent on a substance may or may not be addicted to it, but someone who’s addicted to a drug has always become dependent on it. Could someone who is dependent on alcohol or drugs be diagnosed as having an addiction? The terms “addiction” and “dependence” are often used interchangeably, but there are differences between the two.

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