In 2013, the American Psychological Association (APA) released the fifth edition of the DSM. 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.
When taking prescriptions or using any substances, it’s best to keep an open and ongoing dialogue with your medical care team and monitor for signs of problematic use. You can also always talk to your local pharmacist about any concerns you may have. You can help prevent problematic substance use by following your healthcare provider's instructions and attending regular follow-ups or check-ins with the same prescribing https://ecosoberhouse.com/article/addiction-vs-dependence-what-is-the-difference/ provider. Since there are many substances on which one can develop a physiological dependency, each substance in question requires an individualized approach. Addiction, on the other hand, is not a predictable drug effect, but rather a disease that occurs in genetically, biologically, and psychosocially vulnerable individuals. When genetics, environment, and drug use overlap, addiction may occur.
How To Tell The Difference Between Dependence vs. Addiction
People who have a dependence on alcohol exhibit some or all of the following characteristics. I've been taking Clonazepam, 1mg at bedtime, originally for anxiety, but along the way I found that it keeps me from acting out my dreams, something my wife did not appreciate. It's hard to know just how much it decreases the panic attacks, but they've become less frequent. Reach out to us today by filling out the contact form below with your name, contact information, and a brief message about your recovery journey. If your story is chosen, a member of our team will reach out to you.
Addictive disorders are highly treatable, and treatment at an inpatient or outpatient rehab can greatly increase the likelihood of long-term sobriety. People with physical dependence may benefit from inpatient detox or rehab to ensure a safe and successful withdrawal, and anyone with an addiction should seek out addiction treatment. If you or a loved one is struggling with drug or alcohol dependence, reach out today to a treatment specialist to explore what treatment options are available. 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.
Substance use disorder
The two conditions often occur at the same time, but a person can be dependent on a substance without being addicted to it. Among patients newly initiating buprenorphine treatment for opioid use disorder, 59% of those prescribed the target daily dose of 16 milligrams recommended by the U.S. Food and Drug Administration and 53% of those prescribed the higher 24 mg daily dose discontinued treatment within 180 days.
I haven't experienced any negative side effects in the tapering off process, so I don't think that it could be said that I was addicted to it. I know that I take more medications than others, but there's a reason for each one. After I cleared it with my doctor, I recently stopped taking Diltiazem, which a cardiologist prescribed because I was having brief episodes of tachycardia.
Understanding dependence & addiction
According to the DSM-5, it is possible to meet diagnostic criteria for a substance use disorder without having tolerance and withdrawal symptoms. That said, for many, but not all, substances, tolerance and withdrawal are often part of the package of symptoms of a substance use disorder. 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.
- It is no secret that misinformation about addiction is rampant in popular media.
- Abuse and dependence are defined on a scale that measures the time and degree of substance use.
- While the patient who is physically dependent may experience some euphoria while using the drug, the reward center in the brain remains “offline,” and the patient is still capable of managing impulses and making decisions in their best interest.
- While much of the confusion about this topic can be traced to DSM committees, I would caution against an oversimplified blame game.
- With overdoses soaring in the U.S., more tools are needed in the toolbox to help people with drug and alcohol addiction.
The differences between substance addiction and substance dependence are slight, as many of their signs and symptoms intersect. The recent death of pop star Prince from an opioid overdose was one of the 25,000 fatal opioid overdoses in the US every year. What these opioid overdoses show, according to an article in Scientific American, is how increased tolerance of the drug can lead to higher chemical dependence on the side effects.
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. Addiction and dependence are terms that are used interchangeably to describe an unhealthy, problematic reliance on drugs, alcohol, or other compulsive behaviors. Some people develop physical dependencies on a drug while others only develop a psychological (aka mental or emotional) dependence.
I wanted to bring a few more members into this conversation on dependence vs. addiction. @stressedmesseddepressed talked about seeing what was thought to be addiction was actually physical dependence upon clonazepam. I thought that @johnhans @jimhd @jakedduck1 @rwinney and @sandytoes14 might have some thoughts on this topic of how one knows whether they are addicted or just physically dependent on a medication. Dependence is characterized by tolerance or withdrawal symptoms and can be a consequence of many drugs, such as pain medications, stimulants, and antidepressants. Hailey Shafir is a Licensed Clinical Mental Health Counselor, Licensed Clinical Addiction Specialist, and Certified Clinical Supervisor with extensive experience in counseling people with mental health and addictive disorders.
Mental dependence is when use of a substance is a conditioned response to an event or feeling. These are known as “triggers.” Something as simple as the act of driving can trigger a desire to use. These triggers set off biochemical changes in a person’s brain that strongly influence addictive behavior. Clearly, the government must take more concrete action to address substance use disorder and withdrawal. The same strategies have been employed for over two decades, yet the problem has only worsened.