What’s the Difference Between Dependence and Addiction?

Los Angeles | Orange County | San Diego | San Francisco

Drug or alcohol addiction and dependence often get conflated in everyday conversation, articles you read online, and even in academic papers studying substance use disorders. But the difference between dependence and addiction is significant, and understanding these differences can help you make an informed decision in your treatment options.

Is Dependence a Form of Addiction?

To understand the difference between addiction vs dependence, we first need to consider the origins of these terms in psychological literature, how they differ, and where the field stands now.

The key resource for diagnosing mental health disorders is known as the Diagnostic and Statistical Manual of Mental Health Disorders – or the DSM. The DSM is revised frequently, with the current edition known as the DSM-V-TR, or the fifth edition with text revisions. Drug and alcohol addiction, as well as drug dependence, all fall under the umbrella term “substance use disorders” in the fifth edition of this volume, but this hasn’t always been the case.

In the fourth edition of the DSM, substance use disorders were broken into two main categories: substance dependence, or substance abuse. Dependence was categorized as a pattern of substance use that had a few key criteria:

• Tolerance for your drug of choice
• Withdrawal symptoms if you suddenly stop
• Unsuccessful attempts to cut down substance use
• Spending a great deal of time using substances
• Giving up hobbies or activities in favor of substance use
• Continued substance use despite worsening physical or mental health problems

In contrast, substance abuse had fewer criteria, including:

• Legal problems as a result of substance use
• Continued substance use despite harmful consequences
• Substance use leads to an inability to fulfill your obligations at work, home, or school
• Using substances when it is dangerous to do so, such as while driving

In these circumstances, substance dependence was often considered much more severe than substance abuse. Yet the emphasis on the two diagnoses was different: substance dependence focused on the physical effects that addictive substances can have, while substance abuse focused on the problematic behaviors that can result from addiction.

How Dependence is Different than Addiction

As we can see from above, dependence refers to a physical reliance upon drugs or alcohol, which doesn’t necessarily result in problematic behavior. A practical example of drug dependence maybe somebody who was prescribed opioid painkillers by their physician: they may struggle with physical withdrawal symptoms and tolerance, but not experience many of the social consequences that illicit drug users face.

Addiction, on the other hand, is less well-defined. Some people categorize addiction as an umbrella term that includes drug or alcohol dependence, while others believe addiction is more accurately defined as continued substance use despite mounting consequences.

Regardless of how you define addiction: dependence vs addiction are not the same.

What is Dependence?

Dependence comes from physiological changes that occur when you take drugs for an extended period of time. Take the example of alcohol – a powerful central nervous system depressant that amplifies the effect of the neurotransmitter GABA within the brain. GABA is the brain’s primary inhibitory neurotransmitter, causing people to relax, release their inhibitions, and find relief from anxiety.

Yet when people drink alcohol every day, their brains compensate for the depressant effect that alcohol produces. Your brain’s resting state becomes more stimulated at baseline so that even when drinking large amounts of alcohol you can continue to function. Yet when the alcohol is taken away, the central nervous system becomes dangerously overactive, leading to severe physical withdrawal effects such as seizures, delirium, and shakes.

Put another way, your brain becomes dependent on alcohol to remain at equilibrium. Yet many people may not feel as though they are addicted: they don’t experience the wholesale personality change that comes with addiction, or experience significant consequences that lead them to believe that their drinking has become a problem.

4 Forms of Addiction

Addiction, on the other hand, is often categorized by significant disruptions in your daily life as a result of your addictive behaviors. Addiction can come in many forms, including:

1. Substance addiction – such as becoming addicted to heroin, alcohol, cocaine, or benzodiazepines
2. Gambling addiction – where people cannot cut down or control their gambling
3. Sexual addiction – in the form of dangerous sexual activity, pornography addictions, or masturbation addictions
4. Internet addictions – such as becoming addicted to social media, constant news consumption, or online video games

The key to understanding addiction is that people will continue the behavior even though it is causing damage throughout their entire life. Continued use despite consequences is the hallmark of addiction and can come from either addictive substances or addictive behaviors.

Is Treatment the Same for Dependence and Addiction?

The difference between addiction and dependence treatment comes down to your priorities in treatment. Treating substance dependence can be as simple as a medical detox, helping people overcome the physical aspects of their substance use problems and achieve abstinence in a safe and controlled manner.

In contrast, treating addiction often requires more intensive psychotherapy treatments to treat the behavioral issues that are so common among people living with addiction. Specific psychotherapies may be employed to help people resist future relapse, learn healthy ways of coping with their problems, and strive towards building fulfilling lives in recovery.

Unfortunately, not all treatment centers make delineations in treatment for addiction vs dependence. Truly customized care options are typically only provided by treatment providers who meet with their clients one-on-one, work on their goals for treatment together, and build a plan for recovery that suits your exact needs. At Kinkaid Private Care, we only take on a few clients at a time – and deliver all of our treatment options from the comfort of your own home, with exclusively one-on-one service between our patients and providers.

Start Treatment at Kinkaid Private Care

Kinkaid Private Care offers premium home health solutions for helping people break free from their substance use challenges. Our in-home detox service providers know the difference between dependence and addiction and can cater your treatment plan to your specific needs. Call our team at (866) 337-4596 or fill out our confidential online contact form to get started with a free, no-obligation consultation today.