Dependence vs Addiction: How to Tell the Difference

With over five years of experience in the field, she specializes in translating research into evidence-based, easy-to-understand content. Her work explores post-traumatic growth and the connection between physical and mental health. In addition to writing for Recovery.com she has written meditations for Alcoholics Anonymous NatureSpace and is a licensed massage therapist. The DSM-5’s change in definition eliminated these issues; although, it created a confusing divide and some clinicians still struggle to differentiate addiction and dependence. The older DSM-4 criteria for addiction and dependence led to misdiagnosing patients, which created a false relationship between addiction and dependence (labeling dependence worse than addiction).

Drug dependence is not addiction—and it matters

Addiction, on the other hand, often encompasses the elements of dependence and also includes a host of other considerations across life domains. It’s characterized by a compulsive and uncontrollable urge to seek and use a substance, even when it causes you harm to do so. Some people do well at home with regular doctor visits and support groups.

Mental Dependence Vs. Physical Dependence

It’s like having a detailed map when navigating a complex maze – the more information you have, the better your chances of finding the right path. When it comes to diagnosing substance use disorders, things can get as complex as a Rubik’s cube. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) doesn’t actually distinguish between dependence and addiction. Instead, it uses the term “substance use disorder” with varying levels of severity. It’s like a spectrum, ranging from mild to severe, based on the number of criteria met. Some drugs are more likely to lead to dependence, while others are notorious for their addictive potential.

Differentiating Between Addiction and Dependence

It involves a psychological and behavioral component that goes beyond physical dependence. Cognitive-behavioural therapy allows a person to identify and change thought patterns that lead to drug use. Drug addiction treatment focuses on addressing underlying psychological issues and developing healthier behaviours. In dependence, therapy may be oriented towards managing withdrawal and preventing relapse through behavioural changes. Individual, group, and family therapies are all significant and necessary for recovery. Many people experience both physical dependence and addiction simultaneously, which can make distinguishing between the conditions challenging.

After much discussion and debate, the word ‘dependence’ was chosen by the margin of a single vote. This international committee met over several years in cities such as Washington, Copenhagen and New York, and their work was published in 1987 as DSM-III-R (revised). The committee made most decisions unanimously because there was general agreement from the experts as to how the syndrome should be defined (the names of the members are contained in the preface to DSM-III-R). There was a significant disagreement, however, among members of the committee with respect to the label that should be used. They argued in favor of the more neutral term ‘dependence’, as the discussions were influenced heavily by work on the alcohol dependence syndrome by Professor Griffith Edwards and colleagues 1.

Does Drug Use Cause Dilated Pupils?

• Chronic substance abuse can lead to both physical dependence and the development of addictive behaviors.
• So, while dependence can be a part of addiction, it doesn’t necessarily mean someone is addicted.
• Physical dependence occurs when the body adapts to a substance, requiring its presence to function normally.
• Early intervention is key to giving individuals the tools and strategies they need to navigate life without relying on substances.

Substance abuse can be a precursor to addiction, but not everyone who abuses substances becomes addicted. The line between abuse and addiction can be blurry, making early intervention crucial. Support is available for anyone facing challenges related to addiction or dependence. Identifying signs and accessing resources can empower individuals to move forward toward recovery.

Understanding the difference between dependence and addiction is crucial to recognize the signs and know how to approach treatment. These characteristics can help identify individuals who may require additional support and intervention to address their substance use issues. By recognizing these patterns, we can develop tailored strategies to protect the public and provide effective treatment and rehabilitation for healthcare professionals. While behavioral addictions may not involve the physical withdrawal symptoms seen in substance addictions, they can still have profound psychological and social effects. The compulsive nature of these behaviors can lead to disruptions in relationships, work or school performance, and overall well-being. It’s important to note that addiction and dependence often coexist, as individuals may develop both a psychological and physical reliance on a substance.

The specific substance use disorders may be referred to as ‘alcohol use’ or ‘opioid use’ disorders. The criteria for the disorders are likely to remain similar, with the exception of removal of the ‘committing illegal acts’ criterion and addition of a ‘craving’ criterion. The other major change relates to the elimination of the abuse/dependence dichotomy, given the lack of data supporting an intermediate stage. These changes are anticipated to improve clarification and diagnosis and treatment of substance use and related disorders.