To many individuals, addiction and dependence may seem interchangeable; this, however, is far from the truth. The difference is somewhat tricky to comprehend because some define the two differently or completely disregard them concerning substance use disorder. However, the difference is not that difficult to understand. Sometimes differences can even be understood in the kind of treatment that is given. Regardless of who uses these terms, why they use them, and when, to properly combat a dependency or an addiction, a definitive distinction must be made between the two.
What’s the Difference?
Dependence, when used in the correct context, is a term used to describe either a physical or psychological need for a particular substance. Usually, the degree of someone’s dependence is dependent upon one’s tolerance or their susceptibility to withdrawal. That being said, someone who is dependent is not necessarily addicted.
Addiction is more so behavioral than dependence. Addiction happens when someone’s brain chemistry is changing after prolonged substance abuse. Prolonged substance abuse brings a vast amount of harm to both the user and those around them. When an addiction is present, substance abuse becomes a priority above all else to a user. Because of its influence on behavior, addiction influences users to misbehave in a rather irrational manner when they don’t own the substance they are addicted to.
Different Kinds of Dependence: Mental and Physical
A conditional response is when someone becomes dependant on something and is triggered by an environment, sound, or feeling. Conditional response has been used in a variety of psychological experiments by legendary psychologists, including one Ivan Pavlov. You can take this method and apply it to any situation that solicits a response. In the case of any sort of dependence on drugs, the response would be using.
All of this being said, mental dependence when it comes to substance abuse is when a certain environment elicits a response, also known as a conditional response. Some refer to conditional-response as a “trigger”. Anything could act as a trigger, even a certain sound, a person, a smell, or chill in the weather. Biochemical changes happen in the brain when it is triggered. This has a powerful effect on substance abuse behavior.
There are a few key indicators that may suggest that someone is being triggered. These may include the following:
- Stomach tightness
- Insatiable desire to use alcohol
- Nervous behavior
Sometimes these symptoms will be more obvious than others. Regardless, if any of the above symptoms are presenting themselves, an addiction may exist. The question of whether or not someone is addicted comes into play when both the physical dependency and mental dependency are occurring simultaneously, ultimately when the behavior is uncontrollable.
Is the term ‘addiction’ a bad word then? Why distinguish so heavily between the two? In short, the reason lies within associations and connotations. Largely, addiction is associated negatively, and to combat a negative response as opposed to an understanding one, clear lines must exist. Claiming someone else is, or you are addicted may be a bit rash if dependency is the true struggle.
The difference between the two could determine what kind of treatment one receives. For example, someone who is exhibiting addictive behavior might undergo cognitive behavioral therapy, whereas someone who is merely dependent on a substance may need medical detox to remain at bay in their recovery journey.
The Difference Between Substance Abuse and Substance Dependence
Perhaps the biggest difference between substance abuse and substance dependence is the scale to which these terms are measured. For example, someone repeatedly abusing drugs over some time is not the same as being dependent, but the intensity and length of abuse could lead to dependence. In other words, the more frequent substance abuse is, the more likely dependence will ensue.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), substance abuse and substance dependence are two separate disorders. DSM is quite reputable in diagnosing and making sense of the realm of addiction. More recently, however, DSM has acknowledged that this distinction does not necessarily have to be made.
Why Not Make the Distinction?
In recent years, some have altered how they define substance abuse and substance dependence. More specifically, the American Psychological Association (APA) changed its definition regarding the two. Both of the terms were gotten rid of in favor of using ‘Substance Use Disorder’ instead.
At the current moment, substance use disorder is how the APA refers to addiction. Before this new term was coined, substance abuse was meant to describe a milder kind of addiction. As far as dependence was concerned, it was a more severe kind of addiction. The main reason this changed was because the terminology was flawed. The reason is that, in biology, dependence is the adaptation of one’s mind and body to a substance.
The different classifications of substance use disorder include the following:
The APA is intentional about not using abuse or dependence to communicate the severity of one’s addiction. This is due in large part to the fact that people get confused with the two. Also, having two separate terms can feel exclusive. This way, everybody can sit underneath a wider umbrella so that those who need help feel more comfortable.
What if I Suffer from Substance Use Disorder?
If you are suffering from a substance use disorder, the following treatment options are available to help you recover:
Inpatient Residential Treatment
Meant to treat more severe cases of a substance use disorder, inpatient residential treatment allows patients who suffer from addiction to stay within the care of a treatment facility. This method of rehab gives patients 24/7 access to professional medical personnel, as well as weekly (in some cases daily) access to professional therapists and psychiatrists. This recovery program could last anywhere between 28 days to six months.
Lasting anywhere from three months to over a year, outpatient treatment is meant for those who have either completed inpatient treatment and aren’t ready to leave rehab or those who suffer from milder cases of addiction. This particular method of care allows patients to have anywhere between 10-12 hours of weekly access to professional therapists and psychiatrists. Outpatient rehab provides minimal disruption to one’s day-to-day and allows them to recover in a more patient, less urgent manner.
Drug withdrawal is one of the most difficult parts of suffering from substance use disorder. Some symptoms of withdrawal include the following:
Drug cravings are insatiable, and the withdrawal doesn’t make things any easier. This is why detox treatment is so important. Medically assisted treatment (MAT), or detox as it is more commonly known, is the process of quitting drugs or alcohol altogether while taking medicine to curb the symptoms of withdrawal. This helps the process of becoming sober by allowing those who are dependent on drugs or alcohol to come off of drugs more comfortably.
When it comes to treatment for substance use disorder, there is perhaps no better way for those who are suffering from addiction to recover than to attend therapy. Therapy does incredible things for those who are suffering both physically and emotionally from substance use disorder. The goal of therapy is to meet with a patient (or patients) and allow them to discuss/purge any sort of emotional barriers that pertain to their addiction (or even contributing factors that may seem unrelated)
There are many different kinds of therapy, some of which include the following:
- Individual therapy
- Group therapy
- Family Therapy
- Cognitive Behavioral Therapy
Individual therapy is a method that aims to fixate on the individual in a comfortable, intimate environment. This allows someone who is not as comfortable sharing intimate details about their personal life to just anyone a space to purge everything that ails them mentally. Individual therapy has been known to be successful in many cases of mental health treatment.
Group therapy, in contrast to individual therapy, focuses on treating individuals who suffer from addiction in a group setting. These environments are usually Socratic, allowing individuals to take turns sharing what’s on their minds and hearts. With circumstances that can be as discouraging as addiction, it is encouraging to be surrounded by individuals who are united against a common enemy.
Those who struggle with addiction aren’t the only ones suffering; substance abuse has a sort of splatter effect on any loved one caught within the crosshairs. Family therapy aims to mend the pieces of broken relationships between those who struggle with substance use disorder and their families/loved ones.
Help Isn’t Too Far Away
Addiction and dependence are two terms that are necessary and difficult to distinguish. However, being able to tell the difference between the two helps one understand the nature of someone’s substance use disorder that much better. When it comes to a mental health disorder as serious as this, equipping oneself with as much knowledge as possible is imperative to the recovery journey.
Dependence may exist without addiction being present, but that’s not to say that dependence won’t lead to an addiction. While understanding that a distinction between the two must be made, the possibility of one leading to another is great. If you believe yourself or a loved one are becoming dependent on a particular substance, or are already addicted, help is just a phone call away. If you’d like to reach out to The Freedom Center, you can contact us here.