Drug or alcohol dependence is when a person has become physically dependent on a substance. It is marked by increased tolerance, as well as withdrawal when use is stopped. Addiction is when a person continues to seek out and use a substance despite negative consequences.
Substance Dependence used to be a separate diagnosis to Substance Abuse, which was considered full-blown addiction. However, in the most recent version of the Diagnostic and Statistical Manual (DSM)—the text used to make mental health diagnoses—criteria for each fall under one diagnosis of Substance Use Disorder. This change was made in part because a person can become addicted to substances that don’t cause physical dependence.
However, in some cases, it is still helpful to distinguish between dependence and addiction. While addiction usually accompanies physical dependence, there are cases where people can be dependent but not addicted. For instance, a person taking an opioid prescription as prescribed may become physically dependent—requiring a higher dose to feel effects—but not addicted. It would be important for their doctor to recognize this soon and help them taper off the drugs, as addiction is likely to follow.
Scott Gottlieb, Commissioner of the Food and Drug Administration (FDA), said, ““Someone who requires long-term treatment for opioid addiction with medications—including those that are partial or complete opioid agonists and can create a physical dependence—is not addicted to those medications.”
Gottlieb explained that widespread misunderstanding of the difference between dependence and addiction contributes to stigma surrounding Medication-Assisted Treatment (MAT); an example of this is when people say that those receiving MAT are “replacing one addiction with another.”
Addiction affects the parts of the brain responsible for reward control. A person with an addiction will use the substance despite continued consequences. MAT, on the other hand, is an FDA-approved treatment that helps people recover.
If you are worried about your substance use, there is help available. TruHealing Centers provides high-quality treatment for substance use and mental health disorders. We offer MAT to help you gradually get off substances. At our facilities across the country, our staff—many of whom are sober themselves—will help you thrive in long-term recovery. Call an admissions specialist at 410-593-0005.