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The Difference Between Addiction and Dependence.

Physical dependence does not always mean that you are addicted. To determine if someone has an addiction problem, clinicians use the DSM-5 diagnostic criteria which is described below along with the difference between addiction and physical dependence. Essentially, here we are answering the question if there a difference between physical dependence and addiction.

Is there a difference between physical dependence and addiction?

Yes, there is a difference between physical dependence and addiction. Addiction—or compulsive drug use despite harmful consequences—is characterized by an inability to stop using a drug, failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal.

The body adapts to the drug, requiring more of it to achieve a particular effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even when they are taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction.

This distinction can be difficult to discern, particularly with prescribed pain medications. The need for increasing dosages can represent tolerance or a worsening underlying problem instead of the beginning of substance abuse or addiction.  Research has shown only about 15% of patients in pain management become addicted1

Physical dependence is characterized by physical withdrawal symptoms when the substance is no longer taken.  There are some commonalities shared by withdrawals from different substances.  Generally speaking, withdrawal will include body aches, change of internal body temperature sometimes from fever, chills, extreme cravings to use, irritability, and problems sleeping.

How Do I know If I’m An Addict?

If you are wondering if you are an addict, here is the diagnostic criteria from the Diagnostic statistician Manual, or the DSM, the book which physicians use to diagnose patients:

Picture of the DSM-5
DSM-5
  1. Taking the substance in larger amounts or for longer than you’re meant to.
  2. Wanting to cut down or stop using the substance but not managing to.
  3. Spending a lot of time getting, using, or recovering from use of the substance.
  4. Cravings and urges to use the substance.
  5. Not managing to do what you should at work, home, or school because of substance use.
  6. Continuing to use, even when it causes problems in relationships.
  7. Giving up important social, occupational, or recreational activities because of substance use.
  8. Using substances again and again, even when it puts you in danger.
  9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
  10. Needing more of the substance to get the effect you want (tolerance).
  11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.

The above can be summed up by a loss of control and continuing to use despite negative consequences. 

Wellness Center NJ has the experts on staff to discern the subtle differences involved in substance abuse treatment.  We have years of experience providing drug and alcohol treatment in Northern New Jersey.  If you are questioning whether you have an addiction to alcohol or drugs reach out to the addiction treatment experts at Wellness Center NJ.

Citations

  1. Cheatle M, Comer D, Wunsch M, Skoufalos A, Reddy Y. Treating pain in addicted patients: recommendations from an expert panel. Popul Health Manag. 2014;17(2):79-89. doi:10.1089/pop.2013.0041

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