What is the difference between drug addiction and drug dependence?
When does it change from drug use to drug abuse? Is it common for people to fluctuate between the two?
While it is essential to raise awareness and advocate about the dangers of addictive drugs, in reality, a lot of substances (namely, prescription medications) are a part of many people’s daily lives; does that mean they are addicted? The concept of “needing a substance to get through the day” sounds like an addiction, but it is actually the medical definition of dependence: “A state in which a person requires a steady concentration of a particular substance to avoid experiencing withdrawal symptoms.”
An article from the National Institute on Drug Abuse explains that “Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed. Thus, physical dependence in and of itself does not constitute addiction, but it often accompanies addiction.”
So if dependence is a part of addiction, then why is it condoned at all, especially by doctors? Doctors prescribe these potentially addictive medications because they can solve or remedy the problems that people face every day, like post-surgery pain, ADD, and depression.
So dependence can lead to addiction, but being dependent on a substance is not the same as being addicted. Then when does the drug use become drug abuse? The Medical Dictionary defines substance abuse as “an abnormal pattern of substance usage leading to significant distress or impairment” and causing tolerance and withdrawal symptoms, loss of willpower, and an unmanageable lifestyle.
The Medical Dictionary continues by listing the criteria for addiction as one or more of the following taking place within a year:
- Failure to complete work, home, or school obligations as a result of recurrent substance use.
- Multiple legal substance use problems.
- Recurring usage despite social and personal disputes.
Essentially, there is a fine line between dependence and addiction, but it is a line that makes all the difference. This line is not black and white, and if it is crossed it will not happen overnight. One of the most significant distinctions between the two are the social and emotional influence of addiction; e.g. when someone is not acting like themselves (and not as a side-effect of a medication) in response to not using the drug or not having “enough” of it, or if someone is willing to lie or steal in order to get the drug.
Dependence on a medication can feel slightly scary; everyone likes to be in control of themselves and not have to rely on something as inanimate as drugs. But medicinal science has made incredible progress and sometimes medication can be the key to living a “normal” life for people who have illnesses or injuries that would have prohibited them from doing so.
So, the difference between addiction and dependence will be unique to each person’s situation, their doctor’s opinion, their mental and physical health, and their personal values. It is crucial to remember that addiction is not a choice but a biological illness; escalating from dependence to an addiction is not a result of poor self-control or willpower.
If you or someone you know is exhibiting symptoms of substance abuse in addition to a dependence on a drug, you should contact an addiction recovery center like the Aviary. If you feel uncomfortable with your dependence on a prescription medication or have a personal or family history of addiction, voice your concerns to your doctor and try to find an alternative solution.