Addiction Vs. Dependence

Mental health issues are a growing problem among people of all ages and demographics. As we progress in our understanding and treatment of mental health disorders, more people are finally receiving proper diagnoses and getting the help that they need. While the stigma behind mental health disorders is still alive and well in some instances, these types of disorders are starting to be taken far more seriously by society.

One particular facet of mental health that still isn’t understood very well; however, is addiction. Addiction, or a substance use disorder (SUD), is mental health disorder affecting millions in the United States and worldwide. It causes severe physical, emotional, and financial side effects on the addict and their loved ones.

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But, what exactly determines if someone is an addict? Many different prescription medications can cause the individual to become dependent on the medication physically, as well as build a tolerance to it naturally. Deciphering whether or not you’re struggling with full-blown addiction or simply have a dependence is important. Learn more about addiction vs. dependence and how to get help for both.  

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Struggling with addiction? Let us help! Request a call today!


What Is Addiction?

Many people who use or abuse drugs often find themselves questioning, “Am I an addict?” This can be more difficult to answer than it initially may appear. There are many people who use substances, whether illicit or prescription, who are not necessarily addicts or alcoholics.

Addiction, or known in the medical communities as a substance use disorder (SUD), is finally recognized as an official disease by the Diagnostic and Statistical Manual of Mental Disorders (DSM). Many people still struggle with the concept that addiction is a very real disease and not just an indicator of a lack of morality among addicts.

With this in mind, the DSM-V has made a list of various symptoms that must be present to make an official diagnosis among patients. If the criteria set forth by the DSM-V is observed by a medical professional, they can provide the patient with the diagnosis, and subsequently begin treating the disorder.

According to the American Society of Addiction Medicine, the definition of addiction as used by medical professionals is as follows: “ A primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”

The DSM-V requires the patient to have certain observable traits and behaviors present in order to be given the diagnosis. Patients must exhibit impaired control, social impairment, risky use, and pharmacological criteria. They must be unable to consistently abstain from drugs and/or alcohol, have difficulties in behavioral control, experience cravings for the drugs and/or alcohol, possess a diminished ability to recognize significant problems with their behaviors and relationships, and have dysfunctional emotional responses to situations or stressors in their lives.

What Is Dependence?

In contrast, when patients are asking “Am I an addict?” they must also consider if it is addiction or physical dependence. The terms addiction and dependence are often used interchangeably by people, but this is not correct. A physical dependence is not the same as having an addiction to drugs and/or alcohol. While most people with an addiction also have a dependence on the substance, not everyone with a physical dependence on the substance is addicted.

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The correct use of the term dependence is referring to the body’s adaptation to the presence of drugs or alcohol in the system. With prolonged use of certain substances, even if it’s prescription medication taken correctly each time, the internal chemistry of the human body changes. With the presence of the drugs in the system, the brain may alter its normal functions to operate in tandem with the drugs or alcohol. This means that person will develop a tolerance and physical dependence on the drug, so when use is stopped, the person may encounter withdrawals.

What Is Tolerance?

Tolerance is another way to describe the body’s resistance to certain drugs, alcohol, or medications. As it becomes accustomed to the presence of the substance in the body, the physical dependence develops and eventually a drug tolerance. This means that in order for the person to experience the effects of the substance to the same degree of intensity as before the dependence and drug tolerance were developed, they’ll need to take a higher dose.

As the brain changes the way that it functions and responds to stimuli with the presence of the drugs in the system, the body will eventually naturally begin to resist the drug. Over time with prolonged use, patients taking certain prescription medications may need to increase their dose to still have the medication be effective.

The same premise can be applied to illicit drugs as well. For example, in the beginning, an individual may only need a single dose of heroin to achieve their high. But throughout the course of their using, by the end, they may require multiple doses in order to have the same result. Drug tolerance and dependence are both based on chemistry and the intricate inner workings of the human body.

Mental Dependence and Physical Dependence

It is important to note that there is a difference between types of dependence as well. Physical dependence stems from the body altering its chemistry in light of the presence of drugs in the system. A mental dependence, also referred to as a psychological dependence, on drugs and/or alcohol is entirely different.

A mental dependence does not possess any physical symptoms like its counterpart. People who have a physical dependence on drugs will actually experience withdrawals if they stop using, which has various nasty symptoms like sweating, insomnia, vomiting, and aches and pains.

Instead, a mental dependence directly implicates the thoughts and feelings of the individual. For example, a person may believe that in order to participate at social events successfully, they will need to drink alcohol. It is not a physical need in order to function properly.

Mental dependence is merely a compulsion or perceived need to use. The person may experience obsessive thoughts that can be all-consuming. In some cases, a mental dependence is even more difficult to manage than a physical dependence. People who are psychologically dependent on a substance make it the focal point of their lives and cannot simply take a medication to help with the withdrawal symptoms. They need to undergo therapeutic treatment to break their mental dependence.

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Anatomy Behind Addiction and Dependence

In the comparison and contrast of addiction vs. dependence, there is also some biology involved. When differentiating between the two, there is a key difference in the impact having an addiction or dependence has on the brain.


There are different areas of the brain associated with addiction vs. dependence to a substance. The area of the brain that is directly associated with addiction is known as the reward center or reward pathway of the brain. This is where the neurotransmitter dopamine, which is known as the feel-good chemical, travels throughout the brain. Since the flooding of dopamine to the brain is directly associated with developing an addiction, this is the area of the brain responsible for substance use disorders.

The reward pathway is made of two distinct parts: the nucleus accumbens and the ventral tegmental area (VTA). The VTA is responsible for producing dopamine whereas the nucleus accumbens is the area associated with motivation and reward. There is also an additional dopamine pathway included called the mesocortical pathway, which travels from the VTA to the cerebral cortex.


Dependence, on the other hand, is directly linked to different areas of the brain than the reward pathway. Dependence involves the thalamus and brainstem. These areas are responsible for generating the withdrawal symptoms encountered by people with a physical dependence to a drug whenever they stop usage. In the case of an opioid dependence, symptoms manifest when the opiate receptors on both the thalamus and brainstem are refused opioids.

Because of the difference in areas of the brain being affected by addiction vs. dependence, a person can have a dependence to a drug without necessarily having an addiction to the drug as well. This is the case for many people who are prescribed certain medications such as prescription painkillers.

After using the medication for an elongated amount of time, even if the medication is never abused and proper dosage is taken every time, the body will develop a dependence on the medication simply due to biology.

It is unavoidable, and does not mean that the person has an addiction to their medication. But it is important to understand that people may possess both an addiction AND dependence, and differentiating between the two is important.

Signs of Addiction

As mentioned earlier, there is certain diagnostic criteria set by the DSM-V to assist practitioners in making an official diagnosis of a substance use disorder. However, despite these diagnostic criteria, there are different ways to identify addiction in yourself or others if you don’t have a medical degree.

There are certain tell-tale signs that someone may be struggling with an addiction to drugs and/or alcohol. If you or a loved one is experiencing any of these symptoms in any degree, take them as red flags and make the trip to your local medical professional and pursue an official diagnosis.

Some of the signs of an addiction to drugs and/or alcohol are:

  • Mood swings
  • Rapid changes in weight
  • Bloodshot eyes
  • Enlarged/ reduced size of pupils
  • Tremors
  • Changes in sleeping patterns
  • Financial difficulties
  • Disheveled demeanor
  • New friends and hangouts
  • Decline in performance in work or school
  • Absence from social obligations

It’s important to recognize these signs and symptoms of addiction before it’s too late. Addiction is a chronic and progressive disorder than can ultimately result in death in the most serious cases. Getting proper addiction treatment services is crucial in vastly improving the addict or alcoholic’s quality of life.

There are various methods of addiction treatment that have become available throughout the past several decades. Each one has unique qualities and traits that may be effective in treating your addiction. There are cognitive behavioral therapies, medication assisted treatment, and others. There’s no one-size-fits-all addiction treatment method, so much of finding what works for you may be trial and error.

Let Us Help!

Are you or a loved one currently struggling with addiction or dependence to drugs and alcohol? Let our experts at New Perspectives help you overcome your addiction! With state-of-the-art medication-assisted treatment methods, we are able to help you comfortably find a solution to your addiction or physical dependence on drugs and alcohol.

Our admissions specialists are standing by 24/7, ready to answer any of your questions and walk you through the admissions process. Don’t delay; call (855) 463-0793 now and get connected to the help you need and deserve in order to live your best happy and healthy life!