We often hear these words changed intermittently. However, there is a distinction between the two and it is important.
In short, dependence is the body’s reliance towards a particular substance. When we use some drugs (whether prescribed or recreationally) our body will start to become used to the drug in our system. Over time our body relies on the drug to feel normal. This is what is considered dependence.
When someone is dependent towards a drug or alcohol, they often have to ingest more to obtain the feeling they are looking for. For instance, with Xanax, a person prescribed might have to up their dosage after a few months to achieve the same medicted effects. Over the years and after higher and higher dosages, they will experience severe withdrawals from the drug if they stop using. These withdrawals are extremely unpleasant and can even be fatal.
Everyone can be dependent on a drug; however not everyone is susceptible to addiction.
A physical dependence occurs when the body relies on the chemicals form the drugs to maintain homeostasis. For instance, people often drink alcohol to help them relax, have fun, and socialize. Alcohol makes us feel this way because it releases endorphins in our brain. These are the same endorphins that help maintain our mood levels and keep us happy. However, overtime when a person consistently drinks, a physical dependence to alcohol will begin to develop. This happens because the brain relies on alcohol instead of it’s own processes to release the endorphins. It becomes dependent on the alcohol to provide these chemicals.
Because the brain is not used to making endorphins the way it used to, a person will experience withdrawals like depression, aggression, and irritability. This makes sense as the brain is now deficient at making the endorphins it once used to make before.
All drugs can form what is known as a “psychological dependence.” While most drugs will begin with psychological dependence, some drugs like Marijuana will stop there. Psychological dependence is similar to physical dependence in the way it forms, however psychological withdrawals will not produce physical symptoms when stopping use.
Unlike physical dependence, the symptoms of withdrawals will typically affect our mental state with things like irritability, sadness, and cravings. You may have experienced these feelings when you took a week off of coffee or stopped smoking.
Additionally, unlike physical dependence, a psychological dependence is not lethal and will not promote physical symptoms like sweating, shakiness, and seizures.
How To Know If I Am Dependent on a Drug?
To truly know if you are dependent requires abstaining from the substance of choice. The timeline of withdrawal will depend on the substance but in most cases, psychological withdrawal will appear within the first 24 hours.
If you are physically dependent on the drug, you may experience physical withdrawals within the first day or two.
Signs of Psychological Dependence
If you have ever tried quitting coffee, smoking, or even sugar, you might be familiar with psychological withdrawals. These types of withdrawals are mostly associated with cravings: feeling a need for the drug, not out of necessity, but out of want. This is the common underlying withdrawal symptom with most drugs, however not all drugs will promote physical withdrawals.
Signs of a physical dependence include:
- Withdrawal symptoms: Experiencing physical symptoms, such as insomnia, tremors, and mood swings. after going for a short period without.
- Drinking (or using) to relieve or avoid withdrawal symptoms, such as drinking to stop the shakes or to “cure” a hangover.
- Tolerance: Needing to use increasing amounts over time to achieve previous effects. For example, you used to drink three cocktails every night, but now you need five to get the feeling you’re looking for.
- Using larger amounts or over a longer period than intended and making unsuccessful efforts to cut down.
Physical withdrawals will depend on the drug, but common symptoms can include:
If a person uses a drug or alcohol for a long period of time (generally over 3 months consistently) they will undergo serious and fatal withdrawals with benzodiazepines and alcohol Serious Physical Withdrawals include:
If you have been using or drinking consistently for a long period of time, always consult a professional before quitting as it could be life-threatening – especially with benzodiazepines (xanax) and alcohol.
Many people often confuse the term “substance abuse” with addiction. According to The World Health Organization (WHO), substance abuse is defined as, “the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs.” Put simply, substance abuse is using drugs for unintended circumstances.
Common examples include drinking until drunk, using illicit substances, or taking more medication than prescribed.
Substance abuse is extremely dangerous and can have lasting health effects, including fatal overdoses.
Almost all schedule 1 drugs have the potential for overdose. Overdose deaths are now the leading cause of deaths in Americans under 50! These deaths are all due to substance abuse.
An individual can abuse drugs or alcohol here and there, but does not necessarily have an addiction to the substance. The abuse turns into addiction once a dependence forms and thus a person is no longer able to stop using.
Addiction is different from dependence. If dependence is physical (or psychological) then addiction is the condition in which a person is unable to quit the substance, and as a consequence, the use interferes with a person’s health and life.
Confusing these two terms is quite common and for good reason, they are very similar. However, you can be dependent on a drug without becoming addicted to the drug. The difference is that addiction revolves around a person’s behavior, rather than their physical symptoms.
For instance, a person can take a drug as prescribed and form a dependence to the drug. This often comes with a tolerance towards the drug and requires a higher prescription dosage. If the individual decides to take more than the prescribed amount, this is considered abuse and can be the start of an addiction. This action will begin to have consequences later on affecting their health, behavior, and life.
Individuals will often feel remorse for using the drug, however they are unable to abstain. Addiction can cause a variety of adverse effects like trouble with the law, loss of a job, friction in family life, and school complications just to name a few.
Addiction, referred to as a substance use disorder, is classified as a psychological illness much like depression and PTSD. In fact, mental disorders are often the reason many people choose to use these substances like alcohol.
Symptoms of Addiction
- Not feeling normal without alcohol or drugs
- Going out of your way to obtain substances
- Spending more money on substances than you feel comfortable
- Feeling guilty afterwards
- Interference with family, job, or school
- Behavior affecting your relationships
- Distancing from loved ones
- Loved-ones talking to you about their concerns
- Worrying about one’s supply and thinking about the next time it can be used
- Continued use despite great conflict due to use
- Inability controlling how much or how often
Risk Factors For Addiction
Genetics: If you have a family history of substance abuse, you may be more at risk for addiction. According to the National Institute on Drug Abuse, up to half of your risk of addiction to alcohol, nicotine, or other drugs is based on genetics.
Environment: For children and teens, lack of parental involvement can lead to greater risk-taking or experimentation with alcohol and other drugs. Young people who experience abuse or neglect from parents may also use drugs or alcohol to cope with their emotions. Peer pressure and a person’s social environment also heavily influences whether or not a person is exposed and how often they are.
Mental Health: Mental health disorders like depression and anxiety can cause individuals to lean on drugs to help them self-medicate.
Trauma: Much like mental health disorders, traumatic experiences can create vulnerability towards addiction. The Adverse Childhood Experience study actually showed that kids with troubling childhood experiences have a greater risk of developing addiction later on in life. Compared to an ACE score of zero, having four adverse childhood experiences was associated with a seven-fold (700%) increase in alcoholism.
Early Use: The younger an individual begins using alcohol or drugs, the greater their chances of developing an addiction.
Drug of Choice: Some substances are more addictive than others and some will cause more severe withdrawals. Addictiveness will also vary from person to person.
Method of Use: Drugs ingested through smoking or injecting tend to be more addictive than those taken orally. This is often due to the fact that they are absorbed through the body quicker, causing a more intense feeling.
Even if you have lots of risk factors for addiction, you can fight or avoid it. Risk factors can increase your likelihood of becoming addicted, however they do not guarantee that you’ll experience addiction.
Talk to your doctor if you have a lot of risk factors for addiction. They can help you discover more about addiction, your risk of developing it, and strategies to avoid it. They may recommend abstinence and recommend that you prevent drinking alcohol, using drugs, or practicing other addictive habits.
Ask your doctor for assistance if you think you have an addiction. They might suggest counseling, medications, or other treatment alternatives. It’s possible to recuperate from an addiction and lead a healthy life.
Addiction & Dependency Treatment
All that is required to treat dependence to a drug or alcohol is detox. This procedure, depending on the substance, can be done at an inpatient or outpatient level. The process involves utilizing medications and medical attention to help ease withdrawals and cravings. The detox process for dependency typically takes anywhere from 5-7 days.
Once the procedure has completed, you may still experience cravings for the substance, however, you will not experience physical withdrawals – especially severe ones like seizures.
However, if you find that you are unable to cease using after detox, you may need additional support. This is where treatment therapy comes in.
Treatment for addiction is quite complex. Addiction can spawn due to a variety of reasons such as mental health, trauma, dependency, stress, and multitude of environmental factors like family or career troubles.
In almost every case of addiction, the individual is using it to cope with these underlying disorders. Therefore, in order to treat these addictions we must treat these underlying disorders. This includes medications for mental health and cravings alongside a variety of therapeutic techniques like CBT, ART, and holistic approaches to help you feel happier and back to your better self.