Tolerance, Physical Dependence, Addiction: the Differences

While it isn’t possible to develop an addiction to a substance without repeated use, addictions can form more quickly and easily in certain people. Genetic, neurological, or psychological factors tips for treating and living with essential tremor cleveland clinic can all increase a person’s likelihood of developing a drug or alcohol dependence. In addition, stress, trauma, and hardship are also known ‘risk factors’ that make addiction more likely.

1. The medical community has typically thought of addiction as abuse of a substance that continues even when there are detrimental consequences, such as losing a job or developing physical issues like kidney damage or ulcers.
2. This international committee met over several years in cities such as Washington, Copenhagen and New York, and their work was published in 1987 as DSM-III-R (revised).
3. In severe cases of intoxication or overdose, a person may require emergency care.
4. The World Health Organization also wanted to replace the medical designation of “addiction” with the word “dependence” back in 1964 (which probably contributed to the confusion).
5. But addictions can happen anywhere, from college campuses to rural and suburban towns.

For instance, someone who is on a prescription for pain medication may find that he needs increasing amounts of dosage for the medication to work. Some doctors may diagnose this as an increasing tolerance, or it might be disguised as the possible start of an addiction issue. In most cases, addiction is determined by noticeable negative consequences to one’s life. If a substance harms you, your relationships, and your obligations, it’s most likely addiction.

When they first use a drug, people may perceive what seem to be positive effects. Some people may start to feel the need to take more of a drug or take it more often, even in the early stages of their drug use. As the medical and scientific discussion on these terms has progressed in recent years, both are now considered as part of a larger grouping; that of substance use disorder. Addiction and dependence are words both used to describe an unhealthy and problematic pattern of drug or alcohol use. In the past, drug or alcohol dependence was diagnosed as the most severe form of addiction, but this classification was done away with in 2013. Today, addiction and dependence are used interchangeably, and both refer to an unhealthy and problematic pattern of substance use.

(Substance use disorder, or SUD, is a preferred term in the scientific community.) Because of this lack of consistency, some ground rules can help differentiate between the two terms. Distinguishing between these concepts is essential in recommending the right treatments. Addiction recovery can involve addressing both physical and psychological health.

History of the Terms Dependence and Addiction

Risk and protective factors may be either environmental or biological. Addiction and dependence are terms that are used interchangeably to describe an unhealthy, problematic reliance on drugs, alcohol, or other compulsive behaviors. Some people develop physical dependencies on a drug while others only develop a psychological (aka mental or emotional) dependence.

Drug dependence is not addiction—and it matters

This meeting of the forum will examine the nature of substance abuse and its impact on the nation. Substance abuse is most prevalent among adults between the ages of 18 and 25, and level of education seems to be an important correlate of abuse. Less-educated people are more likely to engage in heavy use of drugs, alcohol, and tobacco. The rate of illegal drug use among African Americans is higher than that of Caucasians, who are more likely to use illegal drugs than are Hispanics, according to the 1995 NHSDA. Among youths, however, the rates of use are about the same for the three groups. The extent of the impact of substance abuse on U.S. society calls for a review of federal intervention efforts, whether at the level of supply reduction, treatment, or prevention.

Understanding dependence & addiction

Regardless of age, gender, race or ethnic background, and level of education, according to government surveys, Americans use cigarettes, alcohol, and drugs—whether legal or not—and often do so in a compulsive fashion. Tobacco use accounted for all but 120,000 of those deaths, making it the most preventable cause of death and disease in the United States.11 The 1964 surgeon general’s report had a dramatic impact on smoking. Almost 50 percent fewer adults patients of sober living centers are often last to know about closures now smoke, but that trend stalled in 1990. Adolescents are using tobacco at higher rates than they did in 1991. This increase is reflected in the report that, every day, 3,000 children and teens begin smoking.12 The 1995 NHSDA reported also that, every day in 1994, approximately 6,300 individuals began using marijuana. The 1995 data reflect a continuing increase in the use of hallucinogens and inhalants, as well as marijuana, among the nation’s youth.

The brain continues to develop into adulthood and undergoes dramatic changes during adolescence.

If that history lesson sounded confusing, that’s because it is, and there’s no way to simplify what happened. But the biggest source of confusion concerns the word „dependence.“ Prior to the DSM-III, the term „dependence“ simply meant physiological dependence, as indicated by tolerance and withdrawal symptoms. Addiction is marked by a change in behavior caused by the biochemical changes in the brain after continued substance abuse.

Sometimes, severe withdrawal symptoms require monitoring from doctors in a hospital setting. Currently, the only behavioral addiction included in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) main list is gambling disorder. It is possible to be physically addicted not to have a brain disease. In a paper written for Training about Alcohol and Substance Abuse for All Primary Care Physicians, published in 1995 by the Josiah Macy, Jr. Foundation, Kathleen Brady, M.D., Ph.D., noted that African-American men are less likely to drink alcohol than white men, whereas the opposite is true for women.

For example, a person with a caffeine dependence who stops drinking coffee may have withdrawal symptoms for a few days but then feel better. I wanted to bring a few more members into this conversation on dependence vs. addiction. @stressedmesseddepressed talked about seeing what was thought to be addiction was actually physical dependence upon clonazepam. I thought that @johnhans @jimhd @jakedduck1 @rwinney and @sandytoes14 might have some thoughts on this topic of how one knows whether they are addicted or just physically dependent on a medication.

We know that the difference between addiction and dependence is often challenging to understand. Some organizations may have different names or definitions or use the words interchangeably, which causes mass confusion. The term substance use disorder (SUD) is the preferred way of saying it in the scientific the signs of a high functioning alcoholic community. Since consistency is lacking, it’s important to establish some ground rules. These changes have already been presented publicly at meetings of the American Psychiatric Association, the Research Society on Alcoholism (RSA) and the College on Problems of Drug Dependence (CPDD).

I suppose that some people would have an addiction problem if they were to take some of the meds I take. I’ve never had a problem with addiction, to drugs or alcohol or nicotine or a behavioral addiction. This article explores the symptoms, causes, stages, and treatment of substance dependence, also known as substance use disorder. In contrast, with SUD, a patient’s actions are directed primarily by an overwhelming need to accommodate the brain’s reward center, and the part of the brain that guides self-control and decision making is directly impeded. A patient with a SUD begins to lose the ability to effectively prioritize their well-being over the continued use of the drug.

Withdrawal symptoms from certain drugs can be fatal, so it is important that detox is done professionally, in a safe and controlled medical facility. Dependence on a drug can certainly lead to a substance abuse disorder (SUD). According to the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there’s not really a distinction between dependence and abuse anymore. Rather, the manual defines substance abuse disorders as mild, moderate, or severe.