Addiction and dependence are closely related. Maybe you have heard the terms used interchangeably. But they do not mean the same thing, even when applied in the same context.
What’s the difference between addiction and dependence? Dependence refers specifically to the body’s reliance on using a substance. Dependence is an aspect of addiction to substances. However, addiction has a psychological component as well.
Let’s take a look at the differences between addiction and dependence, before going into how to recognize and treat each condition.
What is Dependence?
After using substances for a while, the body gets used to their presence in the system. It begins to produce less of the chemicals or hormones that the substance provides as the excess is no longer needed. This is called dependence, because the body now depends on the consistent supply of the substance.
When the person stops using the substance, the body is shocked as the chemicals are depleted. Over time, it will start producing the chemicals at their normal rate. However, until then, the person may experience dangerous withdrawal symptoms as key bodily functions are compromised.
Dependence can occur outside of addiction. This is generally in cases of long-term use of non-addictive prescription medication. These medications are often used to increase chemicals that the body is already not producing enough of. Although the body might produce even less of these chemicals once the person begins taking the medication, effective medications provide enough to cover the shortfall as well as any dips in production.
If the person stops taking the medication all of a sudden, the chemicals drop to levels below what they were before. This abrupt crash is shocking to the body, leaving the person vulnerable to dangerous symptoms as the body tries to adapt.
What is Addiction?
While dependence refers only to the body’s need for a substance, addiction has a behavioral compulsion that goes beyond physical reliance. The person experiences an uncontrollable urge to seek out and use the substance, even when doing so leads to harmful consequences.
Addiction changes the way the brain’s reward system works. Substances like alcohol, opioids, or stimulants flood the brain with dopamine, a neurotransmitter responsible for feelings of pleasure and reward. Over time, the brain becomes reliant on these artificial dopamine surges and starts associating the substance with feelings of pleasure, leading to cravings and compulsive behavior.
This psychological component is what differentiates addiction from simple dependence. Someone with addiction prioritizes obtaining and using the substance over other important aspects of life, including work, family, and personal well-being. The craving becomes all-consuming, leading to a loss of control over how and when the substance is used.
Addiction also involves a cycle of use, withdrawal, and relapse. Once the brain is accustomed to regular substance use, any attempt to quit is met with both physical withdrawal symptoms and intense psychological cravings, making it extremely difficult to stop without help.
How is Dependence Treated?
he goal with overcoming dependence is to safely reduce or eliminate the body’s need for the substance, while minimizing withdrawal symptoms and preventing complications. This process often requires medical supervision, especially when dealing with substances that can cause severe withdrawal symptoms.
We’re going to go into how dependence is treated, which will also apply to treating dependence in the context of addiction.
1. Medical Detoxification
Overcoming dependence requires medical detoxification, or “detox.” Detox allows the body to gradually adjust to functioning without the substance.
For long-term use of prescription substances, tapering is often the method used. Tapering involves slowly reducing the dose of the substance over time to help the body adjust without triggering intense withdrawal. It’s particularly common with prescription medications such as antidepressants, benzodiazepines, and certain painkillers.
Stopping using prescription medication should only be done under the instruction of a medical profession. They will help determine whether it is safe to stop taking the medication and will provide a plan to help you taper safely and comfortably.
When it comes to dependence on substances like alcohol and strong opioids, medical detox is even more important, as sudden cessation can be very dangerous.
2. Medication-Assisted Therapy (MAT)
Medications can be used to ease the transition during withdrawal and recovery from substances like alcohol and opioids. Methadone, buprenorphine, and naltrexone help stabilize the body’s physical functions while reducing cravings, acting on the same receptors in the brain as the substance, providing a safer, controlled alternative during the withdrawal process.
For non-opioid dependencies, medications such as clonidine or benzodiazepines may be used to control symptoms like anxiety, muscle aches, or nausea that occur during withdrawal.
3. Supportive Care
Treating dependence is not only about managing withdrawal; it also involves providing supportive care during the recovery process. This includes hydration, nutrition, and emotional support, which are all essential as the body works to regain balance. Dependence can take a toll on overall health, so holistic care is often provided to help individuals recover more fully.
How is Addiction Treated?
The detox process is also used to treat dependence in the context of addiction. However, treatment for addiction is still necessary even when the body is no longer dependent.
After detox, addiction treatment continues with behavioral therapy. Behavioral therapies aim to change the thought patterns and behaviors that drive addiction, helping individuals to understand the root causes of their substance use and develop healthier coping strategies.
Some of the most common behavioral therapies used to treat addiction include:
- Cognitive-Behavioral Therapy (CBT): CBT helps the person recognize and challenge the negative thought patterns that lead to substance use. It focuses on building coping mechanisms, identifying triggers, and developing strategies to prevent relapse.
- Motivational Interviewing (MI): MI encourages the person to explore their ambivalence about quitting substance use and to find personal motivation for recovery. This therapy fosters self-awareness and empowers individuals to take ownership of their recovery journey.
- Group Therapy and Support Groups: Peer support is a core component of addiction treatment. Group therapy sessions allow individuals to connect with others who are facing similar challenges, providing emotional support and accountability.
Behavioral therapy is not the only aspect of addiction treatment beyond detox. Rehabs provide holistic treatments like mindfulness, yoga, and art therapy. It is also crucial that they treat any co-occurring mental illnesses at the same time. This is why you should speak to an addiction professional about the best course of action.
