The Difference Between Addiction and Dependence: Do I Have a Problem?

When it comes to drugs and alcohol, addiction and dependence are related, but they are not the same. You can be dependent on a drug, but not have an addiction, and vice versa, although more often than not, they go hand in hand. Understanding the difference is important so that you know how to overcome either or both.

What Is Dependence?

Dependence has both physical and mental aspects. Physically, when you use drugs or alcohol regularly for a period of time, changes occur in your brain that makes it come to expect drugs or alcohol. Over time, it requires more of the substance to produce the same pleasurable effects, which is known as tolerance. Additionally, when you don’t use the substance, your brain reacts which leads to withdrawal symptoms. This is physical dependence.

Mental dependence, also called psychological dependence, is when you become conditioned to using a substance in response to triggers, which can be situations, places, or feelings. For example, a trigger could be feeling anxious, being with a certain person, or just going to a restaurant. When you have a mental dependence, you have difficulty not reacting to these triggers by using drugs or alcohol.

Both physical and mental dependence can lead to addiction.

What Is Addiction?

Addiction, also known as a substance use disorder, is continuing to use a substance in spite of negative consequences. Substance use disorders are formally defined in the Statistical Manual of Mental Disorders. This definition has 11 criteria that determine whether a substance use disorder is present.

1. Using a substance more than intended or for longer than intended
2. Wanting to reduce or stop substance use but not being able to
3. Spending excessive amounts of time using a substance or recovering from using a substance
4. Feeling cravings for the substance
5. Failing to live up to responsibilities due to substance use
6. Having relationship problems because of substance use
7. Giving up activities that you enjoy in order to use the substance instead
8. Engaging in risky behaviors like driving while under the influence
9. Continuing to use the substance in spite of negative consequences like health issues
10. Needing more of the substance to get the same effects
11. Having withdrawal symptoms when you are not using the substance

Having two to three of these symptoms indicates a mild substance use disorder, four to five is considered moderate, while six or more is severe.

Do Both Dependence and Addiction Need Treatment?

The short answer is yes, both dependence and addiction need treatment. Physical dependence alone, without mental dependence or addiction, may require detox treatment. Withdrawal from certain substances, particularly alcohol, can be dangerous, so detox should be done in a medically supervised setting. This may last from seven days to two weeks.

Mental dependence is more closely linked to addiction and needs to be treated in a similar way. Treatment involves learning strategies and coping mechanisms to resist your triggers. It may be treatable with outpatient therapy.

Addiction treatment is more involved and complex. It includes therapy, often in both inpatient and outpatient settings, and requires a significant amount of time.

Do I Have an Addiction?

Knowing if you have an addiction involves some honest self-examination. You can evaluate yourself using the 11 criteria in the definition of substance use disorders, but you should also look at how using substances has affected your life. Consequences may include:

• Legal consequences such as a DUI.
• Making poor decisions or acting impulsively while using substances. These poor decisions may be anything from saying something you regret, to cheating on your partner, or going to work intoxicated.
• Relationship problems due to arguments about your substance use.
• Poor job performance or the loss of a job.
• Health consequences such as gastrointestinal problems, or high blood pressure.
• Missing out on activities or events due to using substances or recovering from substance use.

Only you can evaluate your life and the negative consequences that have come due to substance use. You need to be honest with yourself and decide if using substances is really worth the cost.

What Are My Addiction Treatment Options?

If you determine that you have an addiction and need help, you have several treatment options.

Inpatient Treatment

A 30 to 90 day inpatient treatment program includes a detox period and intensive therapy, both individually and in groups. You’ll also be treated for any co-occurring disorders that you may have, such as anxiety and depression. Medication may be part of the treatment.

Most of your time will be spent in group therapy. Group therapy is central to the treatment process, giving you the opportunity to learn and to interact with peers. You’ll likely form mutually supportive relationships with some of these peers, which can be invaluable.

The type of therapy most commonly used in substance use disorder treatment is cognitive behavioral therapy (CBT). CBT teaches you to recognize your irrational thoughts and to challenge and change them to more reality based, positive thinking. It also teaches healthy coping skills and strategies to avoid relapse.

Partial Hospitalization Programs (PHPs)

A partial hospitalization program (PHP) allows you to live at home while attending treatment for four to six hours per day, usually five days a week. The program may last anywhere from four weeks to ten weeks. The treatment consists of therapy similar to that of inpatient treatment, both in groups and individually.

More often than not, a PHP program is a transitional step that occurs after inpatient treatment, although it can be an alternative to inpatient treatment.

Intensive Outpatient Programs (IOPs)

An intensive outpatient program (IOP) consists of two to three hours of therapy five days a week for eight to twelve weeks. Often, sessions are held at convenient times so that you can still go to work or attend school.

An IOP can be a standalone treatment, or it can be attended after inpatient treatment, a PHP, or both.

Support Groups

Some people with substance use disorders don’t attend rehab at all but instead choose support group meetings through a program like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). While this may be effective for some people, it’s not recommended as a standalone option for those who need medically supervised detox or who have a moderate to severe substance use disorder. Support groups can, however, be an effective long-term option after treatment.

Comprehensive Treatment

The most effective treatment plan for substance use disorders is a comprehensive treatment program that consists of an inpatient program, a PHP, and an IOP. Research shows that recovery success rates increase the longer you stay in treatment. After IOP, you can receive continuing support from individual therapy or a program like AA or NA. Recovery from addiction is a lifelong process that requires dedication, work, and a strong support network.

In Closing

Both dependence and addiction need to be treated, but the type of treatment required for each may be different. It’s important to understand which one you have, if not both, in order to follow the right path. At Bridges of Hope we are here to help. We can evaluate you and create a personalized treatment plan for your needs. We are committed to providing comprehensive, compassionate care so that you can move on to a better future. Give us a call today to learn more.