Understanding the Difference Between Dependence and Addiction

Addiction and dependence are two words that are used interchangeably when they shouldn’t be. Dependence occurs when a physical addiction develops. This may develop at the same time, or before, a mental dependence occurs. While all drugs have the potential to be mentally addictive, not all are physically addictive (dependence). It is also possible to be physically dependent on a drug and not be (mentally) addicted to it.

Addiction Vs. Dependence

Many people nzolieve addiction and dependence have the same, shared meaning, but there’s actually a distinct difference between the two terms. Understanding this difference can help you know when you need to get help for physical symptoms, when you have an addiction problem for which you need help, and identify specific ways to change your addiction or dependence issues.

Addiction and dependence should not be confused with tolerance, and those who are addicted to a substance are not always dependent on it. Likewise, people dependent on a substance may not yet have formed an addiction. This can be a confusing concept, yet knowing where you stand in regards to drug abuse may help if you’re considering treatment.

Individuals and medical and treatment personnel alike have yet to agree on the difference between dependence and addiction. Some believe the two terms have separate meanings, some believe they are interchangeable, and some choose not to use either term, replacing them with a blanket term, like substance use disorder.

One thing is clear, whether you have a physical dependence on illicit drugs or a mental addiction to a substance or activity, you may need help overcoming the issue. Knowing what issue you have allows you to determine the help you need. From there, it’s simply a matter of getting that help.

Ohio Recovery Center


Plymouth, Massachusetts

What Is Addiction?

Addiction could also be referred to as mental dependence. When you’re addicted to, but not dependent on a substance, the addiction is in your mind—it’s the reason so much of treatment works to improve mental health, behavior, and management of thought processes.

Consider the way we use the word “addiction” in everyday language. We say people are addicted to certain drugs or activities, and we often mean it in a negative way. In fact, the negative weight associated with the word is likely the reason addiction and dependence have been grouped together to be called substance use disorders.

Yet there are clear differences between dependence and addiction. First, nearly anyone can become dependent on a drug that fosters physical dependence, such as heroin. However, some people are predisposed to addiction.

For example, someone who has several addiction risk factors is more likely to fall into the pulls of addiction, whether it be addiction to a substance, such as marijuana, or an activity, like gambling. Because addiction can result for people who are predisposed to certain factors, it’s classified as a disease and treated as such.

The National Alliance Of Advocates For Buprenorphine Treatment (NAABT) describes addiction as, “a primary condition manifesting as uncontrollable cravings, inability to control drug use, compulsive drug use, and use despite doing harm to oneself or others.”

Addiction can also have external consequences, such as “failure to meet work, social, or family obligations,” according to the National Institute On Drug Abuse (NIDA). When accompanied by physical dependence, which is caused only by certain drugs, addiction can also result in tolerance and withdrawal.

It’s important to understand that addiction alone (without dependence) cannot cause withdrawal symptoms, but mental addiction can still manifest in physical ways, such as fatigue, sleep problems, depression, anxiety, and more. This is largely because when you become addicted, your brain chemistry changes.

As Harvard Health Publications reports, “the word ‘addiction’ comes from a Latin term for ‘enslaved by’ or ‘bound to.’” It’s no surprise, then, that early research focused on finding reasons for people’s addiction, and centered on ways to make these people stop their ways. Addicted persons were previously viewed as corrupt or immoral.

We now know that addiction is a disease that changes the way your brain works and communicates, making it difficult to overcome on your own. People who become addicted may not have an immoral agenda, and may not even see addiction coming.

Research also previously concluded that addiction only resulted from alcohol and powerful drugs, like heroin. But what we thought was only addiction was actually addiction and dependence.

Instead, addiction is a disease that is affected by certain factors, changes your mental faculties, and can keep you caught in its hold for years. A person who is addicted may not have a dependence on a substance, may develop one (depending on the substance), or may never experience dependence at all.

Physical Dependence On Drugs And Alcohol

Physical dependence, or simply “dependence,” is what happens when your body becomes reliant on a drug in order to function. In other words, when you become dependent on a drug, you experience adverse, physical symptoms when not taking it. These symptoms are known as withdrawal.

As the NIDA explains, “physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed.” Because dependence is predictable and highly treatable (usually with tapering off use of the drug) it doesn’t always go hand in hand with addiction, but often does.

When the body becomes dependent on a substance, it relies on a steady flow of that substance in order to maintain regular functioning and to avoid withdrawal. With some drugs, withdrawal can occur as early as a few hours after the last use.

It’s important to recognize that dependence can happen with many substances, not just illicit drugs. To name a few, the NAABT cites sugar, caffeine, nicotine, antidepressants, and prescription opioids. Dependence works by changing your body due to repeated and constant use of the substance.

You can form dependence through habit of use. With time, this can lead to addiction, yet when caught early enough dependence doesn’t always result in addiction. For example, when people become dependent on prescription opioids, and begin experiencing withdrawal, dependence is manageable with medication and/or tapering use of the drugs until no longer dependent. However, once addiction has formed, you may require more intensive treatment than for dependence alone.

What Is Tolerance And How Does It Affect Dependence?

Tolerance may develop in people who’ve been abusing a substance or substances for a prolonged period of time. The NIDA reports that tolerance occurs when, “it takes a higher dose of the drug to achieve the the same level of response achieved initially.”

If you develop tolerance, it doesn’t mean that you’re addicted but tolerance often precedes addiction. It works like this: you abuse a drug, which triggers a certain, chemical response in your brain. The next time you take that same drug, the same response occurs, but often on a lesser scale. While you may be taking the same amount of the drug, your brain no longer responds in the same way and you require more of the drug to achieve the same response.

Tolerance may affect dependence in keeping a person going back to substance abuse again and again. What starts out as recreational substance abuse can build to a habit, which can lead to dependence and later addiction.

The danger of tolerance is that it doesn’t allow you to feel the amount of drugs in your system. If you take more in an attempt to feel the same “high,” you increase your risk of overdose as well as your risk of developing dependence or addiction.

What Drugs Are Physically Addictive?

Heroin, opioids, benzodiazepines, alcohol, and barbiturates are all physically addictive, so they can cause dependence which means they can also lead to addiction.

While some would argue that other drugs can lead to dependence and withdrawal, these are the drugs that have been shown to cause dependence that manifests in physical ways (withdrawal).

Some examples of withdrawal symptoms from these drugs include:

  • Nausea
  • Headache
  • Tremors
  • Insomnia
  • Depression
  • Anxiety
  • Seizures

What Drugs Are Mentally Addictive?

The following is a list of  drugs that are considered to be mentally addictive:

  • Cocaine
  • Amphetamines
  • Ecstasy
  • MDMA
  • Molly
  • Marijuana .

Addiction is largely a mental experience, dependence is a physical process. Because addiction affects your mind, you can actually form addiction to things other than just substances. Gambling, for instance, causes addiction in many people, and treatment for gambling addiction may use modalities also utilized in addiction recovery.

As research from Indiana University explains, “any activity, substance, object, or behavior that has become the major focus of a person’s life to the exclusion of other activities, or that has begun to harm the individual physically, mentally, or socially is considered an addictive behavior.”

Substances, objects, and activities that are mentally addictive are addictive because we allow them to be. Addiction is a process, which begins with a habit that becomes a disease of the mind, and sometimes the body, extending to behavior, mood, overall health, and social functioning.

Which Drugs Can Lead To Both Addiction And Dependence?

If addiction and dependence don’t necessarily occur together, but can occur together, knowing which substances can lead to both can be confusing. First, it’s important to recognize that any substance that is physically addicting (causes dependence) can also be mentally addicting.

The following types of drugs are both mentally and physically addictive:

  • Alcohol
  • Benzodiazepines
  • Barbiturates
  • Opioids (prescription opioids, synthetic opioids, and heroin)

This is because dependence changes your brain structure in order to make you dependent. Therefore, if you’re dependent you’ve already formed some degree of mental addiction. Whether you’ll reach the point of addiction that leads you to be unable to quit use of the substance is up to you and can be affected by whether you seek help for addiction recovery and stop use of the drug before the damage is done.

Other Factors That Lead To Addiction

Certain factors make a person more likely to fall into addiction. Some are genetic, others depend on environment and upbringing, while others may simply depend on personality.

The following risk factors may increase the likelihood of developing addiction:

  • Aggressive behavior as a child
  • A pre-existing mental health disorder
  • Employment status
  • Family history of addiction
  • Lack of parental supervision or involvement
  • Lack of social skills, or social changes
  • Desire to experiment with drugs
  • Type of occupation held
  • Availability of drugs in one’s school
  • Poverty in one’s neighborhood/community
  • Cultural influences

Even if you experience all of these risk factors, you’re not necessarily destined to develop addiction. The factors simply affect your chances of falling prey to habits and lifestyle choices that can lead you into addictive behaviors or substance abuse. In light of this, it’s helpful to know which factors put you at risk so you can learn ways to manage them, free from addiction.

What Are The Characteristics Of Addiction?

How does addiction present itself? It manifests in many different ways. It works in each person differently than the next, but the process is similar for each.

Some characteristics of addiction are as follows:

  • Apparent loss of control
  • Experiencing blackouts during addictive behavior
  • Obsession/preoccupation with the activity, object, or substance
  • Seeking the behavior, activity, or substance even when you realize it’s a detriment in your life
  • Habitual use of substance or engaging in the activity
  • Inability to stop engaging in the activity, using the object or substance
  • Hiding addictive behavior from family and friends
  • Denial of addictive behavior
  • Doing illegal or risky things to continue using substance
  • Low self-esteem or confidence, and self-loathing

Stopping use of the activity, object, substance causes mental symptoms similar to physical withdrawal for dependence: anxiety, depression, range of emotions, sleep issues, and more

In addition, it’s common for those who have formed addiction to not believe they have an issue. If you recognize the signs of addiction in someone, and try to approach them, the person may not only deny it, but try to shift the blame away from him or her. This can be not only frustrating, but can cause the person to become aggressive or even violent.

The sooner we recognize the signs of addiction, and offer access to help, the better chance a person has of reversing the damage caused by it.

What Are The Characteristics Of Dependence?

Because dependence can occur with addiction, dependence may include some or all of the characteristics of addiction. In addition, other characteristics of physical dependence to substances include tolerance and withdrawal.

Withdrawal is different for each person, and the type of symptoms you experience will depend on a number of factors, including drug of abuse, duration of abuse, how much of the drug you take and how often, and personal and physical traits.

Drug Abuse vs. Drug Addiction

As with the terms “addiction” and “dependence,” drug abuse is different from addiction. Drug abuse is the act of using an illicit drug, or misusing a prescription drug. Misuse can include taking the drug a different way than prescribed, changing dosage, taking it more often than prescribed, or taking a prescription that doesn’t belong to you.

Drug abuse is often what leads to addiction. People may believe they are in control of their drug use, and can stop whenever they want, but abuse becomes a habit which can lead to addiction, or dependence with certain drugs.

So, do you need help for drug abuse, or only for drug addiction? Drug abuse is where drug addiction starts. Catching it as early as possible can help you target the problem and find treatment for it before experiencing the vast health problems and life changes that can come with addiction.

Spring Hill Recovery Center


Ashby, Massachusetts

What Treatments Are Available For Drug Addiction And Dependence?

Treatment for addiction and dependence are similar, and tend to coincide. That’s because both addiction and dependence affect health of the mind, mood, and behavior, and both can affect your physical health, though in different ways.

Treatment programs for addiction recovery and dependence can include an array of modalities, integrated into a single program that meets your individual needs. At OpioidTreatment.net, we can connect you with rehab centers who will work to simultaneously address all health issues. A comprehensive treatment plan is an important component of a successful recovery outcome.

If you’re worried you may have fallen victim to addiction, or you may already be dependent on a substance, we can help. Recognizing your issue and having the courage to seek help is half the battle. The rest are details, and we can help you access the resources you need to make the best decisions about treatment.

If you or a loved one is struggling with drugs and/or alcohol, contact us today. Your call will be 100 percent confidential.


Canton, Massachusetts

Bedrock Recovery Center


Levels of Care:

Payment Options: Insurance Accepted, Self Pay

View Center Profile

Plymouth, Massachusetts

Ohio Recovery Center


Levels of Care:

Payment Options: Insurance Accepted, Self Pay

View Center Profile