Addiction vs. Dependence

Hey y'all,

I have read and commented on several different threads lately where there seemed to be confusion over the difference between addiction and dependence. I can remember one thread the person who started the post was not recognizing the term dependence at all and they were using the term addiction for what I would consider dependence. So, I started this thread to put it to discussion. What is Addiction? What is Dependence? What are the key differences between the two terms?

To me Addiction is the psychological obsession with opiates. An addict can get through the pain of withdrawals, and be clean and sober, but he or she will ultimately be triggered to obsess over the DOC and end up using. I the term addiction addresses the addicts obsession to use and it is all mental.

Dependence on the other hand is when the body/brain becomes accustom to having opiates on its receptors and when the drugs are removed the body/brain goes through withdrawals. So, dependence is all the physically related symptoms with stopping opiates.

So, if you are an addict and you are now on suboxone you were addicted to your DOC and now you are dependent on suboxone. However, in my opinion you are not addicted to it, because you don't have the psychological obsession with it.

I would also like to address some other situations i have seen wrongly diagnosed in my opinion. I have heard people say that they are addicted to suboxone because of the withdrawals that are involved with stopping the drug. Again, I would argue that they are not addicted, they are dependent, because the symptoms in question are physical and not mental.y I have also seen posts were people are saying they were not addicted to there DOC when the got on suboxone but they just couldn't handle the withdrawals. So, they were saying that they were dependent to the DOC because of medical reasons or whatever and they couldn't stop only because of the discomfort of withdrawals. In my opinion this is addiction. I'm sorry you don't need Suboxone maintenance if you are only dependent from a couple scripts of vicodin. Maybe a quick detox using it, but not suboxone or methadone maintenance for dependence. In this this case i would argue that they are addicted to the DOC.

Please feel free to correct me if you feel differently. These are my opinions and I felt like it needed to be discussed. Thanks!

I agree that psychological obsession is a huge component to addiction. I would like to add that abuse and misuse of the drug(s) and the behavior of the person also signal dependence. For example if that person goes to great lengths to get the drug and are lying to family and friends about their drug use, this signals addiction and not dependence.

If however a person takes their medication/drug as prescribed and has never taken too many, ran out only to have withdrawals every month; doesn't lie to people; doesn't obsess over it; but they do have withdrawals, I would say that person is dependent rather than addicted.

Just my two cents.
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‎“Just 'cause you got the monkey off your back doesn't mean the circus has left town.”
~ George Carlin

I agree with everything you have said. Behavior is a big part of it and in my case my obsession was the case of those behaviors.

I just ran across this on another web site and think it hits the mark with regard to the differences in dependence and addiction. See if this helps at all:

Physical dependence: it means that you have withdrawal if you stop the medication abruptly. Many medications cause this including anti-anxiety meds. The brain adaptations responsible for it appear to correct themselves within a few weeks of cessation of the medication. Anyone who has taken large doses of opioids for a pain condition probably became tolerant and maybe physically dependent. A gradual taper off of the medication resolves the physical dependence. This is normal, doesn’t require treatment, and is not addiction.

Addiction: is the uncontrollable compulsion to take drugs. It is the inability to control drug use. Addicted people seek drugs despite doing harm to themselves and others. The addiction takes over their life and is prioritized above all else. The brain changes responsible for addiction are different than those of physical dependence and are slower to develop and much longer lasting. These brain changes cause symptoms long after the drugs are stopped. Addiction is a disorder and often requires treatment.