Dependence and addiction are different things but often confused as being one and the same. When looking at addiction the reason for using a substance or engaging in an activity, is to deal with and change the way the addict thinks and feels at that moment. If they were not to use a substance at that point they would not physically feel any ill effects.
For someone who is dependent on a substance, then their body will become physically ill and would not function at it’s normal level without a minimal amount of the specific substance.
Dependence is different to addiction; it is where the body needs a substance, as it has acclimatised to a substance to such an extent that it needs a minimum amount of that substance to function normally, whereas, in the case of addiction it is only a desire for a substance which offers a change in the addicts thinking.
In terms of using a substance the main difference between someone who is experiencing dependence over addiction is that the dependent user uses a substance to stabilise their body, whilst the addict may not physically need it but uses the substance to change how they think and feel about their world and situations.
It is common for an addict to become a dependent user. However, it is also possible for a high user of a substance like alcohol to become dependent without using it purely to manage their feelings.
For a dependent substance user, failure to get the required dose, can in the case of alcohol, lead to sweating, shaking, fitting and in some cases, even death. For other substances failure to access the appropriate dose could lead to extreme anxiety, paranoia, sweating, vomiting, depending on the substance and scale of dependence. To take this definition out of the abstract here is one way of understanding the relationship which an addict may relate to alcohol.
What are the differences between dependence and addiction. The key differences are
often confused by the friends and supporters of an addict as they mistakenly
believe that after a person has had treatment which detoxifies their body, i.e.
so that their body is no longer dependent then they believe that the person is
no longer addicted. They believe that the absence of the substance in their
body will mean that as they no longer need the substance then they will no
longer want the substance. More information on dependence is available from the US National Library of Medicine here.
Dependence is where the body will be sick if the substance, alcohol or heroin for example is not being put into the body, whilst addiction is using a substance or a behaviour like gambling so that the addict can change how they feel.
Removing the physical need (dependence) without addressing the reason they started using in the first place typically leads to either relapse or to adopting a new equally destructive way of dealing with their feelings (often a new addiction).
This confusion between dependence and addiction can make it more likely that an addict returns to using but also does not seek help. This could be because they themselves recognise that they no longer needed to take the substance and so they feel inadequate and feel like failures when they still have not developed the skills to deal with their feelings. Until they are equipped with these skills they will either resume using the previous substance or they may use an alternative substance or activity to mange their mental health.
One way to support people with addiction is to be aware that dependence and addiction are closely related. Some people are both dependent and addicts. However in order to give people the best support and a sense of being understood it is vital to recognise the difference between the two. Removing a substance from someone's body is relatively straight forward whereas the skills to manage addictive behaviours take time, reassurance and sustained personal growth.
Effective therapy will go deeper than addressing the substance. Dependence and addiction are closely linked but by focusing on the dependence you are only removing the person's coping strategy. Therapy will identify why they used in the first place, what coping strategies and person skills they need to move forwards and give them space and time to develop those tools.
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