Dependence and addiction are often confused with one another, but there is a clear difference between addiction and dependence that is important to understand.

Read on for key information that may help you determine whether you or a loved one are struggling with a substance dependence or addiction. As there is no substitute for an official medical diagnosis, it is essential to seek professional help to evaluate symptoms and determine the best course of treatment.

Discovery Addiction Services provides expert, measurement-based care for substance use disorders and more.

What Is Dependence?

When the body adapts to a substance, it creates a biological response called dependence. This means the central nervous system has adjusted to the presence of the substance in the body. As a result, the body learns it needs the substance in order to function normally.

This is why many people experience withdrawal symptoms – when the substance is no longer present in a person’s system, it throws the body into shock as it tries to adapt.

The longer an addictive substance is consumed, the stronger the dependence becomes. This can continue for days, weeks, months…or even years. Dependence doesn’t just happen with illicit drugs. It can occur with prescription drugs as well as alcohol, caffeine, and nicotine.

There are two different kinds of dependence:

• Physical dependence is a physical reaction that involves building a tolerance to a substance and having withdrawal symptoms when the substance is stopped abruptly.
• Psychological dependence is a mental or emotional reliance on a substance that includes cravings driven by triggers. Both physical and psychological dependence have the potential to turn into an addiction.

What is Addiction?

Addiction is a physical and psychological dependence on a substance where repeated consumption persists and cannot be stopped despite harmful effects.

When someone is addicted to a substance, they repeatedly drink, smoke, or take drugs at all costs. They may want to quit and not be able to, even when negative situations arise as a result. This is because substances activate the brain’s reward pathways, reinforcing behavioral patterns associated with addiction and encouraging repeated use.

Addiction has a physical component and a psychological component. The body feels strong cravings for a substance when the brain encounters certain triggers. This leads a person to consume a substance to relieve uncomfortable symptoms.

The more of the substance they consume, the higher their physical tolerance becomes, and they need more of the same substance or begin to mix substances to feel the desired effects.

Common Substances Associated with Dependence and Addiction

Substances such as prescription and illicit drugs, alcohol, marijuana, caffeine, and nicotine can all cause dependence. In many cases, the severity of dependence can lead to addiction. The main substance categories involved in dependence and addiction are depressants, stimulants, and hallucinogens.

Depressants

Depressants, sometimes referred to as “downers,” slow down the central nervous system’s function and initially produce a calming effect.

Depressants include:

• Alcohol
• Marijuana
• Heroin
• Opioid pain relievers (i.e. Oxycodone, Fentanyl)
• Sleep aids (i.e. Lunesta, Ambien)
• Neurological pain relievers (i.e. Cymbalta, Lyrica)
• Depression and anxiety medications (i.e. Zoloft, Lexapro)
• Benzodiazepines (i.e. Valium, Xanax)

Prescription Depressants and Addiction

Certain prescription depressants are dangerously addictive.

Benzodiazepines are highly addictive because of the fast-acting calming effect they produce to counteract anxiety. They may be prescribed temporarily to “take the edge off” before boarding a flight or having a stressful procedure like an MRI. Doctors are often careful when prescribing these medications to help avoid dependence and addiction.  

Withdrawal symptoms from benzos and barbiturates can be life-threatening if not tapered off by a medical professional.

Opioid pain relievers are highly addictive because of the euphoric effect they produce when numbing pain receptors. Oxycodone and hydrocodone are the most widely prescribed opioids for pain relief. They are incredibly easy to become addicted to when they are sent home in a generous supply upon sustaining a physical injury.

Fentanyl is another type of addictive opioid used as anesthesia and pain relief during surgery, for severe post-operative pain, and for chronic pain (such as cancer). It is used especially when other opioids are ineffective. Unfortunately, fentanyl is so potent it can be fatal in very small doses.

Most of the fentanyl used on the street is made in clandestine labs.

Other Addictive Depressants

Heroin is an extremely addictive illicit opioid depressant. People can be hooked from the first time they use heroin because of a “rush” they feel when the drug enters the brain and activates opioid receptors.

Alcohol and marijuana are common depressants people develop physical and psychological dependence to as well as addiction. While marijuana is legal only in certain states, alcohol is legal everywhere and easy to obtain.

These socially acceptable substances are used as social lubricants in many instances. They are seen as “quick fixes” for nerves, stress, and to “have fun.” Unfortunately, when they are used repeatedly, a dependence can form, either physically or psychologically.

Treatment is necessary in order to recover from substance use disorders. Common approaches include talk therapy, group therapy, rehabilitation and medical detox. Holistic measures like acupuncture, mindfulness and meditation, exercise and equine therapy are helpful when used in conjunction with traditional methods.

Stimulants

Stimulants, sometimes referred to as “uppers,” speed up brain-body communication. This leads to heightened alertness, increased attention and energy, elevated blood pressure and accelerated heart rate.  

Legal stimulants include:

• Caffeine
• Nicotine
• Prescriptions for ADHD, narcolepsy and obesity

Illicit stimulants include:

• Methamphetamine
• Cocaine
• “Bath salts,” a nickname for synthetic cathinones, a class of potent designer stimulants

A common example of dependence on a stimulant is the widespread usage of caffeine. Many people rely on a cup of coffee to get out of bed in the morning. Others sip energy drinks to stay awake while driving, studying, or working long hours. While it is possible to be addicted to caffeine, it is more likely for someone to have physical dependence.

In this case, withdrawal symptoms from caffeine include headaches, irritability, drowsiness, fatigue, and increased appetite.

Are Stimulants Addictive?

Yes. All stimulants can be addictive due to their effects of an energy surge on the body. Prescription medications for attention-deficit hyperactivity disorder (ADHD) include amphetamines like Adderall and methylphenidates like Ritalin. These controlled substances are highly addictive and often misused by students and adults who rely on them for increased performance.

Recreationally, people may believe they can think faster and focus better when they drink caffeinated beverages, smoke cigarettes, vape, or do coke or meth. These stimulants have become “vices” for stress relief, socializing, problem-solving and numbing uncomfortable emotions. Occasional “weekend” usage can easily turn into daily consumption.

Bottom line, the more often people rely on stimulants, the more likely an addiction will develop. 

Treatment is necessary to assist with withdrawal symptoms such as headaches, nausea, shaking, tiredness, difficulty focusing, racing thoughts, hallucinations, aggression and unusual behaviors.

Hallucinogens

Hallucinogens are addictive substances that alter a person’s perception of reality. They influence the five senses of smell, taste, sight, touch, and hearing.

Common hallucinogens are:

• LSD/Acid
• MDMA/Ecstasy/Molly
• PCP
• Shrooms/Magic Mushrooms
• Mescaline/Peyote
• Ketamine
• DMT

Hallucinogens are often used recreationally and can cause a psychological dependence to develop.. People may want to escape reality with the effects of mushrooms or acid. They may enjoy the “high” they get from ketamine or the increased sex drive they get from ecstasy. They might seek insight from peyote.

Whatever the reason, the more often people engage in hallucinogen consumption, the more likely they are to develop a psychological dependence.

Addiction Signs: What are the Signs of Addiction?

Signs of addiction include:

• Believing substances are necessary to function
• Strong cravings when triggered
• Being in denial or defensive when confronted
• Loss of interest in former activities, unmotivated
• Obsessive thoughts about substances
• Having anxiety about quitting
• Seeming unmotivated, tired or distracted
• Having unusual bursts of energy, nervousness, or instability
• Increased irritability, sudden mood swings, or angry outbursts
• Unexplained personality or attitude changes

Signs of Physical Dependence

Signs of physical dependence include:

• Physical cravings
• Increased tolerance
• Frequent coughs or colds
• Noticeable weight changes
• Neglecting personal hygiene or self-care
• Feeling more frequent anxiety, panic, or paranoia
• Experiencing insomnia or disrupted sleep patterns

Both physical dependence and addiction may cause withdrawal if suddenly stopped. If the following signs appear, seek professional help.

Withdrawal Signs

When the body is reliant on a substance, it doesn’t know how to function without it. Physical dependence is a response of the body having a chemical need for a substance. Withdrawal occurs when the substance is stopped abruptly. While symptoms vary by substance, the most common include:

• Fatigue
• Shaking
• Sweating
• Chills
• Muscular aches
• Nausea
• Vomiting
• Diarrhea
• Anxiety
• Panic attacks
• Depression

Severe withdrawal requires emergency medical intervention. Serious withdrawal symptoms include:

• Seizures
• Convulsions
• Hallucinations
• Suicidal ideations or actions
• Heart attack
• Very high or low blood pressure
• Stroke

Help Is Always Available

If you suspect a dependence or addiction in yourself or a loved one, please don’t hesitate to reach out to us to discuss supportive treatment options. Discovery Addiction Services is here to help in a nonjudgmental, safe, and caring way.

Contact Discovery Addiction Services today.