Wednesday, April 24, 2013

Addiction and Dependence - Two Ugly and Very Different Siblings

Addiction and dependence are two ugly siblings born of the same temptress mother- substance abuse. While addiction and dependence seem identical at first glance, or even joined at the hip, these twin conditions are really quite different.

Someone can be addicted to something, dependent upon it, or both. Some drugs, like cocaine, cause addiction but not physical dependency. Other drugs, like OxyContin or heroin, are more likely to produce strong dependence and only moderate addiction.

Dependence is the predictable outcome of using a drug for a long time. Anyone who uses a certain drug regularly for more than a few weeks can become physically dependent on that medication, whether he uses it for therapeutic or recreational purposes. In time, his body starts to rely on a certain amount of that drug to feel normal – his body becomes physically dependent.

When he stops using the drug, his body struggles to adjust to the new chemistry. Doctors refer to this chemical battle as detoxification. The drug-dependent person experiences detoxification through unpleasant withdrawal symptoms. Once the patient completes detoxification, his withdrawal symptoms subside as he completes the detoxification process. Withdrawal symptoms do not return unless he starts using drugs again and returns to a drug-dependent state.


In contrast, an addicted person feels cravings and engages in drug-seeking behaviors when his supplies run low. The American Society of Addictive Medicine calls addiction, “a primary, chronic disease” that affects the circuitry of the brain’s reward, motivation, and memory areas. Addiction causes these circuits to malfunction, resulting in certain changes in the way a person thinks, feels, and behaves. These changes can last for months or years and the patient may suffer many periods of relapse and recovery.


Dependence and addiction respond to different treatments. Recovery for a drug-dependent person always includes a detoxification process of lowering drug levels and fighting withdrawal symptoms. Addiction requires rehab that usually includes counseling and behavior modification. Rehabilitation teaches the addict how to avoid relapses by recognizing situations that could lead to drug abuse. Rehab also gives him the tools he needs to refuse drugs when offered.

Addiction and dependence are sometimes Siamese twins, co-joined through substance abuse. Many addicted people suffer a certain degree of dependence, and most dependent people show signs of addiction. These folks benefit from treatment that combines detoxification and rehabilitation.

Hitting rock bottom is not a prerequisite for seeking help for either addiction or dependence. In fact, waiting too long can cause a series of unnecessary dramas including, illness, legal problems, homelessness, divorce or loss of child custody, overdose and death.

The twisted sisters of addiction and dependence do not always have to tear families apart. With proper treatment including detoxification and rehab, recovery is always possible.

Written by Corey Snyder
Director of Hitting Rock Bottom, a new webseries portraying real people and their stories of addiction and recovery, at

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