Addiction, Abuse and Dependence: Know the Difference

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The terms drug addiction, drug dependence and drug abuse are often used interchangeably, though they are not synonymous. Dependence, addiction and abuse are not the same diagnoses.

The difference among the three terms has much to do with motivational issues (addiction), psychosocial factors (abuse) and physiological functioning (dependence).

Addiction, Abuse and Dependence

  • Drug addiction. An addiction diagnosis indicates that an individual demonstrates a pattern of behavior where acquiring and using a drug dominates his or her motivation. The motivation to obtain and take the drug overwhelms the individual’s normal protective constraints.
  • Drug abuse. An individual abuses a substance when the use is outside of social norms. His or her motivation to experience reward may or may not be as strong as other psychosocial factors such as experimentation, belonging to a specific group culture or enjoying a risk-taking lifestyle.
  • Drug dependence. A state of dependence occurs when a person relies on a drug for normal physiological functioning. If the person abstains from taking the drug, he or she will experience withdrawal symptoms such as sweating, vomiting or diarrhea. Abstaining from drug use can also trigger problems in mental functioning such as lack of focus, depression or anxiety.

Further Clarification

  1. Substances can create physical or psychological dependence without producing an addiction. For instance, some antidepressants, steroids and antihistamines may cause withdrawal symptoms when suddenly discontinued. In this case, most individuals are not motivated to continue using the drug.
  2. Drug abuse may or may not coincide with drug dependence or addiction.
  3. Physical dependence on a substance frequently occurs without addiction (e.g., therapeutic steroid use), and an addiction can develop without triggering a significant dependence (e.g., cocaine).
  4. A psychological dependence, such as on morning coffee, can develop without causing addiction. However, it is unclear whether an addiction can ever develop without psychological dependence.
  5. It is possible for a person to be dependent on a drug that he or she abuses because this person is addicted to it.

The brain’s reward and motivation systems control an addiction. Abuse is not related to the brain’s motivation and reward mechanisms, but is related to psychosocial factors. A dependence necessitates the use of a substance to maintain normal body-mind functioning, unrelated to motivation or violation of cultural norms.

Source: Addiction Science

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