A recurring point throughout this discussion is that there will always be an overlap in terms of the definition of addiction and dependence. Addiction and physical dependence are not the same but they are closely related.
Addiction
Addiction can be referred to as:
- A disorder that manifests compulsive use of a substance affected by external psychological and sociological variables. Attempts in understanding addiction have been futile despite having experimented in biological and environmental treatments. Drugs continue to be studied on how they affect genetics, protein makeup, and neuronal circuits.
- A negative behavior as a result of a particular substance, medication, object or activity. It is a neurological disease to an extent because there is a change in the function of different organs in the body. It has reached behaviors that have become disruptive of daily living in the person’s own life and to the lives of other people.
Addiction has two types:
Substance Addiction or Substance Use Disorder
is the disorder that causes impairment to the body, brain, and its functions. It targets the three major areas of the brain: the prefrontal cortex (responsible for decisions and logic), the limbic system ( where the reward system of the brain is located - reinforcing survival behavior), and the midbrain (responsible for the first 15 seconds of a moment). The effects of high dosage substances in the brain can lead to damaged thinking and cognitive processes and long-term malfunction of the other vital organs.
Behavioral Addiction
is a compulsion to engage in activities that satisfy one’s psychological “high”. People continually do these activities despite the negative consequences to the people around them or to their life. The euphoria that the activity gives diminishes after the peak effect is accomplished and users suddenly feel guilt and remorse.
People with behavioral addictions can sometimes justify their behaviors to a state of denial or until a crisis causes their life to collapse (e.g. excessive debt due to gambling addiction). Examples of behavioral addictions are gambling addiction, gaming addiction, exercising addiction, work addiction, among others.
Psychological Causes of Addiction
- Low self-esteem
- Stress
- Peer pressure
- Curiosity
- A desire to be part of a community (if peers are also addicts)
Sociological Causes of Addiction
- Lack of parental guidance or support
- Community poverty
- Unemployment or out of school
Symptoms of Addiction
- Actively seeking or engaging in harmful activities
- Withdrawal symptoms (irritability, depression, and food cravings) when asked to stop
- No control as to when, how long, or how much does addictive activity amounts to
- Denial of engaging in addicting activities
- Hiding this activity or pattern of behavior from family, friends, and co-workers despite advice to stop it
- Moments of ‘phasing out’ or a temporary mental pause
Physical Dependence
The physical dependence on a substance or activity means that the body has gotten acclimatized to a particular substance, medication, object, or activity. This term is one of the indicators of addiction. If an individual stops taking a drug or stop doing an addictive activity abruptly, there can be physiological, mental, and emotional withdrawal symptoms.
Indicators of addiction interchange their meaning because they fall under the same category as addiction--only looking at it from different aspects. These can be:
Development of Tolerance
- when a person feels the need to take more of the drug to get the same physical/psychological effect. Tolerance can also mean taking the same amount of the drug while the body is already immune to its effects. When this happens, the patient takes a stronger dose.
Chemical Dependence
- this term has different types of meaning depending on how it is understood. The most common definition refers to the psychiatric components of the drug that can make one feel dependent on it. These include the method of intake, the dosage value, and how frequent the drug is taken.
Prescription Drug Dependency
Prescription drug dependency happens when there is too much reliance on the effects of a medically-authorized drug. The drug is prescribed for a particular period of time with a particular dosage. Patients slowly become tolerant of this due to it being used on a regular basis--even when the symptoms that the drug is supposed to cure are minimal or do not exist.
Prescription drugs are often legal and accessible and they serve as fast relief from psychological discomfort/pain. Examples: antidepressants, certain antibiotics, and anabolic steroids.
Illicit Drugs
Unlike prescription drugs, illicit drugs are more difficult to get hold of and also difficult to detoxify out of the body. There are three drugs that show frequent patterns of dependence: cannabis products (weed, synthetic marijuana, hashish, and hashish oil), amphetamine-type stimulants with psychoactive and hallucinogenic properties (crystal meth and ecstasy), and illicit opioids (heroin and other pharmaceutical opioids like morphine).
The International Classification of Diseases has defined illicit drug dependence as having three or more symptoms of dependence present throughout a time period of at least a month within a year. Illicit drugs have a reputation for producing harmful and fatal effects towards the individuals using them. The urgency in treating them is more critical.
Drug dependent symptoms (indicators), whether they are prescription or illicit, experience chronic and progressive behavior in biological, psychological, and sociological aspects. Denial, deception, and changes in behavior are all signs that the dependency is of a long-term basis.
Psychological Causes of Dependence
- Feeling unable to cope with the stresses of life
- Peer pressure
- The need to be free or not be in control
- Experimentation
- Curiosity or fun-seeking tendencies
Sociological causes of Dependence
- Availability of illicit drugs within the environment
- Unemployment
- Lack of social or community guidance
- Lack of awareness and knowledge of the consequences of taking drugs
Symptoms of Dependence
- Emotional change
- Strained family and peer relations
- Prone to lying, stealing, and violence
- No interest in activities other than having the drug
- Avoids socialization or any form of social gathering
- Engages in nocturnal activities while sleeping during the day
- Extreme spending habits that lead to debt, borrowing, and selling of possessions
- Legal problems
- Illegal activities (e.g., street crimes, extortion, and sometimes murder)
- Sex-related inappropriate behavior
- Needs drugs to enjoy sex
Difference between Addiction and Dependence
- A person can be physically dependent on a drug but not necessarily addicted to it. With addiction, it is theorized that there is an amount of physical dependency because there are already behaviors and symptoms that are manifesting due to the use of the drug.
- Dependency on drugs often leads to addiction as the user’s body is frequently exposed to it. It is the will and action to seek out for the drug, even if it is not an active choice. Dependency has crossed the line of addiction when withdrawal symptoms are experienced.
- Dependency eventually becomes a symptom of addiction since the patient has developed a form of connection to the drug that continues regularly from a month to several years. As soon as the indicators of dependence are seen, recommendations for intervention, rehabilitation, and professional help will be issued so that the user/patient can recover as soon as possible.