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Dependence vs. Addiction: What's the Difference?

People often use the terms “dependence” and “addiction” interchangeably. The truth is they’re not the same thing, and clarifying these two terms is important for your own depiction and view of drug and alcohol use. Distinguishing between dependence and addiction is also important for your health provider, as it can impact your treatment plan, options, and risk factors.

There’s lots of talk about drug addiction, but where does the term “drug dependence” fall on the scale of substance abuse? Is drug dependence the same as being addicted to a drug?

Drug dependence and drug addiction are not the same, but they do have some overlap. We’ll discuss why they’re different and what they actually mean.

Below is an overview of the topics covered:

  • Drug Dependence vs. Drug Addiction

  • Stages of Addiction

  • Reasons for Addiction

  • Signs of Addiction

  • Resources for Support

Drug Dependence vs. Drug Addiction

While there are similarities and overlaps between these two concepts, it is essential to understand how they differ. Let’s dig into each to create a solid foundation of understanding before talking about the reasons and signs of addiction.

Drug Dependence

Let’s face it — no one sets out with the objective of getting dependent or addicted to something. The definition of '“dependence” refers to the state of relying on or being controlled by something or someone else.

Drug dependence causes someone to grow dependent and slowly build a tolerance to the drug, referred to as a physical effect. Someone dependent can also have cravings and withdrawal symptoms.

Using caffeine as an easy example of dependence on a substance, someone who has a caffeine dependence may get headaches from physical dependency, but this doesn’t mean they have an addiction.

When you think of drug dependence, think of physical effects. There tend to be fewer psychological and social effects of this kind of dependence, but more on that soon.

Drug Addiction

Drug addiction is a chronic brain disease that affects behavior and the inability to abstain from the drug. One of the biggest differences in addiction, as opposed to dependence, is the changes in the brain's reward pathway. These changes cause someone to crave the drug. This can cause obsessive behavior and, at its peak, actions to seek the drug at almost all costs.

The changes that happen in the brain pathways are neurological — and these are not the same brain changes that cause drug tolerance or physical withdrawal symptoms. When a person has a substance abuse addiction, they begin disregarding the negative consequences of their drug use.

When you think of drug addiction, think of the powerful neurological effects. The physical effects are also present, but neurological effects are the main difference with addiction.

If you, or a loved one, are struggling with drugs or alcohol, and want to further understand the difference between dependence and addiction, or get help today, read on to learn more.

Is Drug Dependence Drug Addiction?

If you have a drug dependence, this means you have a physical dependence on a substance, but it does not necessarily mean you have a full-blown drug addiction. Physical addiction can be present due to consistent, long-term use, such as a prescription pain medicine, but drug dependence can happen fairly quickly.

Let’s consider a scenario for drug dependence:

Suzie gets out of the hospital after a minor surgical procedure. She’s prescribed pain medication and uses it for the first week. The pain medication is supposed to be taken every four to six hours. It provides a lot of pain relief and makes Suzie comfortable. Suzie began taking it every six hours for the first few days. By the end of the week, she’s taking it every four hours.

By week two, Suzie is starting to watch the clock for the next dose of her pain medication. It’s only been three hours since the last dose, but she’s having a hard time concentrating on anything else and decides to take her dose anyways. Suzie’s developing a physical reliance on her prescription medication. She calls her doctor to discuss tapering off her medication.

Can Drug Dependence Be an Addiction?

The short answer is yes. Diving into this a bit, a drug dependence or physical dependence on a substance can turn into an addiction. Often, someone who has established a drug dependence is not far from crossing over to drug addiction.

In our hypothetical scenario with Suzie, her growing drug dependence could have easily gone down a different path. Without self-awareness, knowledge, or someone seeing the warning signs of addiction, Suzie’s drug dependence could have turned into drug addiction.

What’s the Timeline of Dependence to Addiction?

There is no one-size-fits-all answer to how fast a drug dependence can turn into an addiction. This largely depends on which drug is being used.

For example, opioid use is known to be dangerous because opioid painkillers are very addictive. Users with good intentions of relieving their pain can get addicted to opioids much quicker than other addictive substances.

On the other hand, alcohol use can take place for years before becoming alcohol abuse. Sometimes, a trigger, such as a life event — like job loss, death of a loved one, or a medical diagnosis, can trigger a social drinker to someone with a substance abuse disorder.

There’s no specific timeline for when drug dependence turns into addiction, but the further along you are with your addiction, the longer it can get to recovery. But don’t worry — there is a community of help and hope for you. We believe connection, community, and empathy are essential keys to recovery. This is your comeback story, and we’re here to help!

Keep reading to learn about the stages of addiction.

Stages of Addiction

Drug dependence can lead to drug addiction slowly over time. For some, it can happen more rapidly. Often, people underestimate the hold a drug can have on them, and sometimes, they falsely think they can quit at any time.

The stages of addiction move at different paces, depending on several factors. This can include which drug is being abused, as some drugs are more addictive than others.

Also, the individual's environment, genetics, and mental health can play a role in how quickly a dependence turns into an addiction.

Let’s walk through an example of the stages of addiction:

  1. Initial use of the drug — You try the drug for the first time.

  2. Abuse of the drug — You begin to experiment further with the drug, and use is more frequent.

  3. Tolerance — You’ve developed a tolerance for the drug over time due to increased habitual use. To get the same high, you may have to start using more.

  4. Dependence — Your drug habit has turned into drug dependence. You have a physical addiction to the substance. You start to notice the substance taking priority in your life. When you try to stop, you have physical effects, such as cravings and withdrawal symptoms.

  5. Addiction — You can’t abstain from the drug. You have strong cravings, and when you try to stop, you likely have strong withdrawal symptoms. Areas of your life are negatively impacted. This can mean job or school performance, financial hardship, health problems, or other more serious consequences.

  6. Crisis/Treatment — You decide to quit and find a support sobriety community.

Reasons for Drug Abuse

We’ve discussed the differences between dependence and addiction, the timeline of addiction, and the stages of addiction. We know that drugs can be addictive, so why do so many people start in the first place?

The reasons for engaging in drug abuse vary, but they generally fall into three categories:

  • Emotional

  • Physical

  • Psychological

Emotional — Sometimes, people turn to drugs as a way to heal painful trauma. They may even suffer from a co-occurrence, which means they have a mental health issue and a substance abuse disorder. Emotional drug abuse can also be out of boredom or trying to fill an emotional void of some kind.

Physical — When people abuse drugs for physical reasons, they want to feel a physical high, depending on if they are managing physical pain. In these scenarios, drugs are used as a crutch, and the person starts to rely on the drug in lieu of other coping mechanisms.

Psychological — Drug addiction sometimes stems from low self-esteem and an all-around negative feeling about oneself. This doesn’t have to be due to a mental health issue but could be a consequence of someone being down on their luck. When you don’t love yourself, for whatever reason, you sometimes aren’t concerned about the effects of substance abuse on your health.

Types of Drugs and Substance Abuse

When many people think of substance abuse, they think of street drugs or alcohol. It’s important to remember that substance abuse can also describe when someone is abusing prescription or over-the-counter drugs — whether prescribed by a doctor or not. In the context of dependence and addiction, many substances can cause addiction.

Most common substances that can cause addiction:

  • Prescription Drugs, such as Opioids

  • Cocaine

  • Heroine

  • Alcohol

  • Nicotine

  • Benzodiazepines (Depressants)

Signs of Drug Addiction

If you, or someone you love, is engaging in drug use, and you’re wondering if it’s turned into an addiction, remember that behavior there are signs to watch for:

  • Frequent intoxication

  • Hangovers

  • Frequent illness or calling off work or plans

  • Drug Paraphernalia

  • Changes in appetite

  • Irritability

  • Mood swings

  • Withdrawal symptoms, such as nausea

Resources for Support

No matter where you are in the stages of addiction, finding a supportive community is key for recovery. Consulting with a healthcare provider is a good idea if you’ve had an ongoing substance abuse issue or tried to quit and relapsed. You can explore treatment options, including treatment centers, that are available to you, as you may need assistance coping through detox.

Depending on the severity of your substance abuse disorder, below are options to consider:

  • Inpatient therapy

  • Outpatient therapy

  • Sober Sidekick App - Sober Sidekick is a free online app that includes a sobriety tracker, messaging, daily motivations, and a supportive community of over 150,000 people rooting for your addiction recovery. They also provide additional resources for professional help.


Understanding the difference between addiction and dependence is important to help evaluate the severity of your substance abuse problem. The more you know about the effects of substance abuse on the mind and body, the better you will understand what is needed for recovery.

If you believe you are growing dependent on drugs, or you feel you’re suffering from an addiction, you’re not alone, and there is help — and hope!

Join an online community of over 150,000 people who understand your challenges and will support you along the way in your journey to recovery.


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