Dependent vs Addicted, what’s the difference?

I’ve been hearing these words bandied about lately, and decided to do a bit of research on it. I have been known to joke about how ‘addicted’ I am to chocolate. Truly, I get cravings for chocolate and can’t seem to resist it, if I have any in my cupboard. Regarding Cannabis, Marijuana in particular, some will say that they are dependent on Marijuana’s medicinal value, but are not addicted. Dependent vs addicted, what’s the difference?

What connects the two is Tolerance

The definition of Tolerance according to the American Addiction center  is the following….

“Tolerance is defined as a person’s diminished response to a drug that is the result of repeated use. People can develop tolerance to both illicit drugs and prescription medications. Tolerance is a physical effect of repeated use of a drug, not necessarily a sign of addiction. For example, patients with chronic pain frequently develop tolerance to some effects of prescription pain medications without developing an addiction to them.

Acute, or short-term, tolerance is caused by repeated exposure to a drug over a relatively short period of time. Cocaine abuse often results in acute tolerance. Experiments have shown that after a first dose of cocaine, test subjects experience a euphoric high and an increase in heart rate and blood pressure.

However, despite nearly doubling the levels of drug in the blood, a second dose of cocaine 40 minutes later does not result in a dose-dependent increase in the “positive” effects of the drug, including a further increase in heart rate or blood pressure .

Chronic, or long-term, tolerance develops when an individual’s body adapts to constant exposure to a drug over weeks or months. People who regularly abuse prescription opioids build up chronic tolerance to the euphoric effects of these medications, leading many of them to increase the dosage taken or switch to more potent ways of taking these drugs, such as snorting or injecting

Learned tolerance may result from frequent exposure to certain drugs. For example, people who abuse alcohol for months or years often do not appear intoxicated to others. Experimental studies have shown that drinkers can compensate for the effects of alcohol on their coordination when they practice a task repeatedly while under the influence 3. However, this tolerance disappears if the task is altered.”

Being Dependent on a drug or any substance is purely physical

Like taking a crutch away from someone with a broken leg. When the break in the leg has healed, it’s often very difficult to give up the crutch and walk unaided.

Many years ago when I broke my leg as a young teen, my Doctor had to forcibly take my crutch away from me once he determined that the bones had knitted together.

It was painful to walk on the leg without the crutch, and I remember being very angry at him for this.  The muscles in the leg were weak and seemed to ‘scream’, when I used my full weight to attempt to walk. There was pain and discomfort during this process, but eventually those symptoms went away.

Seemingly harmless non-addictive drugs can also produce dependence in patients. A prime example is prednisone, a synthetic form of the steroid hormone cortisol that is used to treat asthma, allergic reactions, Crohn’s disease, and many other inflammatory conditions.

However, if a patient has taken prednisone for several weeks and then stops suddenly, they are likely to suffer from withdrawal symptoms such as fatigue, weakness, body aches, and joint pain.

Dependence is caused by changes in the body

as a result of constant exposure to a drug. In the case of prednisone, the body adapts to repeated doses of the drug by decreasing its own cortisol production, resulting in  withdrawal symptoms until the normal balance is re-established.

Drug dependence is a condition that is often medically treated. The goal is to withdraw  the drug slowly, allowing the body to readjust to normal function. Whether the dependency is caused by abuse or medical need, Doctors will use a tapering method, decreasing the dose over time, to minimize withdrawal symptoms.

They may also substitute dangerous drugs with similar but considerably safer drugs to manage both the withdrawal symptoms and the underlying medical need.  Patients detoxing from heroin are often given a longer-acting opioid like methadone or buprenorphine to alleviate withdrawal symptoms and cravings.

Addiction to a substance, involves both tolerance and dependence

 

Addiction is described (by the American Addiction Centers) as a “psychological condition that describes a compulsion to take a drug or engage in other harmful behaviors.

Individuals can develop addictions to illicit street drugs, prescription medications, and even activities such as gambling. Addictions are persistent, and addicted individuals can relapse into drug use after years of abstaining.”

Addiction used to be considered moral weakness, but after much research, is understood as a condition of the brain. Nearly all highly addictive drugs, including alcohol, activate an area of the brain called Nucleus Accumbens. This is the ‘pleasure zone’ of the brain and is also stimulated by natural activities like eating, drinking, wanting to spend time with others and the natural sex drive. All of these are crucial to our survival as a human race.

To the addicted brain, obtaining and taking drugs can literally feel like a matter of life and death for survival. Addictive drugs stimulate the pleasure and survival pathways in the brain much more powerfully than normal healthy activities. The brain gets fooled into believing it needs the substances or drugs more than anything else.

The craving that this creates for the person afflicted, prevents the motivation to stop, no matter the cost. The addicted brain is willing to commit crimes, overwhelming it’s moral compass, in the attempt to take in more of the substance or drug. The brain is convinced that without the substance, it will die. That is what sets Addiction apart from Dependency.

The causes of Addiction are as complex as the treatment  and requires medical attention, behavioral counseling, and long-term support to prevent relapse. Drug addiction is a dangerous and often fatal condition, and it can be virtually impossible for an addicted individual to break the cycle of compulsive drug use without assistance.

Marijuana has been described as a Gateway Drug

but it’s becoming known today, that true addiction to Marijuana is actually rare. Using Cannabis, either the Hemp or Marijuana types for medical or recreational reasons can of course cause dependency. After all, when cannabis heals your body and/or takes the pain away, with no damaging effects, you will naturally want to keep using it.

Marijuana has been successfully used by people, as one of those safer drugs mentioned above, to taper someone off of a more dangerous drug that person is addicted to. Ironic isn’t it? Marijuana has been outlawed and proclaimed as such an ‘evil’ drug since the 1930s, yet it has been and will continue to be, a healing force in addictions to both prescribed and street drugs. Dependent vs addicted, there you have it!

Peace