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Difference Between Addiction and Dependence

In the National Institutes of Health report, it was revealed that an estimated 10 percent of all adults living in the United States have had a substance use disorder during their lifetime. Addiction is a severe mental disorder that has relapsing properties. But in the world of substance use disorder – the DSM-5 term for the disorder – addiction and dependence are often used interchangeably. Information is power when it comes to substance use disorder; therefore, we will explore the difference between addiction and dependence so that you understand what each term means.

5 Minute Read | Published Sep 03 2023 | Updated Feb 19 2024 Expert Verified
Emma Collins
Written by
Amber Asher
Reviewed by
Emma Collins
Written by
Amber Asher
Reviewed by

Is There a Difference Between Addiction and Dependence?

Definition of Dependence

To start with the difference between addiction and dependence, we will examine the definition of substance dependence. Dependence forms only to substances that alter body and brain chemistry, such as opioids or alcohol. When these types of substances are frequently abused, a person’s body and brain change as tolerance develops.

For example, opioids cause an increase in the number of opioid receptors in the brain. These receptors and systems in the brain are responsible for feelings of euphoria and reward. When the number of receptors is increased due to frequent abuse, the person is eventually unable to produce enough dopamine and endorphins to utilize the system naturally. As a result, the person feels that without more opioid abuse, there is no way for them to feel normal. This is what dependence looks like; a state where the new balance created from substance abuse requires continuous abuse to maintain.

Furthermore, with dependence comes withdrawal symptoms, which is what happens when use of the substance stops and the altered state the body is in tries to return to normal function.

Definition of Addiction

The DSM-5, which classifies mental disorders, has adopted the term “substance use disorder” to describe drug dependence, abuse and addiction. However, this doesn’t mean that there isn’t a difference between addiction and dependence.

The definition of addiction focuses more on the person than the drug that they abuse. The definition of addiction is when a person does or uses something like a drug to such an extent that many areas of their life start to become affected. It may start off with fairly low use of a substance but then escalate to such high levels of use that it becomes all-consuming for the individual. The acquisition and abuse of the substance take precedence over all aspects of the person’s life.

Addiction describes the behavior of the person, which is often referred to as “addictive behavior”. Various studies have revealed that an addict’s brain functions differently from a normal brain. Addiction can also be somewhat passed down from parent to child; if there is addiction in the family, then their offspring have a much higher chance of becoming an addict, too. In fact, biological factors account for around half a person’s risk of becoming an addict. Other risk factors for addiction include:

  • The earlier substance abuse occurs, the more likely that an addiction will eventually form. This is mainly due to substances' effects on a developing brain.
  • Environmental factors are another risk factor for addiction. These include things such as peer pressure, how available drugs are, and trauma, among others.
  • Genders also play a role in addiction. While men tend to be more prone to addiction, women develop an addiction faster than men do.

The Main Difference Between Addiction and Dependence

Is there a difference between addiction and dependence? Yes. There are several differences between addiction and dependence. Through the understand of these differences, the right types of treatments can be employed to properly treat someone with either drug dependence or addiction, or a combination of both.

In summary, the main differences between addiction versus dependence are as follows:

  • Addiction – Addiction can happen even when there is no physically addictive aspect to the substance or activity. A person may become addicted to a particular behavior, such as sexual intercourse, computer games, or a substance, even if there is nothing about the activity or substances that alters brain chemistry
  • Dependence – In the case of dependence versus addiction, dependence happens when a substance is taken that alters the way a person’s brain works. This usually happens after repeated use, but some people may become dependent on a substance such as heroin after just a couple of doses. Dependence is also associated with tolerance and withdrawal symptoms whereas an addiction doesn’t necessarily have any connection to withdrawal and tolerance.

Various situations may occur that ultimately link addiction and dependence. For example, a person may use a drug too frequently, such as prescription opioids, which then eventually leads to a dependence. This dependence may eventually lead to an addiction where their behavior changes and the drug is put above everything else in their life.

The Signs of Substance Use Disorder

Substance use disorder (SUD) encompasses both drug addiction and dependence. It is the clinical term that addicts and people dependent on drugs get given. But what exactly is the criteria for SUD?

The following looks at the 11 criteria for SUD. If, in 12 months, two or more of the following criteria apply, then there is a SUD.

  1. Urges and cravings to use the substance exists.
  2. Frequently, the person ends up using more of the drug than they wanted to or planned for, or for a longer period than they intended to.
  3. There is a want to quit or slow down, but the person hasn’t managed to.
  4. More and more time is spent getting hold of the substance, using it, and then recovering from its use.
  5. Certain responsibilities, such as work, are being neglected.
  6. Problems in the person’s relationships due to substance abuse don’t affect their use.
  7. Once-important hobbies and activities are now being ignored for the most part.
  8. Use of drugs or alcohol in what could be considered dangerous situations.
  9. The presence of mental and physical problems due to substance abuse doesn’t cause the person to stop.
  10. Withdrawal symptoms occur unless more of the substance is taken or a full detox occurs.
  11. Tolerance is present, which causes a lessened effect when the same amount of a substance is used.

When substance use disorder is present, regardless of whether it is an addiction or dependence, professional treatment is often the only recourse.

If you think that you or someone you care about might have substance use disorder, then contact Better Addiction Care today at (800) 429-7690 to find help through local rehabs.



bullet National Institutes of Health
"10 percent of US adults have drug use disorder at some point in their lives"
Retrieved on September 20, 2018
bullet National Institute on Drug Abuse
"Drugs, Brains, and Behavior: The Science of Addiction Preface"
Retrieved on September 20, 2018

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