Difference Between Abuse, Addiction and Dependence

Friday, October 21, 2016 | By JP Emerald Coast

prescription drugs

Abuse, addiction, and dependence are words people tend to use interchangeably when they are trying to describe someone they care for who has a problem with drugs or alcohol. These words may also be bandied about when discussing the subject in general, as though all three words refer to the same thing or, at the very least, different levels of severity of the same illness.

In truth, these ideas all describe completely separate things. It’s important to understand the difference between these three terms so we can be specific in our language around addiction. It can be a challenging thing to talk about, with professionals and within our own families, and we need to make sure all of us are on the same page so that we can understand each other clearly.

Definition of Dependence

A dependence on a drug, including alcohol, occurs after exposure to it over time. The body adapts to its presence and needs more in order to achieve the same effects experienced when the drug was first used. If the drug or alcohol use is suddenly stopped, the user will experience withdrawal symptoms.

prescription drug dependence signs

Physical Dependence on a Drug

This doesn’t necessarily mean you or your loved one is addicted to something or has developed an addiction. It’s possible to develop a physical dependence on a prescription drug you have been taking for a long period of time and following the doctor’s instructions exactly.

Some medications cannot be stopped all at once. Instead, people need to be weaned off them by lowering their dosage over a period of time in order to avoid withdrawal symptoms. For example, antidepressants should not be stopped all at once. Discontinuation symptoms, as the withdrawal symptoms from antidepressant medication are called, can be uncomfortable. If someone stops taking the medication abruptly, they could feel anxious or even depressed. Some people complain of flu-like symptoms or dizziness in the days and weeks after stopping their medication.

Prescription pain medications are another type of drug that should not be stopped all at once but instead should be weaned off slowly in order to avoid withdrawal symptoms. Opioid painkillers, such as OxyContin, Oxycodone, Vicodin, and Dilaudid, can create a dependence in people who use them for some time, even if they are following their doctor’s orders as directed.

Signs of Prescription Painkiller Dependency

As you are treated for post-surgical pain, back pain, pain from an injury, migraine pain, or chronic pain, be aware of the following signs you or someone you care for may have developed a dependency on prescription pain relievers:

  • Increased Dosage. Higher levels of the medication are needed to provide pain relief because tolerance has built up over time.
  • Continued Use. Continuing to use the medication after the condition for which it was originally prescribed has resolved is a sign of dependence on the drug. Some people may ask to take the painkillers “just a little longer” when a non-narcotic pain reliever may be indicated.
  • Changes in Mood and/or Energy. Behavioral changes may indicate a sign of dependency on prescription-strength painkillers. Lower energy levels and difficulty concentrating can indicate a person’s main focus is on obtaining and using the prescription drugs.
  • Social Withdrawal: A sudden lack of interest in spending time with family and friends may indicate an issue with prescription painkiller dependency.

prescription painkiller withdrawal symptoms

Prescription Pain Medication Withdrawal Symptoms

Stopping the medication suddenly can lead to symptoms such as:

  • Anxiety
  • Agitation
  • Difficulty sleeping
  • Muscle aches
  • Runny nose
  • Sweating
  • Yawning

These symptoms may start within 12 hours of the last dose of the drug being taken. Other symptoms may occur as the withdrawal phase continues, such as:

  • Abdominal cramps
  • Diarrhea
  • Goosebumps
  • Nausea
  • Vomiting

Psychological Dependence on a Drug

In some instances, you can feel both a psychological and physical dependence on the same drug. Ambien, a medication that is commonly prescribed to treat insomnia, is one medication that falls into this category. It is generally not meant for long-term use but only to help a person get some rest while the source of their sleeplessness is being investigated so that it can be treated.

If Ambien is used for a long period of time, a person can build up a tolerance to the medication. As a result, they must use higher doses in order to fall asleep as quickly as they would like to. This medication can also create a psychological dependency. A person associates going to sleep with taking Ambien, and they stop believing they can sleep without it.

Once the dosage of medication is lowered or stopped, the person could become anxious and agitated as bedtime draws near, knowing they do not have their usual dose of Ambien. This mental state is not helpful if you want to get to sleep and stay asleep. The resulting insomnia is blamed on the lack of the drug, not the person’s psychological state due to their dependence on the medication.

Treatment for Dependence

Although dependence is not the same as either abuse or addiction, it does require professional treatment. If you are concerned you or a loved one has developed a dependence on a drug, discuss the situation with the doctor. You need to know whether treatment with this medication should continue or needs to be modified. If the treatment is about to end, then it’s time to discuss the next steps, including the best way to come off the medication.

Do not try to wean yourself off the medication on your own. You need to be under the care of a professional.

If you have been taking the medication over a long time and/or at a high dose, consider going to a treatment facility that provides medically supervised detox and counseling for psychological dependence, if required.

Keep in mind that dependence, if left untreated, can start the slide down the slippery slope toward abuse and addiction.

Definition of Abuse

Substance abuse refers to a pattern of behavior where a person uses mind-altering substances in amounts or in ways that are harmful to themselves or other people. The mind-altering substances can be drugs — both prescription and illicit — alcohol or chemicals.

Frequently Abused Substances

Commonly abused substances include the following:

  • Alcohol
  • Marijuana
  • Hashish
  • Tobacco
  • Over-the-counter (OTC) cough and cold medications (dextromethorphan and pseudoephedrine)
  • Benzodiazepines, such as Valium and Ativan
  • Narcotics, such as codeine, OxyContin and Dilaudid
  • Club drugs, such as ecstasy, Ketamine, and MDA
  • Stimulants, such as cocaine and methamphetamine
  • Hallucinogens, such as mushrooms and LSD
  • Inhalants, such as glue, solvents, gasoline, and hairspray

signs of alcohol abuse

Signs and Symptoms of Alcohol Abuse

Here are some warning signs of alcohol abuse to be on the lookout for, in either yourself or a loved one:

  • Drinking alcohol to deal with everyday stress and problems, to relax, to cheer up, to go to sleep or in order to “feel normal”
  • Drinking alcohol first thing in the morning or drinking alone
  • Drinking in secret
  • Recurring arguments with family members and friends while intoxicated
  • Blackouts or short-term memory loss
  • Face with flushed appearance and broken capillaries
  • Husky voice
  • Trembling hands
  • Chronic diarrhea and/or blood in stools
  • Unpleasant symptoms when drinking stops, such as headache, nausea, insomnia, and anxiety

Signs of Substance Abuse

What do you need to know about signs of substance abuse in a loved one? There are a number of signs and symptoms that point to a challenge of this type. You’ll want to make note of changes to the person’s everyday demeanor, including:

  • Appetite
  • Behavior
  • Mood
  • Personality
  • Sleep
  • Weight

Someone who previously took pride in their appearance may start to neglect their personal hygiene and stop bathing and changing their clothing regularly. Their speech may be slurred, or they may have tremors or seizures.

The substance abuse may lead to problems at school or at work. It will likely be difficult to keep the problem hidden, and other people will notice and comment on the changes in behavior, difficulties in concentration and getting the person to complete tasks accurately and on time.

Angry or emotional outbursts are not uncommon, and this only makes the person who has challenges with substance abuse more challenging to deal with. Friends, family members, coworkers, fellow students, and others often don’t know what to expect when they approach a person in this situation. Past blow-ups make others feel uncomfortable.

Signs and Symptoms You May Have a Problem With Drug Abuse

How can you tell whether you have a problem with drug abuse? It can be challenging to monitor your own behavior.

If you started experimenting with drugs on an occasional basis out of curiosity or because you wanted to fit in with peers or feel grown-up, you may not have developed an addiction — yet. You may not have built up a tolerance for any chemicals, which means getting high would be easy.

However, if your drug use continues, you may develop the following symptoms of drug abuse:

  • Drug and alcohol use are no longer just something you do on weekends. They are now something you do on weekdays, too.
  • You find you are drinking more and/or doing greater quantities of drugs to get the same effect because you have developed a tolerance.
  • Most, if not all, of your friends, are also involved in drinking and drug use. These are your main social activities.
  • You find yourself spending more and more time and attention thinking about the next time you will be able to drink and/or use drugs.
  • Blackouts are not an uncommon occurrence for you anymore. You find yourself asking, “What happened last night?” more often.

Prescription Drug Abuse Statistics and Facts

Prescription drugs are abused when people take them in a way that is different from the way their doctor prescribed. They can also be abused when someone takes medications that have been prescribed for someone else.

Some people think because these drugs are legal and were prescribed by a physician that they are “safer” than illicit drugs. This is not true. Abusing prescription medication can be very dangerous, whether it’s your own prescription or you are taking one that was originally written for another person. It’s possible to overdose on prescription medications by taking too high a dosage at once.

Consider these alarming statistics:

  • Approximately 16 million people in the U.S. abuse prescription drugs.
  • With the exception of those 12-17, men are more likely to abuse prescriptions than women.
  • Twenty percent of high school students have used a prescription drug that was not prescribed for them.
  • Over half of prescription drugs used for nonmedical purposes were obtained from friends and relatives.

Risks and Dangers of Drug Abuse

You take a risk when you consume quantities of any drug at the level where it could affect your health or your life. Combining two or more drugs or taking drugs with alcohol will increase the risk of causing harm to yourself. Each time you or a loved one are involved in this type of activity, you are taking a risk of overdose.

Other dangers of drug use include injuries caused by slip and fall injuries while under the influence of alcohol or a drug. Drug use affects reflexes, which means you and your family members and friends should not try to operate a car or any type of vehicle after drinking or using drugs. You could be involved in an accident that could injure or kill a passenger in your car, in another vehicle or a pedestrian.

Drug abuse can make a person behave more aggressively than they would normally be if they weren’t under the influence of chemicals. Someone who would normally not be interested in a confrontation may be more likely to press a point in an argument, even if it ends up getting physical after drinking or using drugs. At that point, the likelihood of being injured, or injuring someone, increases.

Along with the dangers to personal safety, engaging in risky behavior brings with it the possibility of a run-in with the police. Being arrested for a DUI/DWI or for assaulting someone brings with it consequences that will have to be dealt with after an evening’s festivities have long passed.

An event like this can be a wake-up call to someone who has developed a substance abuse problem and be the incentive they need to get help. Their lawyer may even recommend they go to a treatment facility to show the court they are serious about changing their life and not repeating their actions.

If drug abuse is not treated, the condition can change and develop into an addiction.

Treatment for Drug Abuse

Professional treatment is necessary to treat drug abuse. When a client arrives at a treatment facility, a thorough evaluation is conducted, and they undergo medically supervised detox, if necessary. Once the detox is completed, an individualized treatment program that includes group and individual counseling, healthy eating and exercise can start. Clients learn how to live an active and healthy lifestyle that is free from drugs and alcohol.


Addiction is a compulsion to use a substance, including alcohol, drugs or tobacco, or engage in a particular activity such as gambling, shopping or sex that may be pleasurable but interferes with a person’s work, relationships or health. The person affected by this chronic brain disease may or may not be aware their behavior is out of control since it affects their ability to think, make decisions and reason clearly.

When someone has crossed over from having an issue with drug abuse to a full-blown addiction, they are no longer making decisions about whether or not they will use. The disease is fully in control, and the person is experiencing cravings for their drug of choice. If the disease is not fed and the person isn’t using regularly, they will experience withdrawal symptoms.

Signs and Symptoms of Addiction

Not all addicts will exhibit all of the signs and symptoms of addiction listed below. The more signs a person has, the more likely that they may have developed an addiction. These signs include:

  • Drinking or using drugs more often or longer than the person wanted or intended to, after promising, sometimes repeatedly, they would either cut down or stop.
  • Hiding the amount of alcohol or drugs consumed or activities while under the influence of the drug of choice.
  • Injuries or accidents a person can’t or won’t explain.
  • Mounting financial difficulties, such as money missing from bank accounts or investment accounts or bills going unpaid because funds are being used to pay for drugs.
  • Becoming withdrawn and spending less time with family and friends.
  • Losing interest in hobbies and activities that used to bring pleasure.
  • Spending time with a new group of friends.
  • Increasing absences from work or school due to recovering from drug or alcohol use
  • Spending time alone and not accounting for where they were or what they were doing during the time away from family. During this time, they could be either drug-seeking or using drugs.
  • Changing appearance, including loss of interest in personal hygiene and slovenly appearance.
  • Relationship challenges with family, friends, coworkers or fellow students. People with addiction challenges can become angry and defensive if family members or friends confront them about their drug use.
  • Promising to stop using drugs to appease family members or friends
  • Claiming they will stop “soon” to deflect attention away from having to discuss going for treatment.
  • Experiencing withdrawal symptoms if a steady supply of the drug of choice is not available. These symptoms may include anxiety, depression, trembling, headaches, nausea, vomiting, loss of appetite and fatigue.

Treatment for Addiction

Addiction is a disease that requires professional treatment. Family members and friends often become frustrated at a loved one who becomes addicted to a particular drug and wonder why they can’t simply stop using. A person who is addicted to drugs can’t simply will themselves to get better. They need to go to a treatment facility where they can get the right type of care.

This type of care starts with medically supervised detox. Addiction treatment won’t be successful if a client is still under the influence of chemicals. When detox is closely monitored by experienced personnel, clients are kept comfortable throughout the process.

After detox has been completed, each client undergoes an individualized treatment plan that is customized to suit their needs and goals. Individual counseling sessions are an opportunity to get to the root of the addiction and examine the reasons the client started using drugs. Group therapy sessions allow clients to share their experiences with and offer support to each other as they learn to live a life that is free from chemicals.

Attending 12-step meetings is often a part of the recovery process and a strategy clients can use over the long term. They continue to attend meetings after leaving the treatment facility, and this source of ongoing support is available to them whether they are at home or traveling. There are chapters of 12-step programs operating in most cities, so people in recovery have access to this important resource.

Get Help for Drug and Alcohol Dependence, Abuse and Addiction

Dependence, abuse, and addiction are not the same thing but could be described as closely related. They share some characteristics, and one condition does have the potential to slide into another over time and with repeated exposure to chemicals. Not everyone who is exposed to drugs will develop a dependence, starting abusing drugs or become addicted, though there is always that risk. There are a number of factors at play that determine who will have these types of challenges.

If you are concerned about yourself or a loved one having a problem with drugs, contact us today to learn about our treatment programs.

Get Help Now

Learn About

What Makes Emerald Coast Different