When people hear these terms – drug addiction and alcohol dependence – they tend to mix it up or think that they mean the same thing. It does not help that various organizations are not consistent in the usage of these terms as well. However, dependence and addiction are two different things. While an addict tends to be dependent, a person dependent on a substance is not necessarily addicted to a substance. The difference lies in the diverging neural pathways that characterize these substance consumption disorders.

Why is addiction different from dependence?

When a person is experiencing dependence, it means they have grown so used to consuming a particular product or substance that their body would experience adverse effects if consumption of that product is stopped. While they prefer having that substance around in their bodies, they don’t feel like they’re forced by something from within their minds to consume that substance. Nevertheless, some people who become dependent on certain substances may develop addiction through time.

In contrast, a person experiencing addition feels compelled to continue consuming a substance, despite its adverse effects. Addiction is not a symptom of dependence, but dependence is a given in persons suffering from addiction. The critical difference is that addiction has a strong sense of compulsion, whereas dependence does not. People who are addicted to a substance also don’t have a sense of control, and they will do anything to obtain that substance. The compulsion is so strong that persons with an addiction don’t pay heed to people around them who might also be affected by their behavior.

The difference between addiction and dependence also lies in the fact that their manifestations in the brain also differ. Where addiction involves a hyperactive reward center in the brain, dependence involves the brainstem and the thalamus (a part of the brain that regulates emotions and motivation). Also, the pulses from the reward center override and overwhelms the frontal lobe, which is responsible for rational thought, as well as the emotion-regulating parts of the brain.

For political correctness and scientific preciseness?

The current confusion about dependence and addiction lies in a World Health Organization resolution way back in 1964 that substituted the term “dependence” for “addiction.” The American Psychological Association (APA), the organization responsible for describing mental disorders, released a new term in their 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) which replaced the phased out terms “substance abuse” and “substance dependence.” The new term that appears to serve as an umbrella term for these two different disorders is now known as “substance abuse disorder.” The APA reasoned out that the stigma associated with the terms “dependence” and “addiction” prevents rehabilitation patients from fully integrating with society. At the same time, the APA claimed that the two words were vague, despite decades of conventional use and neurological studies that distinguishes one from the other.

Importance of recognizing the difference

Regardless of what the APA officially uses that medical doctors would adopt when communicating between themselves, the words addiction and dependence is expected to remain in regular conversational and mass media use. Thus, knowing the difference is essential. Understanding the distinctions would also help persons needing help to seek out professional rehabilitation service without shame or cynicism. Ultimately, regaining control of the drug discourse lies in the hands of the patients. Whatever their substance abuse disorder is, they are still human beings who have rights and needs as everyone else.