In normal day-to-day conversations, substance abuse and dependence are often confused with each other. While there is usually no reason to be precise in most casual contexts, medical and substance abuse specialists make several important distinctions between the two.
The key difference is that a “dependent” needs a certain substance to function normally. While most people become dependent on a substance by abusing it, it doesn’t necessarily follow that abuse is necessary for dependency. For instance, if you get headaches if you drink coffee in the morning, chances are you may be caffeine-dependent, even if you aren’t necessarily an abuser.
During treatments, dependents need detoxification in addition to therapy and other medications. This is not usually true of substance abusers who are not dependent. If you are in the area and have alcohol or substance abuse issues, be sure to check out AA meetings Clarksville residents rely on.
What Does Substance Abuse Look Like?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), substance abuse, including alcohol and other forms of substance abuse, can be manifested in several different ways.
Signs may include some or all of the following:
- Unusual risk-taking
- Criminal activity
- Neglect of personal and professional commitments
- Irritability towards family and friends
- Causing intentional or unintentional harm to one’s self or to others
While substance abuse can often lead to dependence, this isn’t always the case. The use of a substance also does not necessarily equate to abuse. Many people can moderate the intake of different addictive substances for recreational purposes. However, not all abused substances have the same addictive potential. More addictive substances, however, are more likely to be abused, partly due to the frequency they are likely to be taken.
What Does Substance Dependence Look Like?
Substance dependence is a physiological or psychological need for a substance. Once someone with dependence stops taking their drug of choice, they begin to experience withdrawal symptoms. Simply put, a dependent’s body and their brain need specific chemicals to remain comfortable or “normal”.
Here are some common signs of dependence:
- Repeated unsuccessful attempts to quit.
- The need for more and more of a substance to feel the initial “high” experienced the first time the drug was enjoyed
- Inability to think properly when denied access to a drug
- Depression, anxiety, and paranoia when unable to use a drug
- Vomiting, chills, nausea, cold sweats, low blood pressure, hallucinations, or other unpleasant physical symptoms within a short period after stopping a drug
- Consistently valuing a drug over personal and professional relationships
- Committing illegal or risky acts to avoid withdrawal symptoms
While abuse can lead to dependency, this is not necessarily the case. Even so-called “moderate” use of a drug can quickly lead to dependency under the right conditions, such as the case with cigarette smoking or caffeine.
As mentioned earlier, different substances have differing addictive potentials and characteristics. For example, nicotine is both psychologically and physically addictive, where cannabis is highly addictive psychologically but relatively non-addictive physically. Treatment approaches for these dependencies will, therefore, be quite different from each other.
Why Is It Important to Know the Differences Between Dependence and Abuse?
Substance abuse and dependence are treated somewhat differently. While counseling and therapy are important for both conditions, patients suffering from substance dependence typically require much more extensive intervention.
Treating dependency often requires a multi-pronged strategy for the safety of the patient. The physical withdrawal symptoms of certain drugs can be lethal. For instance, the physical symptoms of benzodiazepines and alcohol withdrawal can be deadly, which means that the patient cannot simply stop taking their drug of choice without medical intervention or without properly “ramping down” their intake. The dependence will also usually involve planned detoxification. Afterward, patients may be given less-addictive substitute drugs to ease their withdrawal cravings.
By contrast, treating substance abuse usually requires less medical intervention, if at all. Detoxification is rarely needed and treatments tend to lean heavily on less physically-invasive methods such as counseling and therapy. Depending on the case, the patient may also be prescribed medication to treat psychiatric disorders that may have caused them to abuse the substance, as well as other conditions that resulted from the abuse.
Both dependence and abuse have primarily psychiatric causes, and psychiatrists and therapists are usually in charge of their treatment. Regardless of whether the patient is dependent, an abuser, or both, the main goal of most treatments is to get to the root cause to reduce or eliminate the chance of relapse later on.
While the concepts of abuse and dependency are often confused with each other, medical professionals and addiction treatment specialists use them in very specific ways. Knowing the difference between the two conditions can be useful for laymen as well, as it could help them understand, empathize with, or care for loved ones and other members of the wider community who are struggling with these serious conditions.