Define dependency vs. addiction

[CadillacJack]

I'm serious about this question; are some people simply physically dependent on a drug, and therefore get through the physical withdrawals, and go about their happy way, as opposed to addiction, which results in a mental craving long after physical withdrawals are done? Or if a duck = a bird, then a bird must equal a duck? What defines these two terms?

[SableZen]

"And when I joined here a few weeks ago, some people made me feel like I was definitely an addict.  At first that bothered me, but then I thought everyone thinks different on this. Had I been a person that took this med to get high, then I might feel like everyone did too."

This is EXACTLY why they stopped using the older terms, "physical addiction" and "psychological addiction."

It used to be that when talking about the subject of psychological addiction and physical addiction, that in either case it was often just shortened to 'addiction'. And patients that were simply physically dependent did not like the insinuation that by hearing the term 'addiction' used in reference to them that they were somehow 'addicts' even if they had never abused a drug. It is a poor choice of words... there is a world of difference between the state of being physically dependent and psychologically addicted.


Physical dependency only refers to the physical signs and symptoms of taking a drug which results in tolerance building up and where the body becomes to rely on the presence of the drug to continue normal physical operation. An example would be a person in chronic pain that takes Oxycodone - and over the course of a year their dose doubles to maintain the same level of pain control. The person taking the increased dose is not doing so to chase a high or escape depression, just responding to tolerance building up to maintain control on the pain. Taking more Oxycodone is all for physical pain control - not behavioral/emotional at the core. Addiction does not result - dependency and tolerance does.

With psychological addiction, tolerance also builds up over time - but there are more distinct changes to certain parts of the brain where our survival instincts are controlled which manifests in emotional and then behavioral changes by extension. Tolerance builds, having the result of increasing feelings of not being well (emotionally but this can also extend into actual physical feelings of not being well). More drug is sought out (tolerance builds further), normalcy is felt, etc. into the cycle of addiction. One doesn't even need to actively chase a high - just take it to alter feelings of depression/sadness/anxiety/etc... tolerance will still build over time and drug seeking behavior will result to maintain feelings of normalcy.

[walternowotny]

I think definitions are interesting as an academic discussion.In real world they really don't matter very much.
There are many people who are addicted to prescription meds who are willing to admit the obvious that they are physically dependent but are"offended" when someone mentions the"a"(addict) word.It is part of  denial so characteristic of any addiction.
They describe themselves as"chronic pain sufferers"(I am not questioning their pain) and feel they are being unfairly labeled.
I think that most of the people agree that cancer patient is not an"addict" no matter how much meds he/she needs but are not willing to accept that person with fibromyalgia on Morphine pump taking huge amounts of opiates is not
Walter

[Sportsguy86]

I think this issue is extremely complex and I don't believe there is one clear answer to the question. Experts claim that actual changes in chemistry are present in the brain even after physical dependence, so why some people can be fine post-dependence and others have a mental addiction is beyond me.  Could have to do with some pre-disposition to addiction, or simply their character and the choices they make.  I do believe, however, that some people actually enjoy opiates alot more than others.  I understand its generally considered a good feeling to all human kind, but it does alot more for some than others.  So these people who were once dependent for medical reasons, can stop easily because it doesn't do the same thing for them as it does for the addicted.  It may not be because they are morally against abusing drugs or don't want to be addicted or for whatever other reason.  Myself personally, as long as I am not physically dependent I am totally fine without it.  I may enjoy it and seek it more than the average person, but as long as I don't need it to feel normal or function, then it is something I can do without.  Unfortunately, others don't feel the same way, and that is why forums like this exist.

[SableZen]

In the case of narcotic addiction... it IS a result of chemical changes. The drug is simply a chemical doing what a chemical does - causing a change in the body. We put the chemical in our bodies and there is an immediate chemical result we feel right? Narcotics are just naturally occurring chemicals (it's not coincidental that most of them come from living organisms - plants) that resemble our own natural endorphins.

Endorphins are sometimes called 'endogenous opiates' (naturally made endorphins within the body). The similarities in-between plant produced opiates and our own bodies produced endorphins are so close, that our body uses them thinking they are the real deal. It's not coincidental that our bodies have those little receptors on brain cells that respond to these chemicals. But the foreign opiates work because they are so similiar to our own endorphins. They fit the key to the lock on cells and result to changes in that cell. Even cells which impact our feelings of euphoria/depression and perceptions of reality.

There is no arguing that natural endorphins alter how we feel. Everything from pain perception to states of euphoria and excitement. It's just a chemical. Any narcotic alters natural endorphin production, control and use by the body. Endorphins make us feel good - the lack of endorphins make us feel bad, increases pain perception, increase anxiety, etc... basically telling our active mind that something is wrong and something must be done to correct things and survive. They motivate us to anticipate reward or to fear failure at a very basic emotional level. As far as the body is concerned, survival behaviors make us feel good and release endorphins as a reward. Not meeting survival behaviors and we literally feel as if our lives are threatened or about to end. Otherwise we couldn't care less if we didn't have food (negative state) or find a mate (positive state). And the same cells and receptors involved with our survival instincts in the brain are the ones being screwed up by the opiates that don't really belong there.

Sorry to blather on - just a fascinating subject to me. lol

[wishforchange]

So the only drug users who can confidently declare themselves as not addicts are cancer sufferers?  Anybody else in severe pain is subject to the judgements of others and obviously in denial.  What if one of these people then gets cancer?  Does there addict status automatically leave them as now they have a cultural right to be in pain?  As far as I'm concerned if someone has a paper cut and declares they need morphine then just maybe they do, maybe their experience of pain is just different from the next person.  Nobody can judge another's pain, the question of addiction is one which lies within the personality of the user, the judgement of another's pain is nobody's right.  If we could all just get over this hysteria about drugs then we could just stop labelling each other and help would be so much easier to find.  Addicts are not going to stop just because something is declared illegal or difficult to obtain.  People in pain are not going to calmly nod their heads in agreement at other's judgements of their personal experience.  Drugs are never going to go away.  What is the point of labelling people, controlling substances, and creating more suffering by forcing sections of society to meet their needs through either deception or at the mercy of criminals.  The only people in denial are those who think that labelling themeselves or others is somehow productive.

[Crispy]

to sum it up dependant ppl who need them for legit pain and can take as prescribed. Addicted ppl are abusers and use for the effects instead of the relief. Some will say they take for relief but your only taking to avoid the w.ds. Most abusers stop feeling euphoric and the heavy buzz and keep taking just to feel "normal" or atleast what addicts think normal is