Substance Use Disorder: A New Definition
With the publication of the DSM-5 in 2013, the scientific community has moved away from individual diagnoses of addiction and dependence in favor of the broader label of substance use disorder. This can make it difficult to distinguish the severity of your or your loved one’s drug or alcohol problem. Having an understanding of when dependence crosses over into full addiction can help you recognize the progression of this disease.
What Is Dependence?
Dependence is defined by the National Institute on Drug Abuse as a physical phenomenon that can occur with chronic use of many substances, even those that aren’t expressly addictive. This includes prescription medications, even when taken as instructed by a physician. In instances of dependence, the body has adapted to certain dosages of the drug. This builds tolerance over time: a need to take increasing amounts of a substance to experience the same effect.
Dependence is also characterized by the experience of withdrawal symptoms. These are negative physical side effects from discontinuation of the drug. Even non-addictive medications can create dependence in patients. A good example of this is Prednisone, a popular corticosteroid medication that is used to treat asthma and allergic reactions. While Prednisone isn’t known as an addictive substance, patients who stop using it suffer from withdrawal symptoms – joint pain, fatigue, and weakness.
In cases of physical dependence, some warning signs of substance misuse have formed, including taking inappropriate dosages more frequently than prescribed. Gradually, more and more time may be dedicated to obtaining the substance of choice, primarily to avoid negative symptoms created by withdrawal. This is when dependence on a substance crosses over into addiction.
When Does Dependence Become Addiction?
Addiction is a stage beyond dependence. Beyond simply trying to avoid physical consequences of withdrawal, behavior changes begin to build around the substance use, making this a psychological condition. In cases of addiction, drug use becomes compulsive, even with full knowledge of harmful consequences. It is characterized by an inability to quit using the drug (even if there is intent to stop), increased consumption, and the degrading of other aspects of one’s life.
Now considered to be a chronic, relapsing brain disease, addiction stems from a complex combination of factors. This is considered a “biopsychosocial view,” meaning that one’s genetics, socioeconomic status, upbringing or home life, and access to drugs all contribute to the likelihood of eventual substance use disorders.
Those suffering from addiction begin to dedicate increasing amounts of time to their substance use, which results in a failure to meet expectations of family, friends, and employers. They may stop participating in activities that used to be fulfilling or use drugs in situations that are unsafe, such as while driving. People with substance use disorders continue to use, even when they know they have ailments or personal problems that could be worsened by their drug of choice.
The most direct differences between dependence and addiction are behavioral change and severity. While dependence is primarily physical, characterized by tolerance and withdrawal from any number of substances, addiction consumes all aspects of one’s life. Drugs or alcohol become one’s primary motivation, and everything else falls by the wayside.
Signs of Addiction
- Using the substance more often than one is meant to (or in larger quantities)
- Expressing an urge to quit, but being unable to follow through
- Spending a lot of time obtaining, using the substance
- Experiencing cravings
- Failing to meet obligations at work, home, or school
- Continuing to use, even with knowledge of the consequences
- Giving up important hobbies or activities because of the substance use
- Using the substance in dangerous situations (while driving, swimming)
- Developing tolerance and needing to take more of the substance for the same effect
- Having withdrawal symptoms, which are relieved by the substance
Treatment for Addiction and Dependence
If you’re concerned that you or a loved one have developed some of these characteristic signs of addiction, there is hope. By educating yourself and catching substance use disorders early, recovery is closer than ever. Vista Taos’s convenient location in New Mexico is the perfect haven for addiction treatment. Call us at 575-587-3011 or submit a confidential contact form today to get started.