Addiction Medicine

Abuse Vs. Dependence

Abuse and Dependence are often described as one in the same. But you would be surprised to know that they are really different ends of the same disease process. 

Abuse- Drug abuse is an intense desire to obtain increasing amounts of a particular substance or substances to the exclusion of all other activities. It is a pattern of using substances that leads to anxiety and significant behavioral changes in one or more of the following areas:

1. Recurring substance abuse that effects your work, school and home life(e.g., unable to follow through with tasks, absences to school or work, neglect of children or household)
2. Substance use in dangerous situations(e.g. driving while under the influence)
3. Substance related legal problems
4. Continued use even after continued deterioration of your personal relationships.

Dependence-Drug dependence is the body's physical need, or addiction, to a specific agent. Over the long term, this dependence results in physical harm, behavior problems, and association with people who also abuse drugs. These factors may include:

1. A strong desire or urge to take the substance
2. Difficulty controlling when and how much of the substance you use
3. Emotional withdrawal symptoms when you try to stop taking our reduce your use of substance of choice, or using a similar substance to avoid withdrawal symptoms
4. Feeling tolerant of the substance and increasing your use to get the same effect that you previously had on a lower dose. (clear examples of this are found in opiate dependent individuals who may take daily doses that are enough to disable or kill people who are not tolerant users)
5. Decreased desire to do anything else but use, an increase of the amount of time you spend to find and take the substance and recover from its effects.
6. Continued use even despite the obvious effects on health, both mental and physical

Knowing that you suffer from opiate abuse or dependence can help you be honest with yourself. If you feel you or your loved one are may fit either of these you should seek help.