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Differences in Treatment of Abuse and Dependence

The words “abuse” and “dependence” are often used interchangeably to describe a destructive relationship to alcohol or drugs. In fact, mental health professionals and addiction specialists make a distinction between abusing a substance and becoming dependent on it. Although these two conditions are not the same, they’re often interrelated. Exploring the difference between abuse and dependence may give you insight into your own or someone else’s behavior.

What Are the Signs of Abuse?

Risk-taking behavior, illegal activity, interpersonal problems and a loss of interest in your usual activities are signs that you may be abusing drugs or alcohol, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Abuse implies that your use of a chemical substance is putting you in dangerous situations, jeopardizing your health or making you neglect important commitments at home, school or work. A person who’s abusing alcohol or drugs may:

  • Miss work frequently because he’s incapacitated or needs to score
  • Fail to pick up kids from school because she’s too drunk to drive
  • Get arrested for drug- or alcohol-related behavior
  • Drive drunk on a regular basis
  • Argue with a spouse or break up with a partner over drug or alcohol use

What Are the Signs of Dependence?

Dependence implies that you have such a strong physical or psychological need for a substance that you experience withdrawal symptoms when you stop using it. In other words, your body or mind literally depends on drugs or alcohol to function in a “normal” fashion. The National Institutes of Health stresses that while abuse may lead to dependence, the two conditions are not identical. Someone who’s become dependent on alcohol or drugs may:

  • Develop a tolerance to the substance, so that he or she needs to use more and more of the drug to get the desired effects
  • Experience physical symptoms — such as nausea, vomiting, tremors, chills, sweating, or low blood pressure — within a few hours of stopping the drug
  • Experience psychological symptoms — such as irritability, depression, anxiety or fuzzy thinking — if she can’t get access to the substance
  • Deny that she has a problem with the drug, in spite of the damage that it’s doing to her health, her relationships or her finances
  • Attempt to quit using the drug repeatedly without success

*How Prevalent Are Abuse and Dependence?

Statistics posted by the Institute of Addiction Medicine indicate that both substance abuse and dependence are widespread in the United States:

  • Over 23 million Americans required treatment for a substance use disorder (abuse or dependence) in 2007.
  • The average age that Americans started to abuse alcohol in 2007 was 15.8 years.
  • Approximately 2 million people in the US are dependent on opioid prescription drugs.
  • Almost 5 million Americans use opioid pain relievers illegally, or without medical supervision.

Are There Differences in Treatment?

Treatment for dependence may require medical supervision in one of the top executive treatment facility as you go through detoxification. With some drugs, like alcohol or benzodiazepines, withdrawal symptoms can be fatal. While withdrawal from heroin, cocaine or meth usually won’t endanger your life, medical detox can make the process easier and prevent the worst of the symptoms. After the detox phase, a doctor may prescribe a medication like naltrexone, methadone or acamprosate to help you avoid the cravings that can cause a relapse. Counseling and self-help groups are also key components of a comprehensive treatment program for dependence.

Treatment for substance abuse may not require detoxification, but it does require counseling, group therapy and education to help you get to the root of the problem. A doctor may recommend that you take medication to curb cravings, discourage substance use or treat emotional disorders. Many people who abuse drugs or alcohol have underlying mental health issues that drive them to self-medicate. You may drink heavily out of depression or abuse marijuana to relieve anxiety without understanding the source of these problems. Addiction treatment gives you the skills you need to deal with life’s stressors and lead a sober, drug-free life.