While it isn’t possible to develop an addiction to a substance without repeated use, addictions can form more quickly and easily in certain people. Genetic, neurological, or psychological factors can all increase a person’s likelihood of developing a drug or alcohol dependence. In addition, stress, trauma, and hardship are also known ‘risk factors’ that make addiction more likely. Even certain personality traits like being naturally more impulsive or neurotic can increase the chances of developing a dependence on drugs or alcohol. Physical dependence develops when someone uses drugs or alcohol consistently over a long period of time. Eventually, the body becomes dependent on the substance which causes cells and other essential systems to start to function differently.
However, there are a few key differentiators that separate the two. This international committee met over several years in cities such as Washington, Copenhagen and New York, and their work was published in 1987 as DSM-III-R (revised). This was an important achievement because the committee agreed that the disorder in question was compulsive, uncontrolled, drug-seeking behaviour, and defined it by a set of criteria that produced excellent inter-rater reliability. The committee made most decisions unanimously because there was general agreement from the experts as to how the syndrome should be defined (the names of the members are contained in the preface to DSM-III-R).
Risk factors for addiction and dependence
Regardless of what term you use to describe a substance
misuse issue, Mr. Kump emphasizes that the key is to understand that treatment
is available. He also sees people who have taken heroin without developing an addiction, yet they can’t seem to stop smoking and give up nicotine. You may assume that certain substances are more addictive
than others, and that is partially true, Mr. Kump says. Addiction encompasses both a mental and physical reliance on a given substance. While much of the confusion about this topic can be traced to DSM committees, I would caution against an oversimplified blame game. The topic itself is inherently complicated and confusing, and it’s situated in the context of an evolving medical and cultural milieu.
When you miss your morning cup, you might develop physical withdrawal symptoms, like a headache, fatigue, difficulty concentrating, and more. People who are addicted to a substance use it even if it has no medical benefit. They use the substance no matter what and despite the consequences.
Digital Support Group – Addiction Recovery
It’s also common for people to experience both types of dependence. The ‘abuse category’ has been eliminated from the proposed structure because of the lack of data to support an intermediate state between drug use and drug addiction. The symptoms created for DSM-III-R remain the same, except addiction vs dependence for the elimination of the ‘legal difficulties’ symptom and the addition of ‘drug craving’. Tolerance and withdrawal symptoms are not counted towards the diagnosis when the patient is involved in an appropriate medical treatment program for a problem such as pain, depression or anxiety.
Accurately identifying persons with addiction is critically important for effectively targeting treatment and harm reduction interventions. Misdiagnosis of addictive disorders can lead to a cascade of negative outcomes, including stigma, discontinuation of needed medications, undue scrutiny of both patients and physicians, and even criminal consequences. It is hardly surprising that physicians frequently mislabel patients when the ICD terms used to code for addiction are themselves misleading. ICD codes have not been updated to reflect current understanding of addiction, unlike those in the DSM-5. Diagnosis of substance use disorder usually occurs after discussing your medical history and symptoms with your primary care provider, a psychiatrist, or a qualified mental health professional.
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The erroneous implication is that ‘dependence’ in the DSM was not physical or physiological. Most importantly, the major reason given for the under-treatment of pain with opioids has been the fear that the physician will create an addiction when, in reality, addiction in the course of pain treatment is relatively uncommon. Thus patients have been made to suffer by receiving inadequate pain medication doses when there is evidence of tolerance or withdrawal symptoms . We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.
- Dependence is characterized by tolerance or withdrawal symptoms and can be a consequence of many drugs, such as pain medications, stimulants, and antidepressants.
- Addictions are more likely to result in serious harm, including suicide, unlike tolerance and physical dependence.
- A person being treated for physical dependency in the absence of any substance use disorder will be closely monitored by the prescribing healthcare provider as they taper or decrease the dosage slowly over time rather than all at once.
- “Substance use disorder” is the medical term for addiction and physical dependency describes the phenomenon of your body becoming physiologically dependent on a substance.