Drug Abuse, Addiction and Dependence

More than 23 million Americans are addicted to drugs and alcohol, according to a recent National Survey on Drug Use and Health analysis by the Closing the Addiction Treatment Gap initiative.1 The cost of drug abuse to American society is enormous, to the tune of about $600 billion annually, according to the National Institute on Drug Abuse, but the cost to the individual is often much higher and can’t be expressed with dollar signs.

Nevertheless, despite the overwhelming cost of drug abuse and addiction, the general public—even those who abuse drugs or who are addicted to or dependent on them—have limited understanding of drug abuse and the science behind addiction and dependence. We will explore the distinction between drug abuse, addiction and dependence.

What is Drug Abuse?

The term “drug abuse” is used to describe the act of using drugs in an illegal or unsafe manner. Taking prescription medications in any way other than exactly as prescribed is considered drug abuse, and so is a pattern of drinking alcohol that puts you at risk of injury to your physical or mental health. Any type of illegal drug use is considered drug abuse.

Drug abuse can be intermittent, or it can be chronic. In many cases, chronic drug abuse leads to addiction and physical dependence.

The Difference Between Addiction and Dependence

Addiction is characterized by continuing to use drugs or alcohol despite the negative consequences to your health, relationships and finances as well as by the inability to stop using despite wanting or even trying to, according to the National Institute on Drug Abuse. 2

Addiction results when the brain makes a solid association between using a drug and the pleasurable effects. The association becomes so strong that willpower and good intentions alone are rarely enough to overcome the addiction.

According to the National Council on Alcoholism and Drug Dependence, signs and symptoms of addiction include a loss of control over your drug use, a loss of interest in activities you once enjoyed, intense drug or alcohol cravings and taking risks you wouldn’t take if you weren’t under the influence.3

Dependence is characterized by changes in the structures and functions of the brain that result from chronic drug abuse. As brain function changes to compensate for the presence of drugs or alcohol, it takes higher doses to get the desired effects. This is known as developing a tolerance, and it’s a sign that you may on the road to dependence.

With chronic drug abuse, brain function may shift to the point at which it operates more “normally” when drugs are present than when they’re not. When drugs are withheld from someone who develops a dependence on them, withdrawal symptoms will set in as the body’s way of saying it needs the drug to function properly.

You can be addicted to a drug without being physically dependent on it, and you can be dependent on a drug without being addicted to it. Generally, though, particularly in the case of alcohol and most illegal drugs, addiction and dependence co-occur.

Treating Drug Abuse, Addiction and Dependence

Dependence is addressed through medical detox, which is the process of removing traces of a substance from the body, and it’s the first stage of professional treatment. Medical detox is supervised by medical and mental health professionals who administer medications to help reduce the severity of withdrawal symptoms.

Once detox is complete, brain function begins to return to normal and your body is no longer physically dependent on the drug. After detox, treatment for the addiction begins. According to the National Institute on Drug Abuse, detox alone is rarely enough to end chronic drug abuse or addiction.

You don’t have to be addicted to drugs or alcohol to benefit from treatment, and in fact, treating moderate to severe drug abuse can help you avoid developing an addiction or dependence altogether. Drug abuse stems from any number of underlying issues. Perhaps you abuse alcohol because it alleviates your social anxiety. Maybe you use marijuana to de-stress after a rough day. You may use drugs or alcohol to feel less depressed, to fill a void or because you think you can’t have as much fun without it.

Whether you abuse drugs or your drug abuse has led to an addiction, your underlying issues will be addressed through psychotherapy, or “talk therapy,” which is the hallmark of drug and alcohol treatment.

Cognitive-behavioral therapy is one such therapy that helps you identify self-destructive patterns of thought and behavior and learn how to replace them with healthier ways of thinking and behaving.

Motivational interviewing, another type of therapy, helps you tap into your intrinsic motivation for wanting to stop abusing drugs or beat an addiction.

Family therapy helps restore function to the family system to reduce stress and mitigate potential triggers, and group therapy and 12-step support groups draw on peer support and personal accountability to help you maintain sobriety.

End the Cycle

The benefits of treatment are many, but the consequences of drug abuse may be dire. If your drug use has escalated to addiction or dependence or you want to stop abusing drugs or alcohol but can’t seem to do it, consider a high-quality, holistic treatment program that utilizes research-based therapies to help you end your drug or alcohol abuse once and for all. Treatment can give you a new lease on life, and you’ll emerge with more self-knowledge and a higher sense of purpose for your life. Click here to learn more about our story of addiction.


  1. https://www.opensocietyfoundations.org/sites/default/files/data-summary-20101123.pdf
  2. http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence
  3. https://ncadd.org/about-addiction/signs-and-symptoms/signs-and-symptoms
  1. It makes sense that drug addiction involves the brain making a positive connection with drugs. My wife has a brother who struggles with substance abuse. I think that he should go to a facility where he could receive some true help.

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