Dependence vs.

Addiction

 The distinction between dependence and addiction can be important, particularly when talking
about clinical medications like opiates for pain.
 Dependence is a state of chronic drug taking where withdrawal is experienced if the drug
taking is stopped. Withdrawal can be a serious state and can drive additional drug taking.
 Addiction is the behavior of seeking and taking drugs such that there are negative
consequences in life.
 They are not identical. For example, when someone is taking opiates for chronic pain to make
life bearable, they are dependent on the medication and will likely experience some degree of
withdrawal if the drug is abruptly stopped. But they are not necessarily addicted, because
there is no seeking and drug taking that is having negative consequences in their lives.
Dependence can be tolerated as a side effect when there are medical benefits.
 The concept of dependence can apply to many medicines. Many clinically used medications
(for example, antidepressants) can produce some kind of withdrawal syndrome if they are
abruptly stopped. Taking these medications should be under the direction of a physician who
is likely to gradually wean the patient away from the medication when stopping is a goal.
 Today, the official language for describing use, abuse, and addiction are viewed as substance
use disorders (SUDs) with a continuum of severity. For example, one may be diagnosed with
a substance use disorder that is either mild or severe or in between.

2. Does this course apply only to one country or locale?

 The major ideas in this course about the bases and the processes of addiction are universal
and apply to all of us. But there are some statistics, examples, policies, laws, and studies that
apply mainly to the USA or to western countries. They may not apply to everyone. At the very
least, they can be looked upon as examples and factors that can be considered and studied
wherever you are.