What is the difference between physical dependence and addiction? There is a world of difference between these two, and they’re totally misunderstood most of the time. To really understand the difference, you must first understand how addictive drugs work in the brain.
How Drugs Work in the Brain
All addictive drugs attach to certain receptors in the brain. For example, opioids bind to and activate the mu, the delta and the kappa brain receptors. The mu is most closely associated with addiction, tolerance, overdose, pain relief, euphoria and sedation.
Benzodiazepines, tranquilizers like Valium, Xanax, Tranxene, Halcion, Dalmane and Ativan, work on brain receptors known as GABA. When the GABA receptors are occupied by benzodiazepines, brain activity is slowed, causing feelings of serenity. This specific slowing of the brain is also why benzos can cause marked drowsiness. Prior to the discovery of these drugs in the 1950s, the far more dangerous barbiturates were used for both sedation and sleep. Although dangerous to withdraw from without medical supervision, benzos are much, much safer than barbiturates as far as overdose risk is concerned.
Alcohol also acts on the GABA system, which is why benzodiazepines are used to help alcoholics to safely get through the withdrawal process. Neither alcohol nor benzos are safe to withdraw from at home. Withdrawal from both can cause potentially fatal grand mal seizures and lung aspiration of stomach contents.
Amphetamines as a group affect the brain’s NDMA receptors and dopamine receptors, resulting in both brain stimulation and the release of the pleasure neurotransmitter dopamine. It’s this combination that causes amphetamine’s powerful feelings of grandeur, extreme elation and euphoria.
Except for alcohol, all of these drugs are used medically to treat certain conditions. Opioids ease pain after surgery and for people with chronic pain. Amphetamines help people with attention-deficit disorders to focus and perform better socially at work and at school. Benzodiazepines treat anxiety and panic disorders and are sometimes prescribed to treat lower back pain, too.
The Difference Between Drug Dependence and Drug Addiction
Anyone who takes any addictive drug for any length of time will become physically dependent on that drug. There is no way to avoid this. The changes caused in the brain will occur no matter if the drug is being abused or is being taken medically as prescribed.
The main difference is that someone who is abusing the drug is taking it for non-medical reasons. Even if the drug is prescribed to them, they are still abusing it if they increase the dose on their own and continually run out before their next refill is due. Someone who is addicted is not only physically dependent but emotionally and psychologically dependent, too. They’re preoccupied with the drug and put everything ahead of it. They may even buy it on the black market. They crave the effect and the way it makes them feel. They will go to extreme lengths to get it.
In contrast, someone who is physically dependent is just taking the drug for a medical reason. They feel no emotional attachment to the drug and most likely would prefer not to have to take it at all. However, the drug improves their quality of life, so they accept the trade-off. Someone who is not addicted takes the drug only as directed, does not run out of medication before their next refill and does not seek the drug out.
Physical drug dependence is not the patient’s fault. It’s just a function of how addictive drugs behave in the brain. They cause changes in the brain that prevent it from functioning normally without the drug. If a dependent person suddenly stops taking their medication, they will experience withdrawal symptoms just like an addicted person would.
There is a tremendous amount of social stigma about addictive drugs. Even pharmacists, as highly educated as they are, should know better than to judge people taking opioids and other addictive medications. Just because someone presents at a pharmacy with a prescription for a large number of high-dose addictive pills doesn’t mean they are a junkie. Yet, people are denied these medications all the time based on a judgement call that may be totally wrong. This should not happen. It’s not right.
For More Information
Drug dependence and addiction are misunderstood in everyday life on a daily basis. If you’d like to know more about addiction and physical drug dependence, we can help. Just call us anytime at 833-820-2922 for information to help you understand the difference between physical drug dependence and addiction. Addiction should be addressed and treated, but someone with a medical condition should never be judged and denied the treatment they deserve and need for a better quality of life.