There is some confusion in the field of behavioral health about the terms chemical dependency and addiction. In this article, I clarify current interpretations of what they mean and describe various aspects of dependency.
Understanding the Science behind Addiction
The National Institute on Drug Abuse (NIDA), one of the leading scientific bodies in the study of addiction, uses the following definition. “Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. It is considered a brain disorder, because it involves functional changes to brain circuits involved in reward, stress, and self-control. Those changes may last a long time after a person has stopped taking drugs.” [1]
NIDA further states: “Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision-making, learning, and memory, and behavior control. These changes help explain the compulsive nature of addiction. “
So while NIDA uses the term “addiction” described above, the DSM-5, The Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association, doesn’t use the term addiction as a diagnosis. It now uses substance use disorder with three subclassifications—mild, moderate and severe, based on 11 criteria. The symptoms associated with a substance use disorder fall into four major groupings: impaired control, social impairment, risky use, and pharmacological criteria (i.e. tolerance and withdrawal). But NIDA’s definition of “addiction” is viewed by NIDA as equivalent to the DSM-5’s ”substance use disorder”.
What is Chemical Dependency?
Chemical dependency, also known as physical dependence, is the body’s physical and/or psychological dependence on a psychoactive (mind-altering) substance such as narcotics, alcohol or nicotine, among others.
It describes the use of drugs or alcohol that continues even when someone has serious problems linked to their use. Signs of dependence include [2]:
- You need more of the drug to get an effect
- You constantly think about getting or using the drug
- You have withdrawal symptoms if you decrease or stop using the drug
- You spend a lot of time getting, using and recovering from the effects of drugs
- You withdraw from social and recreational activities
- You keep using the drug, even when you know it causes a lot of problems, whether they be physical, psychological, economic, and family or social problems
Physical dependence can occur with the regular (daily or almost daily) use of any substance, legal or illegal, even when taken as prescribed.
It occurs because the body naturally adapts to regular exposure to a substance (e.g. caffeine or a prescription drug). When that substance is removed, symptoms can emerge while the body re-adjusts to the loss of the substance during withdrawal.
Physical dependence can lead to craving the drug to relieve withdrawal symptoms.
Tolerance is the need to take higher doses of the drug to get the same effect. It often accompanies dependence, and it can be difficult to distinguish between the two.
Addiction is a chronic health disorder characterized by drug seeking and use that is compulsive, despite negative consequences.
What Causes Chemical Dependency?
Chemical dependency is caused by a range of factors: environmental, social, psychological and biological. Some of the environmental factors include:
- Lack of parental supervision
- Aggressive behavior in childhood
- Low peer refusal skills
- Drug experimentation
- Availability of drugs at school
- Community poverty
Biological factors include:
- Genes
- Stage of development
- Gender
- Ethnicity
Scientists estimate that genes account for 40-60% of a person’s risk of addiction.
What Substances Could Cause Chemical Dependency?
A wide range of substances can cause chemical dependency, including among others:
- Nicotine
- Alcohol
- Marijuana
- Prescription medicines (pain relievers, stimulants or anxiety pills)
- Methamphetamine
- Cocaine
- Opiates
- Hallucinogens
- Inhalants
What Role Chemical Dependency Plays in Addiction?
This has been an area of significant confusion as described earlier. Many people are dependent on a variety of medications but do not have withdrawal symptoms when they stop taking it.
Chemical dependency becomes a problem when people persist in using a substance despite its use causing harm or when the risk outweighs the benefits. In other words, it’s not just dependence, but addiction—or severe withdrawal symptoms make stopping a non beneficial medication difficult [3].
When To Seek Help
If you have any of the symptoms outlined earlier, then you would benefit from seeing a medical professional. This is especially the case if your use is causing adverse events in your life or those around you.
Addiction Treatment Available in Anaheim, California
Located in Anaheim, California, Restorations Health Care can help you or a loved one overcome their addictions issues. Our mission is all about saving lives. We offer detox and inpatient treatment programs that help people get back on their feet. Our dedicated team of trained addiction professionals and counselors provides individualized addiction treatment programs for recovery. Reach out to our Admissions team now.
Sources
[1] National Institute on Drug Abuse. 2011. Drugs, Brains, and Behavior: The Science of Addiction. Drug Misuse and Addiction.
[2] University of Rochester Medical Center. Substance Abuse or Chemical Dependence
[3] Szalavitz M, Rigg KK, Wakeman SE. Drug dependence is not addiction-and it matters. Ann Med. 2021 Dec;53(1):1989-1992
Lacey graduated from Brand University with a MA in Psychology, Marriage & Family Therapy. Lacey is a skilled clinician, supervisor, and administrator with extensive therapy experience. She is responsible for providing clinical leadership and policy direction for our program and maintains accepted standards of medical practice throughout the facility.