Abuse vs. Dependence

There is a lot of gray area and uncertainty when it comes to addiction, and one area in particular is the differences between substance abuse vs. dependence. Addiction comes in many different forms, and looks different for everyone affected. Not only is the person who is addicted affected, but so is their family and friends, coworkers, and everyone they come in contact with. Both abuse and dependence are considered an addiction, regardless of how often or how much of the drug is consumed. The difference between the two relates to the way the addiction affects the individual’s every day life, and how it affects those around them.
This topic strikes a cord with me because of the many former patients with addiction I had the opportunity to work with. Some of those patients would not see binge drinking on occasion, for example, as an addiction. This would make working on a treatment plan for these individuals challenging as they would not view their drug use as an addiction, therefore obtaining treatment felt unnecessary to them. This was always concerning to me because of course I wanted those patients to get better! But, the choice must come from the patient to want to receive the help and understand that there may be an issue to come to terms with. There are many different ways to receive help, and sometimes obtaining treatment from a facility may feel intimidating and foreign. There are many other ways to receive help, and I want people to know that!

Below is more detailed information on abuse and dependence which can be helpful in deciding what type of treatment to utilize or how to ask for help, and having a better understanding of addiction in general.

ABUSE
Substance use that harms you physically and/or your mental health causing anxiety, pain, or sorrow.

• Ongoing legal problems related to substance use (DUI, paraphernalia…).
• Continuing to use substances even though it is causing problems in your social  life (canceling plans, arguing with peers, physical fights…).
• Repeated substance use which affects your ability to complete responsibilities in your home life (spending time with family, getting yard work completed…), affects your ability to work (late, ‘no-show’), or affecting your ability to be successful in school.
• Repeated substance use regardless of the usage being physically dangerous (drinking and driving, unsanitary needle use…).

DEPENDENCE
A pattern of substance use leading to pain, sorrow, or anxiety if demonstrated in 3 or more points below:

• The individual often takes the substance in mass amounts, or for longer periods than they expected.
• There is ongoing, unsuccessful attempts to cut down or control the substance use.
• A lot of the individual’s time is spent in activities closely related to substance use or that provide the ability to gain the substance (selling drugs, working at a bar….).
• Give up or greatly reduce enjoyable social or recreational activities due to ongoing usage.
• Tolerance- a need for increased amounts of the substance to obtain intoxication or the sought-after affect. Or the substance seeming to be less effective over time with the same amount of consumption. (If typically it would take a person 5 beers to be intoxicated, over time this would increase to 10 beers before the individual felt any effects.)
• Withdrawal- if the definition/attributes of withdrawal for the specific substance being abused is what the individual’s symptoms are. Or the same substance is taken to avoid/relieve the withdrawal symptoms. (Waking up and consuming alcohol to avoid a hangover).
• The individual lies about their using or is in denial of their use.

*There are self assessment tools available online to help people determine if they are suffering from either abuse or dependence.
As mentioned earlier, both abuse and dependence are considered an addiction. This is so important to understand when trying to come to terms with addiction and get the help you, or someone you know, may need.

Steps to take to help yourself or someone you know:

• Utilize an online self assessment tool to gain a better understanding of your addiction.
• Research research research! There is TONS of helpful information and resources for free on the internet.
• Tell someone you trust about your addiction. Recovering from addiction is much easier when you have guidance, support, and encouragement from others. It is so easy to fall back on old patterns when you do not gain support and understanding from others.
• Attend NA/AA meetings in your area (trust me, there are tons being offered daily)
• Challenge yourself- try to eliminate substance use for a certain amount of time to see if you’re able to accomplish that. With time, hopefully you notice how much better, clearer, healthier, and happier you feel. Setting goals, such as this challenge, is great practice in figuring out what you are capable of accomplishing on your own!
• Think about how your substance use is affecting things in your life that are important to you. Remind yourself not only to make the change for yourself, but also for the people and things you love.
• Speak with an addiction counselor or individual therapist (your information is kept confidential). Most addictions are the root of a pre-existing problem such as depression or trauma.
• Contact local agencies who specialize in addiction to discuss options they have to assist you. Check online to find options in your area.

Please remember that it takes courage to get the help you need. It is no easy task; do not give up on yourself. Most addicts are not successful on their first try, and that is okay! Any amount of time sober is worth celebrating. Be proud of yourself for recognizing there is an issue. Be proud of yourself for attempting to gain education and get the help you need. It takes time, commitment, and motivation to make the change and become a healthier you. We all know change is hard, so if you’re prepared and ready for that you can make this happen!

Strength and growth come only through continuous effort and struggle. Create a life you can be proud of.

–keep shining