FAQs: Addiction or Dependence

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Shlomo Hoffman
May 04, 2021

Question: What is Addiction?

Answer: Addiction is a chronic mental health disease which compels an individual to use substances without regard to the consequences that may follow.  Addiction happens by frequently using substances.  Eventually, the brain creates tolerance to the substance and no longer produces the same effects.  When the brain builds a tolerance to the substance, it requires more of the substance to achieve the desired effects again. 

Using more of the substance to maintain the “high” will lead to physical and psychological dependence.  This means the individual who develops addiction will experience physical and mental withdrawal symptoms.  Drug addiction changes the function of the natural brain chemistry.  This is known as brain damage, which disrupts an individual’s means of functioning.  Addiction compels an individual to continue using substances to feel “normal” and to avoid the unpleasant effects of withdrawal.

Question: What is Physical Dependence?

Answer:  The brain is a highly complex organ that can be changed by substance use.  It can change the emotions, behavior, and thoughts of an individual.  The brain has billions of neurons that give information to other parts of the brain and body through networks.  These networks regulate and manage emotions, behavior, and thoughts.  Physical dependence occurs when the substance interferes and alters this function in the brain.  This means the body must continually have the substance to function properly, otherwise, withdrawal symptoms will occur.  Withdrawal symptoms vary by substance and the frequency of use.

Question: Is There A Difference Between Addiction and Dependence?

Answer:  Often, people misinterpret the difference between addiction and dependence.  Clinicians use the Diagnostic and Statistical Manual of Mental Disorder V to diagnose addiction and dependence.  However, addiction is now referred to as substance use disorder.  Addiction and dependence is classified by severity.  They are categorized by mild, moderate, and severe. 

Previously, dependence referred to the physical dependence, tolerance, and withdrawal of a substance. It was also classified into substance abuse and substance dependence.  Addiction is now called substance use disorder, to include all severities on its spectrum.

Question: What Kind of Substances Can Cause Substance Use Disorder or Addiction?

Answer:  Psychoactive substances are drugs with chemical properties that affect an individual’s physical and/or mental state.  This occurs as the drug reaches the central nervous system. When administered by a physician, psychoactive substances may be used for medical purposes. However, many psychoactive substances are often used recreationally and abused.

Prescription medications, as well as illicit street drugs, are widely abused.  Every substance has a risk of developing addiction or substance use disorder.  When someone begins abusing substances, tolerance and addiction may develop. There are several different types of psychoactive drugs, each with unique chemical structures.  These chemical structures determine how it affects the brain.  They are labeled and classified by their effects on the central nervous system. 

Examples of psychoactive substances include depressants, stimulants, amphetamines, hallucinogens, and anxiolytics.

Question: How Does Addiction or Substance Use Disorder Alter the Brain?

Answer:  The brain is changed in various ways because of substance use or addiction. Neurons are brain cells that communicate with other brain cells.  Substances affect the neurons’ ability to send, receive, and process information.  Dopamine and serotonin are the most common neurotransmitters.  They are known responsible for many functions; however, they are responsible for pleasure.  Substances release more dopamine and/or serotonin in the brain.  The chemicals in the substances overburden certain networks in the brain, resulting in euphoria during use. For example, amphetamines cause neurons to release excessive amounts of natural neurotransmitters or to stop producing them entirely by blocking transporters in the brain. This pleasure can lead to an individual to repeat using substances for many reasons. 

The networks in the brain eventually become used to the chemicals of the substances, resulting in feeling less of the “high” or effects.  Essentially, the brain has been rewired and no longer functions to produce the same motivation before substance use.  The extended amygdala is responsible for feelings like anxiety and irritability.  This is altered by chronic substance use, which causes withdrawal to occur. To escape the extreme displeasure of withdrawal, the individual continues to use substances despite the damages it causes. 

People who do not understand the complexities of substance use disorder may judge an individual who continually abuses substances.  Often, people see these individuals as “weak” or unable to stop using because of their lack of willpower. However, it is not a matter of will; it is a chronic mental health condition which requires professional treatment.

Since joining the Avenues Recovery content team, Shlomo has become a thought leader in the addiction field. His popular addiction podcast "Rubber Bands" is a must listen for anyone involved in Substance abuse treatment. He is a Seinfeld junkie, a recovering Twitter fanatic, and a sports expert. He enjoys milk shakes and beautiful views from rooftops.

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