Substance Dependence

What Does It Mean To Be Dependent On Drugs Or Alcohol?

Drug or alcohol dependence means your body relies on the substances to function. Drug dependence may start with experimental or social use or by being prescribed pain medication by a doctor. You don’t intend to misuse or feel you must have them to get through each day. However, the more you use them regularly, the more likely you will develop a tolerance to the substances.

Tolerance is when you must take more of a drug or drink more alcohol to achieve the same effects you felt when you first started using them. For example, if a doctor prescribes you opiates for pain and tells you to take one pill every 4 to 6 hours, you will notice that, after a few days, the pills are not easing the pain like they first did.

If you go without the substances or try to quit using them, you may feel like something is not normal with how your body is working. You will likely experience painful symptoms that range from mild to severe. The withdrawal symptoms are a sure sign your body is dependent on the substance.

Withdrawal Symptoms

Withdrawal symptoms vary for each person, and many factors contribute to severity, including type, amount, and length of use of the substance. Other factors may include gender, weight, and interactions with other medications you may be taking. If you are in withdrawal, you may experience the following within hours of your last use:

A medical professional can help you manage withdrawal symptoms. The provider can prescribe medication-assistance therapies for symptoms and cravings so you can focus on learning recovery skills.

Physical Dependence

You can develop physical dependence on many different substances, including prescription and illicit drugs, alcohol, sugar, and caffeine. Physical dependence refers to the biological consequences of taking substances for weeks, months, or years. Not all dependence on a substance is negative. For example, people taking medications to prevent high cholesterol or cardiac events rely on these medicines to maintain their health.

What makes physical dependence dangerous is when people continue to take substances that are causing harm to their bodies. Even though they know the drugs or alcohol are harming them, they continue to use them. Still, they may not be addicted, but they are on their way to addiction, which refers to a lack of control over using a substance despite negative consequences occurring as a result.

Psychological Dependence

Psychological dependence refers to the mental symptoms that occur over time due to taking drugs or alcohol. Substances alter how the brain functions, including how neurotransmitters communicate. The neurotransmitters most affected by misusing drugs and alcohol include dopamine and serotonin, chemicals that help you feel good.

When you cut back or try to quit using some drugs and alcohol, your brain notices and reacts by making you feel depressed or anxious. It also makes you have intense cravings and urges to seek drugs or alcohol to feel good again. You may find it challenging to resist these cravings.

These cravings can even appear before you run out of a substance. When you see you are getting low, you may experience panic and feel the need to replace your supply before you run out. It is the fear of not having the substance that is a psychological symptom of drug dependence.

Recognizing The Symptoms Of Substance Dependence

Everyone with substance dependence can exhibit different symptoms, which can include behavioral, personal, professional, academic, or social changes. However, people report common symptoms, such as:

• Being unable to carry out daily tasks without using substances
• Making substance use a top priority over more critical issues
• Increasing the amount of drugs or alcohol you consume
• Drinking or using substances at odd times, like before breakfast
• Feeling unwell when you have gone a while without substances
• Acting defensively or aggressively when questioned about your substance use
• Being unable to get quality sleep
• Feeling confused at times when you shouldn’t be
• Making excuses to use substances
• Behaving secretly to misuse drugs or alcohol
• Isolating yourself from others to use substances alone

Many people who develop a drug or alcohol dependence begin to care less about taking care of themselves. This becomes apparent in a lack of personal hygiene, changes in weight, malnutrition, and a weak immune system.

What Drugs Are Most Likely To Cause Dependency?

Numerous substances, legal and illegal, are addictive, and someone can develop a dependence on them. Drugs, in this discussion, refer to prescription medications and street drugs. The ones most likely to cause dependency are those that quickly alter how the brain functions and cause higher releases of feel-good chemicals than the brain can release naturally.

According to the 2023 National Survey on Drug Use and Health (NSDUH), the following substances were most used among people 12 and older in the month before the survey:

• 134.7 million used alcohol
• 49.9 million used tobacco
• 43.6 million used marijuana
• 2.6 million used hallucinogens
• 2.2 million used prescription pain medications
• 1.8 million used cocaine
• 1.6 million used methamphetamine

Following these drugs, survey respondents also reported misusing prescription stimulants, prescription sedatives, inhalants, and heroin. It is critical to note that people often accidentally use fentanyl and aren’t aware the drugs they are using are mixed with fentanyl.

The survey also revealed how many people had a substance use disorder in the year before participation, which revealed large numbers:

• 28.9 million people had an alcohol use disorder
• 27.2 million people had a drug use disorder

The substances associated with addiction, in order from highest to lowest, include alcohol, marijuana, prescription pain relievers, methamphetamine, prescription stimulants, cocaine, and heroin. Many individuals with a substance use disorder also reported having a mental health disorder, called dual diagnosis.

Addiction Vs. Substance Dependence

Although many people use the terms addiction and dependence interchangeably, they are not the same. You can have an addiction and not develop a dependence. You can also be dependent on a substance but not develop an addiction.

The Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) outlines the 11 criteria for diagnosing someone with an addiction, and the number you meet determines if your substance use disorder is mild, moderate, or severe. The criteria include:

• Taking the substance for longer and in larger amounts than intended
• Being unable to quit using substances even though you want to and have tried
• Spending much of your time seeking, using, or recovering from the use of substances
• Having cravings or intense urges to use the substance
• Being unable to fulfill duties at home, work, school, or socially due to substance use
• Continuing to use substances even though it causes relationship or social problems
• Giving up essential activities to use substances
• Using substances in dangerous situations
• Continuing to use substances even though you know it will cause or worsen a physical or psychological problem
• Increasing tolerance to the substance and needing more to feel the effects
• Experiencing withdrawal symptoms when you cut back or stop using the substance (you may also continue to use the substance to ease or avoid withdrawal symptoms)

If you meet three or fewer criteria, you have a mild addiction. If you meet between four and six criteria, you have a moderate addiction. Meeting six or more criteria classifies you as having a severe addiction. At any level, help is available, and you can overcome a substance use disorder with professional treatment.

Treating Drug And Alcohol Dependence

Drug and alcohol dependency treatment focuses on stabilizing you physically and psychologically so you can focus less on being uncomfortable and more on learning recovery skills.

The first step in the treatment process is to obtain an assessment from a licensed mental health or substance use treatment provider.

Your provider will use the results of the assessment to develop an individualized, integrative treatment plan, which will typically include several of the following:

• Detoxification
• Inpatient rehab
• Partial hospitalization or intensive outpatient program
• Support groups like 12-step programs
• Aftercare planning

Within the above programs, you can receive the following to help you succeed in treatment and recovery:

• Individual counseling and group therapies
• Behavioral therapies
• Couples therapy or family therapies
• Alternative or holistic treatments

There is no one-size-fits-all treatment plan. Your provider will address your specific needs and preferences throughout your treatment, and your treatment team will focus on healing your whole self.

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How To Get Started

Whether you have a substance dependence, substance use disorder, or are just experimenting with substances, reach out for help so you can get back to living an extraordinary life without alcohol or drugs.

It’s important to remember that while substance dependence may be present without substance abuse, it can frequently lead to an addiction. If you think you are struggling with substance dependence or addiction, contact a treatment provider or explore our rehab directory to discover your treatment options.