It’s easy to say that addiction is the problem while others insist on using the term dependence. But is there a difference? Here’s how these terms compare and why we should consider the similarities and differences between them to understand alcoholism better.
Addiction, Dependence, or Something Else?
Before dealing with the particulars of alcohol addiction and dependence, it’s helpful to take a step back and look at the big picture. Substance use disorder (SUD) is an umbrella term used to describe abuses and/or dependence on alcohol and illicit drugs. Rather than using terms like “addiction” or “dependence,” the American Psychiatric Association (APA) ranks SUDs in three categories: mild, moderate, and severe. Whether someone has alcohol use disorder (AUD) can be determined by various factors, such as if ongoing alcohol use significantly impairs their health, causes their disabilities, or makes them unable to meet their daily responsibilities.
On the other hand, if someone can abstain from alcohol by willpower alone, it is unlikely they have a SUD. Because of this, being unable to control one’s drinking is a sign that AUD has developed. Many contributing factors in someone’s life could lead up to them developing a substance use disorder. Risk factors include biology, home environment, and childhood development. However, not everyone experiences all of these. Some people can have alcohol use disorder without any of the added risk factors.
How They Relate
So, how do these considerations help explain addiction and dependence? First, we have to recognize that not everyone who uses the terms “addiction” and “dependence” mean the same thing. That’s why it’s helpful to start with a working definition of a SUD. And now that we’ve done that, we can clarify things further by relating each term to a SUD. Of the two terms, alcohol addiction relates closer to alcohol use disorder. The reason is that an addiction can be identified by characteristics, such as increased tolerance, withdrawal symptoms, hiding alcohol use, or not being able to stop drinking despite the negative consequences. Dependence, on the other hand, would describe the body’s buildup of tolerance to alcohol. By these definitions, alcohol addiction relates more closely to the proper term: alcohol use disorder. Someone could be dependent on alcohol without being addicted, but someone who is addicted is automatically dependent. With that said, if someone has alcohol use disorder, they are addicted and dependent on alcohol.
Another thing to look for in distinguishing whether someone is addicted to alcohol or dependent on it has to do with how they use alcohol functionally. Addiction can create a crash landing in someone’s entire life because their responsibilities and personal health take a back seat to alcohol use. On the other hand, alcohol dependence can appear as a non-violent, non-destructive lifestyle, but in actuality, a person has a physical or psychological need to use alcohol frequently.
Dealing with the Complexities
Understanding the similarities and differences between alcohol addiction and alcohol dependence is an important part of combating the aftermath of death or serious health issues that come with an untreated alcohol use disorder. If we want to take alcohol off the list of preventable causes of death, we must understand the complexities of alcohol and how they affect each person.
When we understand these different terms and categories of alcoholism, we can better support friends and family members who are struggling with alcohol dependence or addiction. And if we are struggling with alcohol use, understanding these terms can help put our own lives into perspective and point us in the right direction toward detoxing and recovery with professional medical help.
