It is interesting to note that there is a discussion among certain professional folk regarding the use (and abuse) of the words addiction and dependence.
According to the dictionary, addiction is a term that refers to the state of being enslaved to a habit or practice or to something that is psychologically or physically habit-forming, as narcotics, to such an extent that its cessation causes severe trauma. At the same time, dependence is defined as the state of being psychologically or physiologically dependent on a drug after a prolonged period of use.
Obviously the terms have been used interchangeably -- both imply a reliance upon substances (or conditions) that cause a psychological and physical habit, yet, according to professionals, there is a difference. The rationale for determining and defining the difference is ever more present as our baby-boomer population ages. With age comes chronic conditions, which, can often mean pain and pain treatment. It is this condition that has prompted the medical and research professionals to determine and define the difference between dependence and addiction -- as pain maintenance often requires narcotics.
However, even as the professionals debate, other organizations are proactive in defining addiction and dependence. According to the American Pain Society, The American Academy of Pain Medicine, and the American Society of Addiction Medicine, there is a distinct difference between these two terms. Their consensus provides an alternative definition to these states (that clarifies the ambiguous definition provided in medical bible: the DSM).
Hence, the definition for addiction, according to the above bodies is:
a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Whereas, the definition of physical dependence is:
a state of adaptation that is manifested by a drug-class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.
While definitions cannot help the person suffering from addiction (or dependence) they can help the professionals that come in contact with these individuals. A better understanding of the condition can lead to a better understanding of how to treat the condition -- and this allows us not to assume that the treatment for addicts is as simple as the treatment for dependents.
For more information on the debate on terms go to:
http://ajp.psychiatryonline.org/cgi/content/full/163/11/2014-a
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