Drug Dependence

Written by Marissa Selner | Published on July 18, 2012
Medically Reviewed by George Krucik, MD


Drug dependence occurs when you require one or more drugs to function normally. You may have a medical condition, such as high blood pressure or chronic pain, which requires you to take drugs to maintain your quality of life. This might be considered “drug dependence,” but is probably not a problem. Drug dependence becomes a health concern, however, when an individual abuses illegal or prescription drugs.

Intermittent abuse can evolve into dependence. Eventually, you can’t live a normal life without the drug. You may use larger doses or other types of drugs to overcome the tolerance that develops with regular use.

Addiction vs. Dependence

Drug addiction and drug dependence are sometimes interchangeable. Many addicts depend on drugs to function. It is possible, however, to be dependent on drugs without being addicted. This often occurs if you rely on medications to control a chronic medical condition. It is also possible to be addicted to drugs without your body becoming dependent on them.

Characteristics of Addiction

  • use of drugs despite the consequences
  • inability to stop using drugs
  • neglect of social and work obligations

Characteristics of Dependence

Features of dependence may include some or all of the features of addiction, plus:

  • high tolerance as the body physically adapts to the drug, often leading to the desire for larger or more frequent doses
  • physical symptoms of withdrawal when attempting to stop using the drug

How Drug Abuse Can Lead to Dependence

Drug addicts often begin using drugs socially and become dependent over time. In some cases, drugs may have been initially prescribed to treat a medical condition (e.g. pain medication). This normal and safe use can sometimes develop into abuse and dependence.

Compulsive drug use may be triggered by:

  • a family history of addiction (addictive personalities may be genetic, and watching family members abuse substances can make drugs seem more normal or desirable)
  • living in an environment where illegal drugs are frequently used and easy to access
  • a history of anxiety, depression, or other mental health conditions

Stages of Drug Use

According to the National Institutes of Health, drug users typically pass through certain stages on the way to drug dependence:

1. You use drugs for recreation. Drugs are taken infrequently and in social settings.

2. You start using drugs on a regular basis, often abandoning family and friends in favor of drug use. You become concerned about losing access to drugs.

3. You become addicted to drugs and preoccupied with getting access to them. You may abandon most or all of your previous interests and relationships.

4. You become dependent on drugs and unable to live without them. Your physical and mental health deteriorates.

Recognizing the Signs of Drug Dependence

It can be difficult to differentiate the symptoms of dependence and the symptoms of addiction. Both conditions are characterized by a preoccupation with drugs, secretive behavior, and avoidance of activities and relationships that were once important. Drug addicts may also neglect their appearance and may suffer extreme fluctuations in weight.

You can often determine whether an addiction has evolved into dependence by observing the addict’s behavior when he or she has not had access to drugs for a significant period of time. Physical symptoms of withdrawal occur when the body becomes stressed without the drug. Symptoms may include:

  • anxiety
  • depression
  • muscle weakness
  • nightmares
  • body aches
  • sweating
  • nausea
  • vomiting

Treating Drug Dependence

When drug abuse escalates to dependence, treatment becomes complicated. Ultimately, you must stop the using the drug, but doing so abruptly can cause harsh physical side effects. You may need to enter a residential detoxification program or attend one on an outpatient basis.

Substances that mimic the effects of illegal drugs may be given to reduce the symptoms of withdrawal during treatment. Detox programs use a combination of therapy and medical care to ease dependence and ultimately stop the addiction. Ongoing therapy sessions may be required for an extended period of time after you are released from a treatment program.

Extreme cases of intoxication, withdrawal, or overdose may require emergency care before addiction and dependence can be treated.

Long-Term Outlook for Drug Dependence

If left untreated, drug dependence is very dangerous. You may increase your drug use as your body adapts to the drugs, which can result in overdose and death.

Treatment may reverse dependence if it is caught early and if you are willing to be treated. Sometimes treatment is successful the first time, but relapse is common among drug addicts. Ongoing therapy and support groups can help recovering addicts stay on track and address signs of relapse.

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