The Difference Between Dependence and Addiction

These terms are used synonymously so often that you may not realize that there is a difference. Dependence means that your body has become physically reliant on the substance. That means that there is an increased tolerance and withdrawal when you cease using regularly. Increased tolerance and withdrawal does not necessarily mean you are addicted, although that is the next step in the progression.

Addiction is marked by a biochemical change in the brain caused by the use of the substance, indicating a mental as well as physical dependence. Irrational behavior is a marked symptom when the drug of choice is not readily available. For many, by the time you are experiencing withdrawal symptoms, you have already started to prioritize using over almost anything else, causing problems in your personal, academic or professional life. For this reason, the scientific community uses the term substance disorder.

What Addiction Does to Your Brain

Drugs and alcohol affect the neurotransmitters in your brain. Neurotransmitters are responsible for releasing dopamine, the chemical that signals pleasure and reward. Since dopamine also affects memory and learning, it is a natural step from use to abuse. Once the brain registers the euphoria from the drug use, it learns that it can repeat the feeling with further use.

Unfortunately, the brain also adapts to the use and needs more of the substance to register a similar level of pleasure. Escalating usage ushers in abuse, which brings less and less pleasure while the need increases. The physiological changes caused by substance abuse can lead to irreversible brain damage over time. Harvard Medical School refers to addiction as “serving while destroying.” This hijacking of the brain proves that addiction is far from a matter of choice or willpower and makes recovery very difficult.

What Addiction Does to Your Body

Substance or alcohol abuse affects every major organ in the body. Prolonged use can result in liver failure, heart disease, kidney failure, some cancers, overdose or death. Alcohol use can cause injury like cirrhosis of the liver, organ damage or failure and cancer. Long term use can cause the immune system to become compromised, making the user prone to other illnesses or diseases.

Addiction causes external changes, as well. The user appears to age prematurely. The skin, hair, teeth and nails change, taking on a yellow hue. They lose weight, giving them a gaunt look. Acne, ulcers and other skin conditions can occur, as well as tooth decay, tooth loss and hormone disruption.

What Happens When You Stop Cold Turkey

Cold turkey is a rapid detox method that is the substance abuse equivalent of ripping off a bandage. The term comes from the goosebumps that many people experience in the early days of withdrawal that look like the skin of a turkey in the refrigerator. Proponents claim that it allows you to get the inevitable discomfort from withdrawal over with more quickly so that you can progress to healing and recovery.

For reference, let’s look at what happens to someone addicted to alcohol. Their brains are used to increased levels of dopamine and gamma-aminobutyric acid commonly referred to as GABA. While dopamine affects pleasure and memory, GABA affects how the body reacts to stress, resulting in slowed breathing, heart rate, blood pressure, and lower body temperature.

Like benzodiazepines, barbiturates, opioids and other central nervous system depressants, alcohol releases GABA. Withdrawal exhibits symptoms that are the opposite of the effects of alcohol. Within eight hours of stopping, the low blood alcohol will trigger exhibitions of severe anxiety, raised body temperature and hand tremors. These symptoms will peak at 72 hours and will continue for up to seven days.

According to the New England Journal of Medicine, rapid cessation of alcohol consumption can cause acute withdrawal. 3-5% of people will suffer from grand mal convulsions or delirium, and some of those result in death. The severity of withdrawal is rated from 0-8, with zero indicating no symptoms. Some of the other severe indications include constant nausea and vomiting, drenching sweats, severe tremors, continuous hallucinations, severe headache and agitation.

After the Withdrawal

For those who choose to undertake this drastic and potentially dangerous method and successfully quit using alcohol or other depressants, there is another syndrome known as post-acute withdrawal syndrome or PAWS. In short, the person may not drink anymore, but they have not addressed the underlying condition that caused problems in the first place.

Some mood symptoms are:

• Anger 
• Irritability
• Resentment
• Impatience
• Restlessness

Some behavioral symptoms include:

• Aggressive behavior
• Harsh judgment, criticality and blaming others
• Trouble sleeping
• Dishonesty
• Other addictive behaviors

Addiction is frequently about much more than substance abuse. Without help to understand the underlying motivations, you may be destined to repeat the same or other destructive behaviors. The realization that life is not as expected can lead to refuse, depression or even suicidal thoughts.

What Happens When You Taper Off Slowly

The purpose of tapering off of drugs or alcohol is to try to avoid severe withdrawal and prevent life-threatening complications. While you may still experience withdrawal, it may be much less severe. Some of the most common symptoms with tapering off include anxiety and headache. However, without the right support to understand the precise amount to reduce, trying to taper off of drugs like heroin and methamphetamine can frequently cause relapse as withdrawal symptoms strike.

Opioids are incredibly addictive and very difficult to kick, leading to a worldwide epidemic of opioid abuse. That is why opioid replacement therapy has become more accepted as a way to taper off. In ORT, patients are supplied with small amounts of an opioid replacement like methadone and naloxone in measured doses. The dosage is cut each day over weeks until the user can function without opioid use or withdrawal symptoms.

Choose To Live Clean

Substance abuse and substance use disorders are complicated. The motivation, the brain’s adaptation, the body’s reaction when the substance is no longer supplied, all require support and specialized treatment to recover safely and successfully. Cessation of alcohol, depressants or stimulants like cocaine or Adderall can trigger severe and potentially fatal withdrawal symptoms. Even those who manage to stop the substance abuse may still suffer from destructive behaviors that prevent them from living a full, rewarding life with healthy relationships.

If you, a friend or a family member is suffering from substance or alcohol abuse, there is help available. Clean Recovery Centers take a holistic approach to treating addiction, healing the mind, body and spirit. Our programs are different than most. We focus on the strengths of the individual, not the weaknesses, and build from there to help the patient get clean and stay clean. For questions or more information on our medical detox, residential and outpatient treatment programs, contact us today.

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