Substance Use Disorder and Physical Dependence: What’s the Difference?

Substance use disorder (SUD) and physical dependence on substances are not the same. “Substance use disorder” is the medical term for addiction. It can happen without dependencies. SUD applies when a person is forced to use a substance despite harmful consequences to their health, finances and/or relationships.

SUDs can produce changes in the brain that make it especially difficult to stop using the drug. Depending on the substance and severity of the addiction, a person may experience mild to severe withdrawal symptoms and cravings while trying to quit, making continued use more difficult.

Physical dependence is when a person’s body adapts to the presence of a certain drug in their system. Without this substance, a person may experience physical symptoms. When physical dependence arises, addiction often follows.

This article will share more about the difference between substance use disorder and physical dependence. Be sure to speak with your PCP if you have concerns about any medications you are taking and the potential for dependence and addiction.


Physical dependence on a drug can manifest as tolerance or withdrawal from the substance. These are considered symptoms of SUD, but they do not need to be present to make a diagnosis of SUD. Tolerability is when you need a larger amount of the drug to get the same effect. Withdrawal symptoms are physical symptoms that occur when a substance is reduced or stopped as the body readjusts to not having the substance.

Symptoms of substance use disorder include:

  • Seek, protect, and use behavior that has become a priority
  • Continuing to use drugs despite harmful consequences
  • Uncontrollable use (i.e. difficult to reduce or stop using)
  • Neglecting social and work obligations due to drug use
  • Tolerance to the substance as your body adapts to the drug, leading to cravings for larger or more frequent doses
  • Withdrawal symptoms vary by drug type
  • Brain changes in areas critical to judgment, decision-making, learning, memory, and behavioral control

Causes and dependencies of SUD

About half of the risk of addiction or substance use disorder is genetic. The reason is that genes can affect how people receive rewards when they initially use a substance, and how the body processes alcohol or other drugs.

Other contributing factors include:

  • Environmental stressors, such as being unsafe at home or experiencing trauma
  • Social pressures and norms, such as peer pressure
  • Personal Character Traits
  • mental problems
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Dependence is caused by a persistent drug in your system. For example, a person may become physically dependent on an antidepressant medication used to treat depression and even experience withdrawal symptoms when tapering or stopping use. This is because your body has adapted to the drug. This is not the same as being addicted to antidepressants.

Prescription Drug Addiction: Signs and Symptoms

Diagnose SUD and dependencies

A diagnosis of a substance use disorder usually occurs after discussing your medical history and symptoms with your primary care provider, psychiatrist, or qualified mental health professional. The clinician will take into account your medical history (including whether SUD is used in the household), the substances you are using, the frequency of use, and the length of time since your last use to determine exactly whether use is a problem. You may be asked a question A series of questions about your usage and how it affects your relationships and responsibilities.

Medical professionals consider all of the following factors when evaluating someone for a substance use disorder:

  • lose weight
  • persistent fatigue
  • Hygiene changes
  • Lab Test Abnormal
  • Unexpected abnormalities in heart rate or blood pressure
  • Depression, anxiety, or sleep problems


Substance use disorder and physical dependence are treated differently, which is why understanding the difference between the two is so important.

Treating Substance Use Disorders

Substance use disorders are treatable. Depending on the severity of use, treatment may involve inpatient or outpatient support, including medical detox programs, various forms of therapy such as cognitive behavioral therapy (CBT) or home-based interventions, medication-assisted treatment for SUD (if applicable), and Peer Support or Recovery Services Group.

Treatment for SUD may also involve taking medication to treat comorbid conditions such as depression or anxiety that can lead to use disorders.

According to the National Institute on Drug Abuse (NIDA), the goal of treating SUD is to allow you to:

  • stop using the drug
  • do not return to use
  • Be productive at home, at work, and in society

Only about 1 in 10 people with substance use disorders receive any type of professional treatment. This is primarily due to denials related to the severity and illusion of control associated with substance use disorders, but also to financial constraints and inability to access services or not knowing that such services are available.

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The right treatment is one that you can and are willing to receive that will help you achieve and maintain abstinence. Abstinence from drug and/or alcohol use during treatment and during recovery from substance use disorder is associated with more positive long-term outcomes.

How to treat addiction?

treatment of physical dependence

People who are being treated for physical dependence in the absence of any substance use disorder will be closely monitored by the prescribing healthcare provider as they slowly reduce or reduce the dose over time rather than all at once. Medications may be needed to reduce the effects of any withdrawal symptoms.

Since there are many substances that can create physiological dependencies, each requires an individualized approach.

However, not all physical dependencies should be seen as something in need of repair. Keep in mind that a person may rely on certain medications to treat chronic conditions that they need for the rest of their lives. For example, people with type 1 diabetes (sometimes called insulin-dependent diabetes) do not receive treatment for this dependence because it is necessary for their survival.

ask for help

If you are struggling with an addiction and concerned about relapse, you can call the Substance Abuse and Mental Health Services Administration (SAMHSA) at 800-662-HELP (4357) for more information about treatment options.

If you are in crisis or suicidal, you can seek support by calling the National Suicide Prevention Lifeline at 800-273-TALK (8255) or texting “HOME” to 741741 to chat with someone on the Crisis Text Line.

If you have a medical emergency and need immediate care, please call 911.


It is possible to prevent the use of problematic substances. Different methods of prevention are available, depending on whether the substance is a prescription drug or can be found over the counter or elsewhere.


Some drugs have a higher risk of misuse and developing substance use disorders. They include opioid pain relievers, stimulants used to treat ADHD (attention deficit hyperactivity disorder), and benzodiazepines used to treat anxiety or sleep disorders.

Prevention of substance use disorders in these situations begins with screening patients for prior or current substance use problems and assessing their family history of substance abuse or addiction before prescribing psychotropic medications. It also includes close monitoring of patients taking such drugs.

According to NIDA, prescribing healthcare providers also need to educate patients about the potential risks so that they can follow the provider’s instructions, protect their medications, and dispose of them appropriately.

Keep your healthcare provider informed

You can help prevent problematic substance use by following your healthcare provider’s instructions and attending regular follow-up visits or checking in with the same prescribing provider.

Non-prescription drugs

Dependence and use disorders can also develop when taking over-the-counter substances, including alcohol and marijuana, and hallucinogens (drugs that cause hallucinations). While there is no single way to prevent substance use disorders, here are all strategies for reducing risk:

  • Learn what substance use disorder is and how it develops.
  • Develop healthy friendships that do not involve the stress of using drugs.
  • Seek professional help for mental health problems (avoid self-treatment).
  • Find out about your personal risk factors, including whether SUD affects family members.
  • Develop healthy stress management strategies to help you live a balanced life (avoid running away from your emotions with drugs)
  • Talk to someone if you think you or someone else is having a drug problem

Support loved ones​​​

For spouses and family members of people with substance use disorders, participating in a support group (such as Al-Anon) and seeking help from a mental health professional may be critical.

Choose the right therapist


Substance use disorder and physical dependence are related, but not the same. “Substance use disorder” is the medical term for addiction and physical dependence, which describes the physical dependence of your body on a substance. The lines between the two can sometimes blur, though, especially when discussing habit-forming prescriptions like opioids.

When taking prescription drugs or using any substance, it is best to maintain an open and ongoing conversation with your healthcare team and monitor for signs of use problems. You can also discuss any questions you may have with your local pharmacist at any time.

VigorTip words

There is no shame in experiencing a substance use disorder or physical dependence. Many factors can contribute to the development of any of these. Thankfully, there are help and many treatment options. Consult your healthcare provider if you are concerned that you may have any type of substance use disorder. Relying on a supportive community of loved ones can help as you go through the recovery process.

Relapse after recovery