If you or a loved one is grappling with substance abuse or physical and psychological dependence, they may be inclined to ask: why can’t I/they merely choose to stop using?
Unfortunately, the reasons why a person continues to abuse drugs or alcohol are not always clear cut and may, in fact, be quite complex. Some individuals continue to use due to being chemically dependent, and others do so for deep-seated emotional reasons. For those with full-blown addiction, however, both components are included.
Understanding the difference between psychological and physical or chemical dependence and how they are intertwined and are both hallmark characteristics of addiction can benefit you if you’re concerned about your substance use patterns or those of a loved one.
Addiction is an insidious disease but is very treatable. The more understanding you have about the disorder, the better you may be able to help yourself or a loved one get through treatment successfully and sustain long-term recovery.
What Is Psychological Dependence?
Psychological dependence is an emotional reliance on drugs or alcohol that adversely interferes with an individual’s thoughts, feelings, and mental health.
Common symptoms of psychological dependence include the following:
- Cravings or urges to use one’s substance(s) of choice
- Anxiety manifests when faced with the possibility of losing access to one’s substance(s) of choice
- Irritability, agitation, or mood swings when questioned about substance abuse or while attempting to quit
- Depression while attempting to discontinue drug or alcohol use
- Feeling that drugs or alcohol are needed to cope with daily stressors, including mental health issues such as anxiety
- Recurring or persistent thoughts about obtaining drugs or alcohol
It’s important to stress that while not all psychoactive drugs are believed to lead to physical dependence, many drugs that do not may still be habit-forming, and a psychological reliance has the potential to develop.
Physical Dependence and Full-Blown Addiction
There is a considerable amount of medical and social terminology associated with substance abuse, dependence, and addiction. Many terms are frequently used interchangeably, but they are not always used in the proper context. It’s essential to know the difference between physical and psychological dependence and how both of these factors are two sides of the same coin, and how they play into addiction.
Physical dependence (also sometimes referred to as chemical or physiological dependence) on a substance means a person will experience physical withdrawal symptoms if they decrease their dosage significantly or stop using the drug all together.
These symptoms can vary depending on the substance and the amount of use or abuse. Some physical withdrawal symptoms are more mild, such as nausea and vomiting, headache, and shakiness. Others, like in the case of alcohol and benzodiazepines, can include life-threatening symptoms, such as seizures.
This type of dependence also tends to include tolerance to alcohol or a specific drug. When tolerance develops, over time, the body has become used to operating with exposure to a certain amount. For this reason, the person begins to require ever-increasing amounts of the substance(s) that they are dependent upon to achieve the sought-after effects.
Health organizations roughly define addiction as a chronic brain disease characterized by compulsive drug-seeking and using that has become difficult to control, despite the incurrence of adverse consequences.
Addiction actually causes functional and structural changes in the brain’s pleasure and reward centers, making it challenging for an individual to stop using long-term or permanently. This is one of the reasons that addiction is classified as a chronic disease. Although it can be managed and treated, similar to other chronic health conditions, such as diabetes, currently, there is no surefire cure for addiction that works for everyone.
Examples of addictive behaviors include the following:
- Being unable to control or stop drug or alcohol use despite failed attempts to do so
- Placing oneself or others in harm’s way while using
- Failing to meet obligations at home, work, school, etc. in favor of drinking or using drugs
- Engaging in illegal activities, such as dealing drugs or stealing to obtain the substance(s) of choice
Dependence Without Addiction
While psychological and physical dependence can and often do co-exist, the two conditions also occur independently. An example is an individual taking prescription amphetamines, such as Adderall, precisely as directed by their health provider. Over time, however, this person may become chemically reliant on the medication, and if they were to stop using the medicine abruptly, they would experience physical withdrawal symptoms.
However, if the person is not engaging in compulsive and abusive drug-seeking behaviors, such as using more of the medication than prescribed or more often than directed, they would not be classified as having an addiction.
It’s possible to have a psychological dependence on a substance without having addiction, as well. For example, an individual may have a glass of wine every night when they come home from work. Over time, they may associate this act of moderate drinking with relaxation after a long day. If they cannot have their nightly glass of wine, they may feel anxious or concerned they won’t be able to wind down.
However, like the Adderall example, if this individual is not experiencing withdrawal symptoms or engaging in addictive behaviors, such as losing control of alcohol use, from a clinical perspective, they would not likely be considered to be in imminent danger of developing an addiction.
Substances commonly associated with psychological dependence, but not necessarily chemical dependency, include marijuana, salvia, cocaine, and hallucinogens, such as LSD and psilocybin mushrooms.
Drugs that have a high potential for physical dependence but are also linked to psychological dependence include alcohol, opioids such as prescription painkillers and heroin, and benzodiazepines such as Xanax and Valium.
Treatment for Substance Abuse, Dependence, or Addiction
When an individual enters treatment for drug or alcohol addiction, the first step is to detox from drugs and/or alcohol. During detox, the objective is to eliminate toxic and addictive substances from the person’s system. Although uncomfortable, this is one of the easier parts of treatment.
Physical withdrawal symptoms tend to follow a general timeline. Although they can vary in their forms and intensity, health care providers and addiction specialists typically know what to expect when individuals are undergoing detox.
Detox is focused explicitly on treating physical withdrawal symptoms related to physiological dependence. However, once detox is over, many individuals need to continue treatment to address their emotional dependence on drugs or alcohol.
Reputable substance abuse treatment centers should have comprehensive services that address varying forms of dependence and addiction, such as psychotherapy, counseling, support groups, psychoeducation classes, medically-assisted treatment, relapse prevention planning, and a wide variety of other therapeutic methodologies and activities.
When to Seek Professional Help
While some people can safely address the symptoms of physical dependence at home, many individuals find that treating psychological dependence on drugs or alcohol is most effective when performed under the care of mental health providers and addiction specialists. Choosing a rehab facility that focuses on personalized care may be essential to maintaining long-term sobriety.
Just Believe Recovery Center is committed to providing the most effective, customized treatment plans for everyone we treat. Our programs focus on treating all aspects of addiction—including psychological and chemical dependence. We’re here to help you take the first step down the road to sustainable recovery.