What Does it Mean to Be Substance Dependent?

Table of ContentsView AllTable of ContentsDefinitionSubstances That Cause DependenceSymptomsStages of Substance UseCausesDiagnosisTreatment

Table of ContentsView All

View All

Table of Contents

Definition

Substances That Cause Dependence

Symptoms

Stages of Substance Use

Causes

Diagnosis

Treatment

Substance dependence occurs when a person is physically dependent on a substance such as alcohol, nicotine, drugs, or medication to the extent that their body adapts to it and develops a tolerance to it, resulting in withdrawal symptoms when they stop using it.It is a complex condition that affects the person’s brain, body, and behavior.When you are substance dependent, you may struggle with aspects of your normal daily life like school, work, self-care, and relationships. It can also lead to risky behaviors, health problems, legal issues, behavior changes, and other problems that have a reverberating effect on every area of your life. That’s why recognizing the signs and getting help is so important.At a GlanceBecoming substance-dependent leads to tolerance and withdrawal. It can involve the use of depressants, stimulants, hallucinogens, opiates, and marijuana. Signs that a person is substance dependent include needing to use more and more of the substance to experience the same effects, feeling unable to control drug use, having problems functioning normally, and experiencing withdrawal. Problematic use often starts with experimentation and progresses to regular use and eventual dependence. If you think you are substance dependent, it is important to talk to your doctor about your treatment options, which may involve detox, medication, therapy, rehab, and social support.What Does It Mean to Be Substance Dependent?When a person is substance dependent, they have to keep taking more of a substance to experience the same effects, and if they stop taking it, they develop symptoms of withdrawal.Substance dependence and substance abuse used to be classified as separate health conditions in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM), which is the guiding manual for diagnosing mental health conditions.However, the latest edition,DSM-5, has included both conditions under the umbrella term ofsubstance use disorder.According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 20 million people in the United States over the age of 12 experienced a substance use disorder in 2019.It is estimated that substance use disorders cost the United States $420 billion dollars a year.Substances That Can Lead to DependenceThese are some of the most commonly used types of substances:DepressantsDepressants, which reduce anxiety and cause drowsiness.Depressantsincludealcoholas well as certain types of medications such asbenzodiazepines(Valium,Xanax, andAtivan),barbiturates, chloral hydrate, and paraldehyde.StimulantsStimulants, which stimulate the brain and nervous system.Stimulantsinclude drugs likecocaineandamphetamines. Amphetamines are also used in certain stimulant medications, likeRitalin, that help treat conditions likeADHD.HallucinogensHallucinogens, which cause people to hear or see things that don’t exist.Hallucinogensinclude drugs such asLSD,psilocybin(commonly known as mushrooms), mescaline, andphencyclidine(known as PCP or angel dust).Opiates and NarcoticsOpiates and narcotics are strong painkillers that reduce pain, induce drowsiness, and produce feelings of well-being, happiness, and excitement.Opiatesinclude drugs likeheroinand opium, as well as pain-relieving medications, such asVicodinand morphine.MarijuanaMarijuana produces a sense of happiness, calm, and relaxation. While people often perceive marijuana as a less serious or less addictive type of drug, it is important to note that it is still possible tobecome addicted to it. The National Institute on Drug Abuse (NIDA) reports that 30% of people who use marijuana will develop marijuana use disorder.Is It Possible to Overdose on Antidepressants?Symptoms a Person Is Substance DependentThese are some of the symptoms and behaviors associated with substance dependence and substance use disorder:Needing the substance on a daily basisDeveloping atoleranceto the substance and needing to take more of it over time to achieve the same effectLosing control over use of the substance and being unable to stop using itExperiencingwithdrawalsymptoms upon stopping one’s use of the substanceSpending a lot of time procuring, using, and recovering from the aftereffects of the substanceUsing the substance in risky settingsMissing school or work, or performing poorlyAvoiding recreational and social activities due to substance useContinuing to use the substance despite negative consequences to one’s family, work, and healthMaking excuses to use the substanceUsing the substance when aloneResorting to secretive behaviors to hide one’s use of the substanceBecoming hostile when confronted with one’s substance dependenceNeglecting to eat and maintain personal hygieneWhen Does Drug Use Become an Addiction?Stages of Substance UseSubstance use often progresses in stages, which can include:ExperimentationThis stage often involves trying different substances with one’s peers, sometimes with the goal of defying one’s parents or other authority figures.Regular UseThis stage involves using the substance more often, displaying an increased ability to handle it, and starting to develop a tolerance to it. The person may use the substance to try and fix negative feelings. Their loved ones may notice that they are starting to miss school or work, and that they spend less time with their family and friends and more time with people who are misusing drugs as well.DependenceDependence occurs when the person’s body adapts to the substance and becomes physically dependent on it, causing them to need more and more of it to achieve the same effect.Problematic UseThe person prioritizes their use of the substance over everything else, including their relationships, school, work, family, and other interests. They lose all motivation to do anything else and display significant behavior changes. They may worry about losing their source of the substance, engage in risky or secretive behaviors to obtain more of it or even start selling it themselves, to support their habit.AddictionIn thisstage, the person loses control over their use of the substance and cannot face everyday life without it. They deny that they have a problem despite mounting health issues, family conflicts, financial difficulties, and legal problems as a result of their substance use.Young people generally go through these stages much faster than adults do.What Causes a Person to Become Substance Dependent?According to the American Psychiatric Association (APA), addictive substances likealcoholand drugs cause changes in the brain that trigger intense cravings for the substance.However, the APA explains that as the brain and body adapt to the effects of the substance, the person needs to consume more and more of it to achieve the same effect. This leads to a cycle of addiction and dependence that contributes to substance use disorder.A combination of factors can contribute to the risk of developing substance use disorder, including:Social pressuresEnvironmental stressorsGenetic vulnerabilityIndividual personality characteristicsMental health conditionsWhy Does It Seem Like Everyone Has More Than One Mental Illness?Diagnosing Substance DependenceIf you suspect you may have become physically dependent on a prescription medication that your healthcare provider has asked you to take, contact the physician who prescribed the medication to you.On the other hand, if you think you have become dependent on a substance such as alcohol, drugs, nicotine, or prescription medication that you’re not supposed to be taking, contact a healthcare provider such as your family doctor or primary care physician. They can diagnose your condition or refer you to a healthcare provider who can.Your healthcare provider will determine whether your symptoms matchthe criteria for substance use disorder listed in the DSM-5. Depending on how many symptoms you have, your condition may be classified as mild, moderate, or severe.Substance Dependence TreatmentTreatment for substance dependence can vary depending on factors such as:AgeMedical historySymptom severityDependence severityType of substance usedTolerance for medication, procedures, and other treatmentsLifestyle and personal preferenceTreatment Approaches for Substance Use DisorderTreatment approachesfor substance use disorder include:Detoxification, to help flush the substance out of the person’s system. Thedetoxprocess may need to be undertaken at a hospital or treatment facility if the person is at risk of experiencing severe withdrawal symptoms or health complications.Medication, to treat any withdrawal symptoms, reduce cravings for certain substances, and prevent relapse.Therapy, to help the person explore their motivations and behaviors, cope with stressors and triggers, and address any other mental health conditions they may have. Therapy can be performed on an individual basis or group basis, and may involve partners or family members.Rehabilitation, orrehab, which involves staying in a treatment facility for a certain period of time.Mutual-aid groups, such asAlcoholics Anonymous (AA),Narcotics Anonymous (NA), Cocaine Anonymous (CA), orSMART Recovery, that follows a peer-based recovery model.How to Stop an AddictionTakeawaysSubstance dependence and addiction are complex conditions; however, they are treatable. If you or a loved one have become substance dependent, it’s important to seek help and treatment as soon as possible.If you or a loved one are struggling with substance dependence or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.What Does a Substance Abuse Counselor Do?

When you are substance dependent, you may struggle with aspects of your normal daily life like school, work, self-care, and relationships. It can also lead to risky behaviors, health problems, legal issues, behavior changes, and other problems that have a reverberating effect on every area of your life. That’s why recognizing the signs and getting help is so important.

At a GlanceBecoming substance-dependent leads to tolerance and withdrawal. It can involve the use of depressants, stimulants, hallucinogens, opiates, and marijuana. Signs that a person is substance dependent include needing to use more and more of the substance to experience the same effects, feeling unable to control drug use, having problems functioning normally, and experiencing withdrawal. Problematic use often starts with experimentation and progresses to regular use and eventual dependence. If you think you are substance dependent, it is important to talk to your doctor about your treatment options, which may involve detox, medication, therapy, rehab, and social support.

At a Glance

Becoming substance-dependent leads to tolerance and withdrawal. It can involve the use of depressants, stimulants, hallucinogens, opiates, and marijuana. Signs that a person is substance dependent include needing to use more and more of the substance to experience the same effects, feeling unable to control drug use, having problems functioning normally, and experiencing withdrawal. Problematic use often starts with experimentation and progresses to regular use and eventual dependence. If you think you are substance dependent, it is important to talk to your doctor about your treatment options, which may involve detox, medication, therapy, rehab, and social support.

What Does It Mean to Be Substance Dependent?

When a person is substance dependent, they have to keep taking more of a substance to experience the same effects, and if they stop taking it, they develop symptoms of withdrawal.

Substance dependence and substance abuse used to be classified as separate health conditions in the “Diagnostic and Statistical Manual of Mental Disorders” (DSM), which is the guiding manual for diagnosing mental health conditions.However, the latest edition,DSM-5, has included both conditions under the umbrella term ofsubstance use disorder.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 20 million people in the United States over the age of 12 experienced a substance use disorder in 2019.It is estimated that substance use disorders cost the United States $420 billion dollars a year.

Substances That Can Lead to Dependence

These are some of the most commonly used types of substances:

Depressants

Depressants, which reduce anxiety and cause drowsiness.Depressantsincludealcoholas well as certain types of medications such asbenzodiazepines(Valium,Xanax, andAtivan),barbiturates, chloral hydrate, and paraldehyde.

Stimulants

Stimulants, which stimulate the brain and nervous system.Stimulantsinclude drugs likecocaineandamphetamines. Amphetamines are also used in certain stimulant medications, likeRitalin, that help treat conditions likeADHD.

Hallucinogens

Hallucinogens, which cause people to hear or see things that don’t exist.Hallucinogensinclude drugs such asLSD,psilocybin(commonly known as mushrooms), mescaline, andphencyclidine(known as PCP or angel dust).

Opiates and Narcotics

Opiates and narcotics are strong painkillers that reduce pain, induce drowsiness, and produce feelings of well-being, happiness, and excitement.Opiatesinclude drugs likeheroinand opium, as well as pain-relieving medications, such asVicodinand morphine.

Marijuana

Marijuana produces a sense of happiness, calm, and relaxation. While people often perceive marijuana as a less serious or less addictive type of drug, it is important to note that it is still possible tobecome addicted to it. The National Institute on Drug Abuse (NIDA) reports that 30% of people who use marijuana will develop marijuana use disorder.

Is It Possible to Overdose on Antidepressants?

Symptoms a Person Is Substance Dependent

These are some of the symptoms and behaviors associated with substance dependence and substance use disorder:

When Does Drug Use Become an Addiction?

Substance use often progresses in stages, which can include:

Experimentation

This stage often involves trying different substances with one’s peers, sometimes with the goal of defying one’s parents or other authority figures.

Regular Use

This stage involves using the substance more often, displaying an increased ability to handle it, and starting to develop a tolerance to it. The person may use the substance to try and fix negative feelings. Their loved ones may notice that they are starting to miss school or work, and that they spend less time with their family and friends and more time with people who are misusing drugs as well.

Dependence

Dependence occurs when the person’s body adapts to the substance and becomes physically dependent on it, causing them to need more and more of it to achieve the same effect.

Problematic Use

The person prioritizes their use of the substance over everything else, including their relationships, school, work, family, and other interests. They lose all motivation to do anything else and display significant behavior changes. They may worry about losing their source of the substance, engage in risky or secretive behaviors to obtain more of it or even start selling it themselves, to support their habit.

Addiction

In thisstage, the person loses control over their use of the substance and cannot face everyday life without it. They deny that they have a problem despite mounting health issues, family conflicts, financial difficulties, and legal problems as a result of their substance use.

Young people generally go through these stages much faster than adults do.

What Causes a Person to Become Substance Dependent?

According to the American Psychiatric Association (APA), addictive substances likealcoholand drugs cause changes in the brain that trigger intense cravings for the substance.

However, the APA explains that as the brain and body adapt to the effects of the substance, the person needs to consume more and more of it to achieve the same effect. This leads to a cycle of addiction and dependence that contributes to substance use disorder.

A combination of factors can contribute to the risk of developing substance use disorder, including:

Why Does It Seem Like Everyone Has More Than One Mental Illness?

Diagnosing Substance Dependence

If you suspect you may have become physically dependent on a prescription medication that your healthcare provider has asked you to take, contact the physician who prescribed the medication to you.

On the other hand, if you think you have become dependent on a substance such as alcohol, drugs, nicotine, or prescription medication that you’re not supposed to be taking, contact a healthcare provider such as your family doctor or primary care physician. They can diagnose your condition or refer you to a healthcare provider who can.

Your healthcare provider will determine whether your symptoms matchthe criteria for substance use disorder listed in the DSM-5. Depending on how many symptoms you have, your condition may be classified as mild, moderate, or severe.

Substance Dependence Treatment

Treatment for substance dependence can vary depending on factors such as:

Treatment Approaches for Substance Use DisorderTreatment approachesfor substance use disorder include:Detoxification, to help flush the substance out of the person’s system. Thedetoxprocess may need to be undertaken at a hospital or treatment facility if the person is at risk of experiencing severe withdrawal symptoms or health complications.Medication, to treat any withdrawal symptoms, reduce cravings for certain substances, and prevent relapse.Therapy, to help the person explore their motivations and behaviors, cope with stressors and triggers, and address any other mental health conditions they may have. Therapy can be performed on an individual basis or group basis, and may involve partners or family members.Rehabilitation, orrehab, which involves staying in a treatment facility for a certain period of time.Mutual-aid groups, such asAlcoholics Anonymous (AA),Narcotics Anonymous (NA), Cocaine Anonymous (CA), orSMART Recovery, that follows a peer-based recovery model.

Treatment Approaches for Substance Use Disorder

Treatment approachesfor substance use disorder include:Detoxification, to help flush the substance out of the person’s system. Thedetoxprocess may need to be undertaken at a hospital or treatment facility if the person is at risk of experiencing severe withdrawal symptoms or health complications.Medication, to treat any withdrawal symptoms, reduce cravings for certain substances, and prevent relapse.Therapy, to help the person explore their motivations and behaviors, cope with stressors and triggers, and address any other mental health conditions they may have. Therapy can be performed on an individual basis or group basis, and may involve partners or family members.Rehabilitation, orrehab, which involves staying in a treatment facility for a certain period of time.Mutual-aid groups, such asAlcoholics Anonymous (AA),Narcotics Anonymous (NA), Cocaine Anonymous (CA), orSMART Recovery, that follows a peer-based recovery model.

Treatment approachesfor substance use disorder include:

How to Stop an Addiction

Takeaways

Substance dependence and addiction are complex conditions; however, they are treatable. If you or a loved one have become substance dependent, it’s important to seek help and treatment as soon as possible.

If you or a loved one are struggling with substance dependence or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.For more mental health resources, see ourNational Helpline Database.

For more mental health resources, see ourNational Helpline Database.

What Does a Substance Abuse Counselor Do?

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Is there a difference between physical dependence and addiction?.Wada K.Abuse, dependence, and intoxication of substances.Nihon Rinsho. 2015;73(9):1450-1456.American Psychiatric Association.Substance-related and addictive disorders.Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States.Mclellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.National Library of Medicine.Substance use disorder.Medline Plus.Hser Y-I, Mooney LJ, Huang D, et al.Reductions in cannabis use are associated with improvements in anxiety, depression, and sleep quality, but not quality of life.Journal of Substance Abuse Treatment.2017;81:53-58. doi:10.1016/j.jsat.2017.07.012American Psychiatric Association.What is a substance use disorder?Johns Hopkins Medicine.Substance abuse and chemical dependency.

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Is there a difference between physical dependence and addiction?.Wada K.Abuse, dependence, and intoxication of substances.Nihon Rinsho. 2015;73(9):1450-1456.American Psychiatric Association.Substance-related and addictive disorders.Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States.Mclellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.National Library of Medicine.Substance use disorder.Medline Plus.Hser Y-I, Mooney LJ, Huang D, et al.Reductions in cannabis use are associated with improvements in anxiety, depression, and sleep quality, but not quality of life.Journal of Substance Abuse Treatment.2017;81:53-58. doi:10.1016/j.jsat.2017.07.012American Psychiatric Association.What is a substance use disorder?Johns Hopkins Medicine.Substance abuse and chemical dependency.

National Institute on Drug Abuse.Is there a difference between physical dependence and addiction?.Wada K.Abuse, dependence, and intoxication of substances.Nihon Rinsho. 2015;73(9):1450-1456.American Psychiatric Association.Substance-related and addictive disorders.Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States.Mclellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.National Library of Medicine.Substance use disorder.Medline Plus.Hser Y-I, Mooney LJ, Huang D, et al.Reductions in cannabis use are associated with improvements in anxiety, depression, and sleep quality, but not quality of life.Journal of Substance Abuse Treatment.2017;81:53-58. doi:10.1016/j.jsat.2017.07.012American Psychiatric Association.What is a substance use disorder?Johns Hopkins Medicine.Substance abuse and chemical dependency.

National Institute on Drug Abuse.Is there a difference between physical dependence and addiction?.

Wada K.Abuse, dependence, and intoxication of substances.Nihon Rinsho. 2015;73(9):1450-1456.

American Psychiatric Association.Substance-related and addictive disorders.

Substance Abuse and Mental Health Services Administration.Key substance use and mental health indicators in the United States.

Mclellan AT.Substance misuse and substance use disorders: why do they matter in healthcare?Trans Am Clin Climatol Assoc. 2017;128:112-130.

National Library of Medicine.Substance use disorder.Medline Plus.

Hser Y-I, Mooney LJ, Huang D, et al.Reductions in cannabis use are associated with improvements in anxiety, depression, and sleep quality, but not quality of life.Journal of Substance Abuse Treatment.2017;81:53-58. doi:10.1016/j.jsat.2017.07.012

American Psychiatric Association.What is a substance use disorder?

Johns Hopkins Medicine.Substance abuse and chemical dependency.

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At a Glance#

What Does It Mean to Be Substance Dependent?#

Substances That Can Lead to Dependence#

Depressants#

Stimulants#

Hallucinogens#

Opiates and Narcotics#

Marijuana#

Symptoms a Person Is Substance Dependent#

Experimentation#

Regular Use#

Dependence#

Problematic Use#

Addiction#

What Causes a Person to Become Substance Dependent?#

Diagnosing Substance Dependence#

Substance Dependence Treatment#

Treatment Approaches for Substance Use Disorder#

Takeaways#