The Difference Between Tolerance, Dependence and Addiction

You might hear the terms tolerance, dependence and addiction in reference to prescription drug use.  It’s important to know that these three terms do not all mean the same thing, so let’s break them down:

Tolerance

Tolerance is when a person’s body doesn’t respond to a drug as much as when they first started taking it. For example, a medication isn’t relieving pain as much as it used to. When a person develops tolerance, their body needs a larger amount of the drug to produce the same effects.

Dependence

Dependence is when a person uses a medication and then when they try to take less of the medication or stop using it, they experience withdrawal. Withdrawal is usually seen as a physical symptom that ranges from being mild (like headaches) to life-threatening (like slowed heart rate or breathing). Withdrawal can also cause mental symptoms such as irritability, anxiety and mood swings.

Addiction

Addiction is a chronic disease that can last a long time and requires treatment. When someone starts taking a drug and the need to use it becomes uncontrollable over time; this may be a sign of addiction. This can even happen when a person starts taking a medication as prescribed by their health care provider. If a person shows drug-seeking behaviors, loss of self-control and can’t stop taking the drug, despite the negative effects from using it (such as failing to follow through on work or social commitments), they may have an addiction.

Addiction happens due to multiple social, biological and psychological factors. Some factors cannot be controlled such as genetic makeup, socioeconomic status and family environment. People can also develop addictions from other harmful behaviors such as gambling or using nicotine, marijuana, THC or illicit drugs.

Key takeaways:

Tolerance and dependence refer to the negative physical and mental impacts that can occur from using drugs. However, addiction is a psychological condition that occurs from changes in the brain after using substances. Many people who take a prescription drug exactly as prescribed by their health care provider can become dependent or tolerant. However, people who develop a tolerance or become dependent are not necessarily addicted.

Before lowering the dosage or going off of a medication that someone has taken for a while, it is important to talk to a health care provider to avoid withdrawal discomfort or life-threatening consequences. If you have concerns about tolerance, dependence or addiction, talk to your health care provider. If you want to speak with someone in confidence, contact Military OneSource or your chaplain.

Experiencing tolerance, dependence or addiction does not mean a person is weak. Remember, reaching out for help is a sign of strength.