Addiction to a substance like alcohol or drugs is also known as dependence. People can become dependent upon or addicted to things other than substances, but for the purposes of this article, we’re going to limit our focus to substance use disorders.
Physical and Psychological Dependence
Most people understand that becoming addicted to drugs or alcohol is a genuine risk. Yet, there is a serious knowledge gap when it comes to what people know about alcohol and drug addiction. The truth is, it would take a book to cover all the misconceptions and misunderstandings about substance use disorders. So this article is going to dial in on the confusion about the different ways in which a person can be dependent on a substance.
There are two main types of substance dependence:
Physical dependence on Drugs or Alcohol
Physical dependence on a substance may be slightly better understood by the general public. For example, many if not most people know that an opioid-dependent person will get physically ill when they go without opioids for a prolonged period of time. Many also understand that alcohol-dependent people also have symptoms when they abruptly abstain from drinking. The symptoms of physical dependence when drugs or alcohol are removed are known as withdrawal. The reason for the withdrawal symptoms is that a person has become physically addicted. This is just another way of defining physical dependence.
When Does Physical Dependence on Alcohol or Drugs Occur?
Physical dependence occurs when a person continues to use a substance even when it causes harm, often due to the body’s adaptation to the presence of the substance. When physical dependence is present, stopping or reducing use of the substance can lead to withdrawal symptoms such as nausea, sweating, shaking, and headaches. The precise symptoms a person has depend upon what type of drug they are using and their own unique physiology, but there are certain constants.
Physical Opioid Withdrawal Symptoms
- Nausea and vomiting
- Abdominal cramps
- Muscle aches
- Chills and tremors.
These opioid withdrawal symptoms can last for days or weeks, though the severity of symptoms usually peak within the first 24-48 hours after opioid use has stopped. It is important to seek medical help if opioid withdrawal symptoms occur. While death from these symptoms is extremely rare, they are very unpleasant. Not getting medical help can not only lead to needless suffering, it also greatly increases the odds of relapse.
Physical Alcohol Withdrawal Symptoms
- Sweating (cold sweats)
- Nausea and/or vomiting
- Racing heartbeat
- Increased body temperature
Alcohol use disorder (AUD) can result in physical alcohol withdrawal symptoms, typically experienced within 6-24 hours after a person’s last drink. Severe alcohol withdrawal may also include delirium tremens (DTs), which is a condition marked by confusion, rapid heart rate, high blood pressure, and severe tremors. It is important to note that alcohol withdrawal symptoms can vary in terms of duration, intensity and severity depending on an individual’s alcohol consumption habits as well as their physical health. Physical withdrawal from alcohol can result in fatal seizures.
Alcohol or Benzodiazepine-dependent people must NEVER abruptly stop drinking or taking benzos without medical advice and support. It can be deadly. If you suspect someone is in benzo or alcohol withdrawal, get them to an alcohol detox immediately or call 911.
Physical Withdrawal Symptoms From Other Drugs
Physical withdrawal symptoms from benzodiazepine and barbiturates are very, very similar to alcohol withdrawal. They also come with equivalent potential risk of fatal seizures. This means a person dependent on benzos like Xanax or Klonopin or barbiturates like Amobarbital or Butalbital. must NEVER abruptly stop their use without professional medical advice and support.
The physical withdrawal symptoms from other drugs tend to be milder than those from opioids, alcohol, benzodiazepine and barbiturates. This does not mean they don’t warrant treatment for addiction or that they aren’t uncomfortable and even potentially dangerous. For example, physical withdrawal from stimulants like cocaine, methamphetamine or Adderall include fatigue, low mood and headaches. Even marijuana has been shown to have some physical withdrawal effects. Primarily irritability and insomnia.
The Difference Between Physical and Psychological Dependence
Psychological dependence occurs when a person uses a substance to achieve certain feelings or as an escape from emotions or situations that are difficult for them to cope with. This could include drinking alcohol to numb emotional pain or using drugs for stimulation and energy. Psychological dependence can be just as dangerous as physical dependence because the user may not recognize how their behavior has changed over time.
When physical dependence and psychological dependence occur together, it can be referred to as a substance use disorder. Addiction is a term used to describe a severe form of dependence, where the user experiences intense craving for the substance and is unable to control their use despite negative consequences.
The main difference between physical dependence and psychological dependence is in the symptoms. The lines between the two are sometimes blurry as well. For example, depression is a common withdrawal symptom from many drugs. Depression is a psychological condition, but in this (and most) cases, it has a biochemical component. That is, depression isn’t just because the person no longer has their drug of choice. It is also a physical phenomenon caused by changes in neurotransmitter levels and other chemicals in the brain and body, including hormones.
Is There Such a Thing as Purely Psychological Dependence or Mental Addiction?
Purely psychological dependence almost never exists without some form of accompanying physical addiction. That said, drinking or using drugs can have a powerful psychological dependence effect that can be just as difficult to overcome as the physical dependence. In fact, psychological dependence can be more difficult to manage, especially in the long term. Physical withdrawal symptoms will subside on their own eventually, even without intervention (remember the warnings about alcohol, benzos and barbiturate withdrawal!). But psychological dependence symptoms can linger for weeks, months or even years without treatment. This is one of the reasons addiction treatment and actively living a recovery lifestyle are so important.
Examples of Psychological Dependence on Drugs or Alcohol
- Feeling compelled to drink before going to a party
- Worrying about enough alcohol or drugs being available where you’re going
- Drinking to cope with anger or depression
- Feeling the need to be high or drunk to perform sexually
- Being triggered to use or drink by certain people, places or things.
When it comes to the difference between physical dependence and psychological dependence on a substance, the most important thing to remember is that willpower isn’t the answer. People do not become addicted because they lack discipline or character. That is a myth that deserves to be smashed. The fact is that drug and alcohol dependence are a disease.
Getting Help for Dependence on Drugs or Alcohol
Behavioral health treatment and adopting a recovery lifestyle are the best response to these conditions. It makes no difference how much of a person’s addiction is psychological or physical. Either way, their best chance of getting sober and staying that way is if they get professional help. At JourneyPure, we are in the business of helping people just like you or the one you love, overcome dependence on drugs or alcohol for good. Give us a call at (888) 985-2207 anytime if you want to learn more about how we can help.
- years in the field