April 23, 2016
Dr. Michael J. O’Connell, Healthcare Consultant, New Hampshire commented that the distinction between addiction and dependency is constantly mangled by the press, lay people and even many professionals. The difference between dependency and addiction is not withdrawal. Withdrawal is a phenomenon common to both.
Addiction marks a transition into pathology; the chemical, activity or behavior to which one is dependent (oxycodone, heroin, alcohol, THC, sex, eating, extrovertism/introvertism) becomes harmful…physically, psychologically and/or functionally, to the individual. Withdrawal or craving is not necessarily a pathology and therefore not necessarily an indication of addiction.
One would be hard pressed to declare a weekly snorter of heroin or cocaine an addict. If a person dreams much about food, craves certain tastes or dishes, but lives a functional work and social life and is not obese, this can hardly be defined as an addict. If another has elevated liver enzymes, presence of abdominal fat in an otherwise slender body, is thinking about drinking alcohol much of the day, has a couple DUIs, occasional blood in the stools, and yet persists in drinking alcohol, this is most likely an addict.
If a chronic back pain patient has had a laminectomy and then fusion, still requires pain meds but goes into intense withdrawal with sweating, shakes, diarrhea, and piloerection, when away on a trip forgetting meds at home, this is dependency, but unlikely addiction.