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"Addiction" versus "Dependence"
Replies
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stevencloser wrote: »stevencloser wrote: »Question: Does a substance have to create a dependency in order to be called addictive?
It appears to be in the definition of substance addiction.
"Drug addiction, also called substance use disorder, is a dependence on a legal or illegal drug or medication. "
http://www.mayoclinic.org/diseases-conditions/drug-addiction/basics/definition/con-20020970
This one doesn't say "dependency", but it does say they change the way your brain works by being present in your blood stream, and lists how they do this.
https://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction
The answer to the question is "no". That was pretty much the whole point of my original post.
According to both definitions I have posted, a substance that is addictive has to have a physical effect on your body that facilitates the addiction.
A physical effect does not necessarily imply dependence. Sugar, for example, has an effect on the body. I use it in mile 23 of a marathon for a reason. But I have seen no evidence of chemical dependence with it. (I believe it's only very rarely addictive, incidentally.)
I don't believe I have ever had a food addiction. I believe I have known others who have.
I sorry that this doesn't square with your agenda.
But a food addiction (better named as an eating addiction) is a behavioral disorder, most comparable to gambling. You're not going to undergo the same physical withdrawal symptoms by restricting your food intake that a drug or alcohol addict is. There's a reason there's a very short list of substances that fall into "substance-related disorders," and tolerance for and withdrawal effects from these specific substances are part of that criteria.
I can't believe I'm throwing a rat study out there, but FWIW:
https://www.scopus.com/record/display.uri?eid=2-s2.0-0034212626&origin=inward&txGid=0
They showed cocaine activates a different part of the reward circuit than food and water in rats. This is not confirmed by a scientific study on humans as far as I know, but it's possible that substances we currently classify as addictive would do the same in humans. Take it or leave it.
Also, the DSM-5 did away with addiction as an official term because it was too ambiguous. So if we just call everything disorders, with some disorders being with substances that cause physical dependence, we no longer have a debate, right?1 -
mskessler89 wrote: »stevencloser wrote: »stevencloser wrote: »Question: Does a substance have to create a dependency in order to be called addictive?
It appears to be in the definition of substance addiction.
"Drug addiction, also called substance use disorder, is a dependence on a legal or illegal drug or medication. "
http://www.mayoclinic.org/diseases-conditions/drug-addiction/basics/definition/con-20020970
This one doesn't say "dependency", but it does say they change the way your brain works by being present in your blood stream, and lists how they do this.
https://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction
The answer to the question is "no". That was pretty much the whole point of my original post.
According to both definitions I have posted, a substance that is addictive has to have a physical effect on your body that facilitates the addiction.
A physical effect does not necessarily imply dependence. Sugar, for example, has an effect on the body. I use it in mile 23 of a marathon for a reason. But I have seen no evidence of chemical dependence with it. (I believe it's only very rarely addictive, incidentally.)
I don't believe I have ever had a food addiction. I believe I have known others who have.
I sorry that this doesn't square with your agenda.
But a food addiction (better named as an eating addiction) is a behavioral disorder, most comparable to gambling. You're not going to undergo the same physical withdrawal symptoms by restricting your food intake that a drug or alcohol addict is. There's a reason there's a very short list of substances that fall into "substance-related disorders," and tolerance for and withdrawal effects from these specific substances are part of that criteria.
I can't believe I'm throwing a rat study out there, but FWIW:
https://www.scopus.com/record/display.uri?eid=2-s2.0-0034212626&origin=inward&txGid=0
They showed cocaine activates a different part of the reward circuit than food and water in rats. This is not confirmed by a scientific study on humans as far as I know, but it's possible that substances we currently classify as addictive would do the same in humans. Take it or leave it.
Also, the DSM-5 did away with addiction as an official term because it was too ambiguous. So if we just call everything disorders, with some disorders being with substances that cause physical dependence, we no longer have a debate, right?
Well stated.0 -
mskessler89 wrote: »stevencloser wrote: »stevencloser wrote: »Question: Does a substance have to create a dependency in order to be called addictive?
It appears to be in the definition of substance addiction.
"Drug addiction, also called substance use disorder, is a dependence on a legal or illegal drug or medication. "
http://www.mayoclinic.org/diseases-conditions/drug-addiction/basics/definition/con-20020970
This one doesn't say "dependency", but it does say they change the way your brain works by being present in your blood stream, and lists how they do this.
https://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction
The answer to the question is "no". That was pretty much the whole point of my original post.
According to both definitions I have posted, a substance that is addictive has to have a physical effect on your body that facilitates the addiction.
A physical effect does not necessarily imply dependence. Sugar, for example, has an effect on the body. I use it in mile 23 of a marathon for a reason. But I have seen no evidence of chemical dependence with it. (I believe it's only very rarely addictive, incidentally.)
I don't believe I have ever had a food addiction. I believe I have known others who have.
I sorry that this doesn't square with your agenda.
But a food addiction (better named as an eating addiction) is a behavioral disorder, most comparable to gambling. You're not going to undergo the same physical withdrawal symptoms by restricting your food intake that a drug or alcohol addict is. There's a reason there's a very short list of substances that fall into "substance-related disorders," and tolerance for and withdrawal effects from these specific substances are part of that criteria.
I can't believe I'm throwing a rat study out there, but FWIW:
https://www.scopus.com/record/display.uri?eid=2-s2.0-0034212626&origin=inward&txGid=0
They showed cocaine activates a different part of the reward circuit than food and water in rats. This is not confirmed by a scientific study on humans as far as I know, but it's possible that substances we currently classify as addictive would do the same in humans. Take it or leave it.
Also, the DSM-5 did away with addiction as an official term because it was too ambiguous. So if we just call everything disorders, with some disorders being with substances that cause physical dependence, we no longer have a debate, right?
Maybe...in some long lost land of logic (I'm killing if on the alliteration lately), but even here in this thread where the terms were clearly defined, there was plenty back and forth.
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I get what the OP is saying. Another way to think about it is this: If an alcoholic is sober and free of any physical dependencies, is it reasonable for them to attempt drinking moderately?
No. They're always an alcoholic - dependency is always there - even if they don't drink anymore.
That's where the saying about obesity Is - you need food to survive. You can safely stop using crack and alcohol but can't stop eating; have to develop a new , healthy relationship with food. There is no safe, healthy way to smoke crack or abuse alcohol. It's not a clear-cut thing as with substance abuse.2 -
I often see someone post that he or she is addicted to a food. When this happens, someone invariably responds with something like ________ addiction is "not a thing." (I suppose sugar is the most common example.)
When this happens, the person responding is confounding two related but different clinical concepts.
ADDICTION occurs when someone carves something so strongly that they consume the substance, or repeat the behavior, even when that substance or behavior is doing substantial harm. Note that the craving alone does not suggest an addiction. It is the inability to fight off this craving even though satisfying the craving causes damage.
Physical DEPENDENCE occurs when someone would experience withdrawal symptoms when stopping the substance. (In many cases, the user will also build tolerance over time, and need more of the substance to be satisfied._ In the case of drug dependence, withdrawal can even be life threatening. In other situations, such as caffeine, for example, withdrawal may mean a couple days of headaches.
A person can, of course, be addicted AND dependent. Drug addiction often falls into this category. But a person can be addicted and NOT dependent. There is, for example, extensive psychiatric literature on the treatment of gambling addiction. Obviously, physical dependence does not play a role here.
Dependence can occur without an addiction. I know many people who consumer caffeine daily in moderation who would get mild withdrawal headaches if they were to stop. Nevertheless, their pattern of use does not suggest they are doing themselves harm, so there is no addiction present.
So when someone says they are addicted to food, I am disinclined to immediately correct them. When people post this, they are not usually asking for their definitions to be corrected. They are usually seeking strategies to avoid overindulging.
Thank you for this. People split hairs about definitions when a person is asking for advice.
I don't think it's very helpful.6 -
mommarnurse wrote: »I get what the OP is saying. Another way to think about it is this: If an alcoholic is sober and free of any physical dependencies, is it reasonable for them to attempt drinking moderately?
No. They're always an alcoholic - dependency is always there - even if they don't drink anymore.
That's where the saying about obesity Is - you need food to survive. You can safely stop using crack and alcohol but can't stop eating; have to develop a new , healthy relationship with food. There is no safe, healthy way to smoke crack or abuse alcohol. It's not a clear-cut thing as with substance abuse.
Yeah, I think we kinda agree on principle, but I disagree on the terminology of "dependency". They are not dependent because their body is no longer experiencing side effects or withdrawal symptoms from lack of alcohol. However, the condition in them which rendered them unable to control their intake of alcohol still exists. That was the point of the analogy. They are still addicts even though they are no longer dependent.
Regarding people claiming a food addiction, I believe it is possible for a similar condition to exist within them. This condition being that whenever they take in certain substances (whether it be sugary, fatty, salty, a combination of them, or something entirely different) their body reacts abnormally in the form of an uncontrollable and unfulfillable craving. Many find success through identifying those trigger foods (which tend to be "highly palitable") and abstaining from them in the way an alcoholic abstains from alcohol.
There are some people who claim an eating addiction in which the act of eating anything will trigger them to overeat. This is pretty rare, but I have met a couple with this issue. That seems to be the condition to which you are referring.
The other part of the analogy is to differentiate between the addiction and the dependency. I have no issues with alcohol. I can drink 2 drinks or 10 and never trigger an uncontrollable compulsion to drink more. However, if I were to force myself to drink more and more over a period of time, I would build up both a tolerance and a physical dependency for it. That condition does not quite occur with food.
Most of the arguments about food addiction within these boards seem to revolve around the absence of physical dependence regarding the claimed substance (usually sugar). The OP was a good statement about why the lack of dependency does not disqualify it from being an addiction.1 -
GaleHawkins wrote: »I know when I went off sugar and all forms of grains Oct 2014 the cravings started to fade in 2 weeks and after a month physically cravings stopped and have not returned. My pain dropped like a rock in the first 30 days. Other health improvements came over time.
No cravings gave me a slow weight loss and I have maintained around 200 for over a year now automatically/no conscious effort on my part to do math. That could not have happened back when I had cravings for things that went to glucose quickly.
One can use the terminology they wish as far as I am concerned. What works for me is the only thing that counts in my life.
This is similar to my experience. I had "withdrawal" symptoms for a little over a week, and then felt much better. I'm not sure if sugar is an inflammatory but I experienced less muscle and joint pain as well. Cravings for sugar went away unless I ate something with a high glycemic level. Then the cravings returned.1 -
I think I must have been addicted to coffee. The headache I got from withdrawing from it was mild and only happened for three days, so my dependence was minimal. The ramifications of not being able to pour another cup of coffee into my mouth when I'm bored, stressed, emotional, or tired, are still reverberating through my life, after almost two months.0
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I think a lot of the ambiguity comes from the fact that addiction very often includes dependence, especially in the case of drugs (which seems to be the default comparison for many regardless of their position on the debate). In general, when one says they are addicted to drugs, the general population reads that as being physically dependent on them. I know in my case I have visions of Pookie from New Jack City detoxing in a cell. I imagine many have similar visions. So, when someone says they are addicted to sugar, the same visions occur and people react to the absurdity of that condition being brought about by something that people consume every day...in large amounts.
However, when one is intimately involved in the addiction experience, they have to analyze it a little further. The terms as defined in the OP are evidence of that analysis. The idea that addiction does not always include dependence and dependence is not always brought on by addiction does not jive with the misunderstood definition of the word "addiction" used by the general public.
I am learning that a lot of times people seem to be saying the same things but using opposite words to do so. So it looks like they are disagreeing. It has happened several times in this thread and elsewhere. It's kind of like the opposite idea of color perception. We all see the same thing, but we call it by different names.0
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