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Tolerance vs. Dependence vs. Addiction: Understanding the Differences

Medically Verified: 2/1/24

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All of the information on this page has been reviewed and verified by a certified addiction professional.

Drug abuse and addiction have far-reaching effects on the mind and body. Two of the first symptoms of addiction include drug tolerance and physical dependence, but these symptoms can also develop as a result of medications prescribed by a doctor.

Understanding the difference between chemical tolerance, physical dependence, and drug addiction can help you understand substance abuse a little bit better, and, more importantly, know when it’s time to seek addiction treatment.

What is Drug Tolerance?

Drugs produce psychoactive effects because of the ways in which they act upon the brain and body. The first few times you abuse a specific drug, you may experience the desired effects.

After regular drug abuse, the body will begin to recognize the drug and get more familiar with it because it has been consumed on multiple occasions. The body begins getting used to having the drug in the system, especially if the drug is taken every day.

Over time, the body will need a higher dose of the drug to feel the same effects as before. For example, someone who used to get high after taking 1-2 Xanax pills may need to start taking 3-4 to feel the desired effects. Or, someone who used to get drunk off of three beers may feel the need to drink four or five to feel the same way three used to make them feel.

When the body gets used to the presence of a substance and requires an increased dose, this is known as chemical tolerance or drug tolerance.[1] Tolerance develops rapidly with some drugs while other drugs may take several weeks or months for tolerance to occur. Tolerance can also differ from one person to the next based on their dose, frequency of use, age, weight, and gender.

What is Physical Dependence?

Physical dependence usually develops after tolerance because it takes longer to form. Dependence happens when the body changes, on a chemical and structural level, to adapt to the constant presence of the drug in the body.

Opioids, for example, are central nervous system (CNS) depressants that slow down vital functions such as breathing and heart rate. In order to compensate for these depressive side effects, the body increases excitatory actions, performing in an over-active or hyper-aroused state. If a person who is dependent on opioids suddenly stops taking them, their body will continue acting in this hyper-aroused state, as if the body expects another dose of opioids at any time. This state of hyper-arousal leads to withdrawal symptoms, such as body aches, cravings, agitation, sweating, tremors, and more.

In order words, if you experience symptoms of withdrawal when you suddenly stop taking a specific drug, you have developed physical dependence.[2]

What is Addiction? Signs and Symptoms

Addiction, also known as substance use disorder or SUD, is a chronic and oftentimes progressive condition characterized by compulsive and hazardous substance use patterns. People who struggle with addiction are usually unable to control when they use substances and how much they use.

Signs and symptoms of addiction include:[3]

  • Tolerance – needing to take higher doses over periods of time to feel the desired effects
  • Dependence – having symptoms of withdrawal when you suddenly stop taking the drug
  • Wanting to stop using drugs/alcohol feeling unable to do so
  • Making multiple failed attempts to stay sober
  • Engaging in dangerous or risk-taking behaviors
  • Loss of interest in activities or hobbies that were once enjoyed
  • Having trouble at work, school, or home due to substance abuse
  • Having mental or physical health problems due to substance abuse
  • Continuing to use drugs/alcohol despite the negative consequences occurring in your life
  • Spending excess time thinking about or obtaining substances
  • Lying to friends and family about substance abuse

Tolerance, Dependence, and Addiction: When Should You Get Drug Addiction Treatment?

Although tolerance and dependence are signs of addiction, tolerance and/or dependence alone do not always indicate a need for substance abuse treatment. After all, you will develop a tolerance (and potentially a physical dependence) on any substance you take for an extended period of time–including prescription medications. If you are taking your medication as prescribed and are not exhibiting any behavioral signs of addiction, it is unlikely that you need treatment.

Even medications that are usually thought of as non-addictive, like anti-depressants, can lead to the development of tolerance and dependence. Antidepressant tolerance occurs when your regular dose is no longer working and your doctor increases your dose. Antidepressant dependence occurs when your body is reliant on your medication, which is why people often experience symptoms of withdrawal when quitting antidepressant medications.

An easy way to determine if your tolerance or dependence has crossed the line into addiction is to ask yourself if you have the four “Cs” of addiction. The four Cs are:

  1. Compulsive – Do you exhibit compulsive drug-seeking behavior?
  2. Cravings – Do you experience overwhelming cravings for drugs and alcohol?
  3. Consequences – Are you still abusing drugs or alcohol despite the consequences you have suffered as a result of them?
  4. Control – Do you have a hard time controlling how much and how often you abuse substances?

If you answer yes to any of the four questions, it may be time to seek a professional substance abuse evaluation to better diagnose your situation.

Find Help for Substance Abuse and Addiction Today

At South Carolina Addiction Treatment, We offer individualized, extended-term treatment in an intimate setting located in Greenville / Simpsonville, SC. We take a holistic approach to treating addiction, offering a variety of treatment modalities centered around identifying and resolving the underlying issues associated with the addiction.

Each client enrolled in our program will receive individual attention from a therapist and psychiatrist as well as gain exposure to a multitude of traditional and alternative therapies to promote long-term recovery.

If you or a loved one are struggling with addiction, please contact us today. Our expert admissions coordinators are available now to verify your insurance, assess your needs, and help you get started in your recovery.