Tolerance, Dependence and Addiction: What’s the Difference?

PR Newswire PR Newswire • January 7, 2020

When it comes to drug abuse, many people, even medical professionals, use the terms tolerance, dependence and addiction interchangeably, leading to the erroneous belief that all three refer to essentially the same thing. However, when it comes to someone’s recovery, it is paramount to know the differences.


“Tolerance” refers to when a person using a drug experiences a reduced impact from repeated use. It is a physical effect of recurring drug use, but it is not inherently a telltale sign of addiction. For example, people who use prescription medication to treat chronic pain may feel the effects diminish over time; the medication may not be as effective in dealing with the pain, which could lead to the pursuit of other methods. It is important, therefore, to be aware of the three different types of tolerance.

  • Acute: Short-term or acute tolerance refers to the frequent exposure to a drug over a brief period of time. Cocaine users often experience acute tolerance. Using cocaine initially will result in a sense of euphoria, as well as an increase in blood pressure and heart rate; however, taking cocaine again soon after will not result in a further escalation in blood pressure and heart rate.
  • Chronic: Chronic tolerance occurs when a person’s body gets used to a certain substance after constant use over the course of several months or years. People who take prescription medication, including opioids, will often feel the need to increase their dosage to feel the same way.
  • Learned: Learned tolerance occurs when a person has frequent exposure to an illicit substance. For example, people who frequently drink may not appear intoxicated to others. They have learned to act sober and accomplish certain tasks. This can lead to people thinking they are all right to drive after a night of drinking.


“Dependence” refers specifically to the physical condition when the body adapts to the constant presence of a drug. A person with a physical dependence will experience withdrawal symptoms when the drug is suddenly absent. While dependence is typically a component of addiction, it is in its own separate category. For instance, non-addictive substances can lead to dependence in some people.

Many people rely on prednisone, a synthetic variation of a steroid hormone commonly used to treat allergic reactions and asthma. There is no research to suggest it will lead to addiction, however, it is possible for the body to become dependent on it. A person who takes prednisone for several weeks, and then suddenly stops taking the drug, may suffer from certain withdrawal symptoms including body aches, weakness and fatigue. It is important to recognize that drug dependence is medically treatable; rehabilitation facilities offer programs designed to assist people in detoxification by slowly separating the drug from the body. Quitting cold turkey is also an option, but many people require professional aid to feel better sooner.


While tolerance and dependence are physical conditions, addiction is purely psychological. “Addiction” refers to an overwhelming or uncontrollable need to partake in a experience similar feelings toward gambling, sexual intercourse and eating certain foods.drug. The compulsion can last for years, and even after some time of sobriety, it can return. People can develop addictions to drugs, but it is also possible to

Years ago, society generally viewed addiction as a moral weakness. Thanks to advancements in science, people now understand that addiction alters a person’s brain, particularly the nucleus accumbens, the part of the brain that becomes stimulated by rewarding activities. Certain drugs with continued use can overload this part of the brain, resulting in addiction over time.

Addictive substances stimulate pleasure in the brain, and can actually create new pathways to the brain craving the reward more than normal. Repeated usage can trick the brain into prioritizing getting the next hit over more productive activities.

Understanding that addiction is psychological more than a physical is crucial for recovery. A person with a dependence on caffeine and will experience headaches if he or she does not have that morning cup of coffee. However, this person is unlikely to prioritize espressos over family and commit crimes to get another drink. Additionally, if a doctor advised his or her patient to quit coffee, most would comply. However, an addict being told to quit alcohol will have a much more difficult time maintaining sobriety.

Understanding Different Terminology

Understanding what you or a loved one is actually experiencing becomes critical for getting the right treatment. Most importantly, it is vital to recognize when using a certain substance extends into addiction, which requires prompt, effective medical attention. Drug addiction is dangerous, and unfortunately, it is often fatal. It is crucial to know when assistance is needed to intervene in the situation. The National Institute on Drug Abuse offers numerous resources to help you understand addiction and recovery better.

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