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Understanding Tolerance, Dependence, and Addiction

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These 3 terms are thrown about often and used as if they are the same thing. They are not. I thought I would post definitions of each so we can understand the differences.


Tolerance is defined as a person’s diminished response to a drug that is the result of repeated use 1. People can develop tolerance to both illicit drugs and prescription medications. As stated above, tolerance is a physical effect of repeated use of a drug, not necessarily a sign of addiction. For example, patients with chronic pain frequently develop tolerance to some effects of prescription pain medications without developing an addiction to them.



The words dependence and addiction are often used interchangeably, but there are important differences between the two. In medical terms, dependence specifically refers to a physical condition in which the body has adapted to the presence of a drug. If an individual with drug dependence stops taking that drug suddenly, that person will experience predictable and measurable symptoms, known as a withdrawal syndrome.



According to the National Institute on Drug Abuse (NIDA), addiction is a “chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences” 7. In other words, addiction is an uncontrollable or overwhelming need to use a drug, and this compulsion is long-lasting and can return unexpectedly after a period of improvement.




So tolerance is a normal response and is to be expected. It does not mean you are addicted, far from it. Tolerance also develops to side effects, a good thing. 

Dependence is a normal response and to be expected. Lots of people are dependent to a medication. It in no way implies addiction. We are dependent on oxygen and no one is concerned. Generally dependence itself has no negative consequences other than the need to take the med on time and have a reliable source.

Addiction is where the shit hits the fan. Loads of consequences. Rapidly increasing dosages over what the prescribed dosage is set at. The inability to cut back on the med after taking too much. It requires an existing propensity to addictive behavior. People say a med is addicting but it is really the person taking the med that is addictive. So addiction is partially rooted in psychology. Tolerance and dependence are merely medical conditions.

Quite often people talk about addiction when they really are talking about dependence or sometimes tolerance. Just because you are tolerant does not mean you are one step closer to addiction. Dependence, too. Tolerance and and dependence are not gateways to addiction. 



Edited by notloki
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I don't agree with OP on some parts (most of it) but I don't want to discuss this, but I wanted to post what I think about it all.

I don't think tolerance is a good thing, vanishing side effects could be just a body adaptation without losing the therapeutical efficiency of the medicine that comes with tolerance.

Tolerance and dependence can make an addict, not everybody into an addict tough.

Apparently OP has not problems with addiction so can't empathize with those who have/had or are in denial.


I think:

It depends on the drug profile and the patient.

It varies from drug to drug, person to person.

Case to case.


General talking, my opinion and experience:

Some drugs sustain a low level of tolerance mostly because of how it's structured* and how low the therapeutical levels are achieved.

*some drugs have more potential of abuse based on half-life, potency, pleasure... and the list goes on.


As soon as the patient need to increase the dose to obtain the same therapeutical level, those guidelines change and the patient will be risking to develop a tolerance to achieve the benefit of the therapy.

Meaning, the first dosage no longer will be efficient, this can be something transient, on it's roots on the primary symptoms.

As you have to adjust your dosage to a larger one, those drugs on those profiles, will start building a tolerance.


The time will pass and as you take it constantly your body will adjust to the drug and dosage and you'll become dependent, like I said, varies from person to person, drug from drug, duration, reason of treatment, those thins will determine of how this dependence will occur.


In order to self regulate, your body from lack of words will become 'addicted' and will show symptoms of withdrawal.

At this point,

Taking the med will certainly divide between reaching a minor therapeutical value and it mostly will cease the body of  it's needs.

Post starting needs of the drug are created or symptoms will be exacerbated as a rebound effect, a demand that first wasn't the objective of the treatment, will now be considered.

If you're not psychological addicted your body at least will show effects or 'withdrawal symptoms'.

When you crave it, you are psychological addicted.

A dependence that was first made by a tolerance developed in a new thing called addiction.

Those are my thoughts and addiction has less to do with abuse than you'd think, but abusing can increase tolerance, increase dependence and tcharam. worse your addiction.

You can abuse something and just let it go, but when you take it constantly maybe the problem is easier to relate.
You can be just self harming by anything and not creating any addiction in the process.

Edited by uncomfortable thoughts
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