The Difference Between Tolerance, Dependence & Addiction

Apr 12, 2021

The Difference Between Tolerance, Dependence & Addiction

Human nature and substance abuse can be hard to understand, especially the difference between tolerance, dependence, and addiction. Misconceptions of tolerance, dependence, and addiction run rampant throughout our society. Despite popular belief, they are not the same.

In the medical field, professionals will use tolerance, dependence, and addiction in the same sentence because they understand the core differences. The confusion began when society merged the three, which led to the misconception of the terms. Let’s explore the differences between tolerance, dependence, and addiction and why they are related but not interchangeable.


Tolerance is a term that expresses how the body is adapting to a substance. When an individual uses a substance regularly, they will develop a tolerance and require a higher amount of the substance to get the same effects they got in the beginning. Increased tolerance can be a major warning sign for addiction. However, tolerance is not necessarily the problem itself.

For example, an individual who drinks alcohol regularly will develop a tolerance for the drink. Over time, the individual will require multiple drinks to achieve the same effect because their tolerance level has increased. The same goes for drug use. Those who use a drug regularly will develop a tolerance and require more of the drug to achieve the same effect.


Dependence is a term indicating that an individual’s brain functions normally when a substance is present in the body. When the substance is removed from the body, withdrawal symptoms occur, such as headaches, sweating, vomiting, mood changes, heart palpitations, and more.

This is where dependence comes into play. Individuals who don’t want to deal with withdrawal symptoms will depend on the substance to relieve those symptoms. Dependence is like tolerance with warning signs. However, this doesn’t mean that an individual is addicted — at least not yet.

For example, when a doctor prescribes medication for a headache, an individual uses it to relieve the symptoms. When they stop using, the headache may come back, so they rely on the medication to relieve those symptoms again. They depend on the medication.

When discussing addiction, the term dependence is frequently thrown around. According to Healthline it “refers to the process by which your mind and body come to depend on a substance so you keep feeling a certain way. This tends to result in withdrawal symptoms when you stop using the substance.” It is most often characterized by the symptoms of withdrawal and tolerance from substance abuse. Dependence can affect an addict physically, psychologically, and emotionally.

The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) defines dependence on a scale based on the time and degree a person has abused substances. Substance abuse is seen as an early stage of dependence. As the frequency of abuse increases, the more likely a person is of developing a dependency

In 2013, the DSM-V swapped the terminology to describe “substance abuse” and “substance dependency” to “substance use disorder.”

Professionals in the addiction recovery industry rely on medical and managed detox processes as a part of addiction treatment in some facilities. They may introduce medication that alters withdrawal symptoms and then alter any dependence on the medication with more efficiency and direction later in the process. In most cases, it is easier to take decreased dosages of specific medication than it is to decrease substance use.

Physical, Psychological, and Emotional Dependence

Dependency has multiple effects on a person suffering from addiction. The effects are never “purely psychological” or “purely physical.” Instead, it is a mixture of all of these to varying degrees. Rehab facilities can help to address these forms of dependence.

Psychological dependence and emotional dependence often go hand in hand. These forms of dependence refer to cognitive and emotional aspects of addiction. Addicts may also experience these forms of dependence while going through the withdrawal process as well. Some examples of the symptoms of psychological and emotional dependency include:

  • Anxiety and Depression – This often comes out when someone attempts to put a stop to the addictive behavior.
  • Irritability or Restlessness – This can happen while going through withdrawal or while not being able to use the substance they’re addicted to.
  • Mood Swings
  • Cravings
  • Dramatic Change in Appetite
  • Denial of Their Substance Use
  • Obsessing or Romanticizing Their Substance Use
  • Cognitive Issues – This can include difficulties with concentration, memory, or judgment.
  • Social Isolation

The abuse of substances can cause an addict’s body to become so dependent that it may struggle to function without it. No matter what substance is abused, the body can become addicted. The physical effects of dependency can vary from person to person. Many people who abuse a large number of drugs for a long time will affect far worse effects than someone who uses less.

When substances are introduced into a person’s body, their system will create its own chemical reaction to counter the effects of the substances. Over time the body stops reacting in the way that it did in the beginning. This leads to the development of tolerance. Some examples of the symptoms of physical dependency include:

  • Heart Palpitations or Racing Heart
  • Sweating
  • Tightness in the Chest
  • Difficulty Breathing
  • Nausea or Vomiting
  • Tremor


Tolerance and dependence may show signs of addiction, but they don’t necessarily mean that someone is addicted. Addiction is a substance use disorder. When someone becomes addicted to a substance, they rely on the substance continuously regardless of any negative consequences.

Defining an addiction can be difficult. Many people who abuse legal or illegal substances aren’t always addicts–but many addictions begin with substance abuse. There are many people who use illicit substances without developing a dependency on them. People suffering from addiction have no control over their use of substances. The term “addiction” encompasses the mental and physical dependence one has on a substance.

Addiction happens when an individual cannot stop using the substance even if they try. Both tolerance and dependence can lead to addiction and do so frequently. They can also lead to physical and behavioral changes. Therefore, this often causes confusion about dependency, tolerance, and addiction. To put it in a more refined construct, we characterize addiction as a powerless control function.

Addiction causes a change in a person’s behavior, causing them to act irrationally when the substance they are addicted to is not in their system. A person suffering from addiction will find themselves prioritizing substance use without any regard for the harm they are causing themselves or others. They will neglect social, family, and work obligations. This is due to the biochemical changes in their brain caused by continued substance abuse.

If an individual has built up a tolerance or dependence on a medication, they can easily be monitored. They may require a different dosage amount to eventually get off the medication altogether. But addiction is a term where someone is unable to stop using and will usually require professional help. Addiction can and should be addressed by a professional who understands how to alter the physical and tolerance levels of the individual. With the right plan, addiction recovery can be a success for anyone who reaches out for help.

Related, But Not Interchangeable

Tolerance, dependency, and addiction are related because they are all contributing factors for someone who is struggling with substance use. While these three terms may seem similar, they are not interchangeable. Tolerance describes the amount of a substance that an individual can withstand, dependence is when they depend on the substance for specific outcomes, and addiction is a disorder that encompasses both tolerance and dependency but goes above and beyond both terms.

To learn more about addiction, dependence, and substance abuse, join a free class at Renaissance Ranch, taught by an expert with real-life experience. We offer a variety of educational meetings designed with a number of perspectives in mind, from the spouses of people struggling with addiction to their family members and parents. Some of our free classes are open to the public, while others are specific to a certain demographic. Reach out to us today to get involved.

The definitions of tolerance, dependence, and addiction are not as clear as many think. Regardless of what phase you are in, whether it be tolerance, dependence, or addiction, it’s important to reach out for help from someone who understands the difference and can direct you on the right path. When the crossover of tolerance, dependence, and addiction occurs, conditions often worsen. When a person is addicted, they may have a higher tolerance level and a physical dependency on the substance. But they may not have the outlets or resources to get help. If you think that you or someone you love may be on the path to addiction, Renaissance Ranch can help. Many individuals who are tolerant or dependent on a substance may not understand how bad the situation is. Therefore, it’s essential to seek treatment sooner rather than later. To learn more about Renaissance Ranch and our programs, call us today at (801) 308-8898.