What is dependence and addiction?

Dependence and addiction are not the same. Dependence means your body gets used to a medicine and you might feel unwell if you stop suddenly. Addiction means you keep using a medicine even when it's harming your health, relationships or daily life.

Other differences, and some examples, are listed below.

Dependence

Dependence is when you have a physical need for a substance. If you stop taking the medicine, you will develop withdrawal symptoms. Your body may become physically dependent on some medicines if you take them for a long time.

You may be dependent on a medicine to manage a chronic health condition such as:

• diabetes
• heart disease
• epilepsy
• depression

Do not suddenly stop taking medicines without talking with your doctor about it.

Addiction

Addiction is when you feel a strong need to keep doing, taking or using something, even if it harms you. Addiction can negatively affect your life.

When you are addicted, you can't control your use of the medicine. You find it hard to stop.

You can have a physical or psychological addiction, or both.

Addiction and dependence can happen to anyone.

What are the symptoms of being addicted to medicines?

Some symptoms of being addicted to a medicine are:

• needing to use it regularly, or in larger amounts, to cope with everyday life
• using more of the medicine than you were prescribed
• cravings, or a strong desire to use the medicine, and not being able to stop, even if you know you have a problem
• feeling anxious about not being able to get your medicine
• spending too much time getting, using or recovering from the medicine
• having withdrawal symptoms — unpleasant feelings of illness if you stop taking it regularly
• feeling judged or ashamed when your pharmacist or doctor wants to discuss how much medicine you are taking

What causes addiction to medicines?

Some medicines, such as opioids, cause a chemical called dopamine to be released in your brain. Dopamine makes you feel good. This can make you want to take the medicine again. You can become physically or psychologically dependent on the medicine.

Factors that can increase your chances of becoming addicted to a medicine include:

• living with mental health conditions such as anxiety, depression, bipolar disorder or schizophrenia
• genetics — genetic factors can make you more susceptible to addiction
• your environment — being surrounded by poverty, crime, violence or other people addicted to medicines
• living with chronic pain
• living with high levels of personal stress, such as unemployment and grief

What types of medicines can I become dependent on?

Some medicines can cause dependence, but that doesn't mean you're addicted. Here are examples:

• If you have diabetes, you might rely on insulin to manage your blood sugar. This doesn't mean you are addicted to insulin.
• If you have epilepsy, you may need to take medicines to prevent seizures.
• If you have some mental health conditions, you may take antidepressants or antipsychotic medicines.
• If you have high blood pressure, you may take antihypertensives.
• If you have cancer pain or chronic pain you may be dependent on medicines to control the pain.

Do not stop taking these medicines suddenly. If you are on a high dose, you will need to slowly reduce the dose to reduce the chance of withdrawal effects or complications.

What types of medicines can I become addicted to?

Some types of medicines can become addictive, including:

• opioids
• nerve pain medicines
• benzodiazepines
• stimulant medicines

Some of these medicines should only be used for a short time (days or weeks) because of the chance of addiction. You need a prescription from your doctor to buy these medicines. There is also a limit on the amount of medicine that you can get.

Opioid pain relief medicines

Some strong pain relief medicines are known as opioids. These medicines include:

• codeine
• tramadol
• morphine
• oxycodone
• fentanyl
• tapentadol

All opioids can be addictive and should be used only under the supervision of your doctor — especially if you have had problems with alcohol or substance use before. Heroin is also an opioid.

Access to overdose-reversing medication

Naloxone is a medicine that can temporarily reverse the effects of an opioid overdose. The Australian Government is offering this medicine free of charge and without a prescription to people who may experience, or witness, an opioid overdose.

Learn more about the Take Home Naloxone program.

Nerve pain medicines

Some pain relief medicines were developed to help manage epilepsy, but can also help with nerve pain or anxiety. These medicines include pregabalin and gabapentin.

Sleeping pills

Benzodiazepines are prescription-only medicines used to help with sleeping problems or anxiety. They can be addictive. Examples include:

• diazepam
• temazepam
• nitrazepam

Read more about the safe use of sleeping pills.

Stimulant medicines

Stimulant medicines, such as methylphenidate that are used to treat:

• attention deficit hyperactivity disorder (ADHD)
• narcolepsy (repeatedly falling asleep during waking hours)

These medicines can be addictive if they're not used properly.

When should I see my doctor?

You should see your doctor if:

• you want to stop taking a medicine that can be addictive
• you're experiencing withdrawal symptoms after stopping an addictive medicine
• you or someone around you is worried you're becoming addicted to a medicine

Here are some questions you can ask your doctor or pharmacist about a prescribed medicine:

• What are the side effects of this medicine and is it addictive?
• How long should I take the medicine for?
• How do I take the medicine safely?
• What are the signs of dependence or addiction?
• What are my alternatives to taking this medicine?
• What else can I do to help my condition?
• What's the plan for dealing with my problem long-term?

If you are prescribed a medicine for pain, stress, sleeping problems or anxiety, you can ask your doctor about your chance of addiction.

Talk to your doctor if you're worried — they're there to help. They are required to keep all your information confidential, except in very special circumstances, such as an immediate concern for your own or another person's safety.

How is addiction to medicines treated?

Living with addiction can be challenging, but there are many strategies that can help.

Treatment for addiction to medicines can include:

• making changes to your lifestyle
• gradually decreasing your dose, with your doctor's guidance
• counselling — help for the underlying issue that led to addiction
• rehabilitation support
• detoxification in a hospital or clinic

Can addiction to medicines be prevented?

To reduce your chance of addiction:

• If your doctor recommends a medicine that can be addictive, they will prescribe you the lowest effective dose and only for the time you need it.
• Take your medicine exactly as prescribed by your doctor.
• Never use someone else's medicine or give your medicine to someone else.
• Look out for signs of addiction and talk to your doctor or pharmacist as soon as you're worried.

What are the complications of addiction to medicines?

If you are addicted to a medicine, you are more likely to develop serious complications that can affect all parts of your life. For example, you might:

• fail to meet your responsibilities at work, home or school
• stop attending or enjoying social or leisure activities
• have an accident or harm yourself due to drowsiness or poor judgement
• become involved in crime to obtain more medicine
• take an overdose of medicine leading to illness or even death

Resources and support

• Learn more about opioids on the NPS MedicineWise website.
• Family Drug Support Australia is a support service for families affected by drug issues. They can be called on 1300 368 186.
• The Alcohol and Drug Foundation have a path2help tool to provide up-to-date resources to assist people looking to support someone who may be addicted to medicines and other drugs.
• You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than languages

The Alcohol and Drug Foundation has resources about addiction translated into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

The Aboriginal Health & Medical Research Council of NSW (AH & MRC) has resources about alcohol and other drugs for Aboriginal and/or Torres Strait Islander people.

The Alcohol and Drug Foundation has resources about alcohol and other drugs for Aboriginal and/or Torres Strait Islander people.