Tolerance, Dependence, Addiction: What's the Difference?

Many people think drug addictiondependence, and tolerance are pretty much the same thing. But in fact, each term means something very different about how drugs affect a person’s body and brain. Learning the difference is important.

Tolerance

Tolerance happens when a person no longer responds to a drug in the way they did at first. So it takes a higher dose of the drug to achieve the same effect as when the person first used it. This is why people with substance use disorders use more and more of a drug to get the “high” they seek.

Dependence

Dependence means that when a person stops using a drug, their body goes through “withdrawal”: a group of physical and mental symptoms that can range from mild (if the drug is caffeine) to life-threatening (such as alcohol or opioids, including heroin and prescription pain relievers). Many people who take a prescription medicine every day over a long period of time can become dependent; when they go off the drug, they need to do it gradually, to avoid withdrawal discomfort. But people who are dependent on a drug or medicine aren’t necessarily addicted.

Addiction

Unlike tolerance and dependence, addiction is a disease; but like tolerance and dependence, addiction can result from taking drugs or alcohol repeatedly. If a person keeps using a drug and can’t stop, despite negative consequences from using the drug, they have an addiction (also called a severe substance use disorder). But again, a person can be dependent on a drug, or have a high tolerance to it, without being addicted to it.

See what teens are asking about tolerance, dependence, and addiction—and the answers—here.


This article is posted as part of National Drug and Alcohol Facts Week Drug and Alcohol Facts Week® (NDAFW). NDAFW is a national health observance for teens to promote local events that use NIDA science to SHATTER THE MYTHS® about drugs.

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Submitted by Brewster, NY

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