woman thinking about symptoms of opiate withdrawal
By BrightView
Published: December 10, 2020
Updated: December 10, 2020

There is a lot of misunderstanding around the terms “tolerance” and “dependence”, especially when referring to addiction.  Tolerance can be seen in someone who is actively addicted to a substance whether it be heroin, tobacco, alcohol, or another illicit substance.  Tolerance can also be seen in people who are taking medication as prescribed and appropriately. describes tolerance as “a person’s diminished response to a drug that is the result of repeated use. 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.” Sometimes, tolerance can develop quickly.  Since there are genetic and behavioral elements involved, even the first few times you take an illicit drug, drink alcohol, or take prescribed medications you can develop tolerance. It is important to know that tolerance is not the same as dependence.  Tolerance tells your body that when a drug is continuously present that it should stop responding to that amount of drug in the body, therefore requiring the person to use or take more of that drug to feel the same euphoric effects. Dependency comes in two forms – physical and psychological.  The physical dependence to drugs or alcohol means the body has developed a physiological reliance on a drug because it has caused changes in its natural state of being.  Physical dependence on a drug or alcohol can stem from many things, including:

  • Genetic vulnerability
  • Individual personality characteristics
  • Psychiatric problems/mental health issues
  • Environmental stressors (loss of a job, death of a loved one)
  • Social pressures (job performance, social acceptance)

The psychological aspect of dependency is broad as well. defines dependence as when a person stops using a drug, their body goes through withdrawal which is 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). The American Addiction Centers identifies symptoms associated with the psychological components of addictive (dependent) behaviors as:

  • Cravings
  • Issues with anxiety that occur when someone tries to stop their addictive behavior
  • Issues with depression when one is not using their drug of choice or tries to stop their addictive behavior
  • Irritability and restlessness that occur when someone is not using their drug of choice or trying to quit
  • Any other issues with mood swings that occur when one is not using their substance of choice or attempting to quit
  • Appetite loss or increased appetite associated with not using the substance of choice
  • Issues with sleep associated with quitting or not using the drug of choice
  • Issues with uncertainty about being able to stop using the substance of choice
  • Denial that one has a substance use issue or romanticizing one’s substance use/abuse
  • Obsessing over obtaining or using the drug of choice
  • Cognitive issues, such as issues with concentration, memory, problem-solving, and other aspects of judgment, etc.

If you or a loved one need long-term help to recover from opioid or alcohol addiction, please call us today 1-833-510-HELP. Our caring and friendly staff answer the phone 24 hours a day. In fact, many of us are in recovery too. We will treat you with respect and dignity and can answer any questions that you may have.  We never judge and can answer any questions that you may have. We accept Medicare and commercial insurance plans. Don’t let fear get in the way of reclaiming your health.