I want to be clear here about the difference between substance use, abuse, addiction, and dependence:
The difference between addiction and dependence is this, if someone who depends on a prescribed substance, once they are “cut off” or the prescription runs out after a long period of time, they do not take extreme measures to acquire the substance or substitute the substance with something else legal nor illicit (alcohol, heroin, ecstasy, literally anything). So, essentially, they’re not going to rob their Grandma for pills or something to pawn in order to go to the street to get some pills or whatever they want. Substance dependence, however, can be a slippery slope, especially if there’s a family history considering addiction is a brain disease also based in genetics (nature and nurture, as well). In my experience with clients, this applies most often with alcohol.
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