According to the World Health Organization the term "dependence" means:
"A cluster of physiological, behavioural, and cognitive phenomena in which the use of a substance or a class of substances takes on a much higher priority for a given individual than other behaviours that once had greater value".
What does this mean for a person who is substance dependent?
The characteristics of this dependence include:
- A strong desire to take the substance
- Difficulties controlling substance-taking behaviours
- Withdrawal upon cessation
- Evidence of tolerance
- Progressive neglect of alternative interests
- Continued use despite harmful consequences
"Dependence" as opposed to "addiction"
We choose to use the term "dependence" rather than the term "addiction". Besides the fact that dependence is a less emotive term than addiction, we believe that it more appropriately conveys the relationship between the young person and the substance. Like any close relationship, the individual experiences an intense desire to be with the other and this involves certain benefits as well as certain costs. In this way the young person's substance(s) of choice may be likened to their "best friend".
A best friend is usually there to celebrate with us when things go well, and to commiserate when things go bad. Similarly, there is great sadness and loss felt when our best friend is no longer around, even if we get annoyed and angry with our friend sometimes. It is the same for young people who make a decision to change their substance use, and this needs to be acknowledged with them. That is, that they are going to lose something they enjoy and they will miss that.
Often, instead of acknowledging this, we ask young people who have reduced or ceased substance use, how much "better" they feel for the change. In reality they often will not feel better, they will feel much worse because their best friend, upon whom they've been able to rely upon and trust, and whose support has been invaluable, is now gone.
Thinking about your own life, what do you get from your best friends?
What do you feel when they are not around, or when that friendship has ended?
What do you do?
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Working with Young People with Alcohol or Other Drug Issues: A self-paced learning package Published: 2006 Funded by NSW Drug & Alcohol Workforce Development Council. Written & compiled by Kristy Delaney, YAPA, and Matt Stubbs & John Howard, Ted Noffs Institute. Additional material by Nick Manning, YAPA, & by Shopfront Youth Legal Centre. Opinions are the author's.
Be careful! YAPA and the authors took reasonable care to ensure that this information was correct at the time of publishing. However health information, and government regulations, laws and standards are complex and changing. The authors may not have health, safety, or legal qualifications, and information provided is general - it is not specific health, legal or professional advice. Do not rely on it - check with other publications and authorities and if necessary get qualified, medical, legal or professional advice for your situation.
