How to Spot Addiction vs. Physical Dependence

A physician’s day is filled with tending to patients, filling out paperwork, and prescribing medications. In doing the latter, it can be tough to determine who really needs medications and who doesn’t. Addiction and physical dependence are two very different needs in the medical world and telling the difference can be tough. Here are some ways doctors can spot addiction and make judgments based on physical needs and craving.

Addiction and Physical Dependence: Knowing the Difference

Physical Dependence

When a patient requires medication such as opioids for an existing issue, they are physically in need of treatment. The body is dependent on an external source of relief to treat physical pain. Usually, there are natural opioids found in the body, such as endorphins, that prevents withdrawal in the body. But opioids aren’t the only form of addictive substances. Sugar, caffeine, and nicotine are all substances that cause physical dependencies. The dependence of medical prescription drugs is often expected by physicians and monitored through proper dosage.


Often confused with dependence, addiction is most commonly referred to as an opioid use disorder and classified as a disease. Addiction patients suffer from strong cravings for prescription and non-prescription drugs; but, the body has no physical requirement for treatment. In these patients, the biology of the brain has been altered to think it needs a specific substance. Addiction is often linked to destructive behavior and compulsive and uncontrollable drug use.

How Physicians can Spot Addiction

Nearly 80 percent of the world’s addicts are located in the United States. The media often portrays addicts as dirty, homeless, and skinny people, but this isn’t always the case. Users are usually proficient at hiding their addictions from the world and maintaining a fairly successful life. There is no clear depiction of someone facing addiction and it can be difficult for physicians to spot signs and give proper treatments. Here are some telltale signs for physicians to spot addiction in their patients:

Making Excuses: This can take the form of the phrase, “everyone I work with drinks or uses this much.” Those with addiction issues will often make excuses for physical pain as well, and the ailments they list wouldn’t normally require prescription medication.

Have Friend with Addictions: Addicts are more comfortable around other people who use. If they report hanging around friends with similar destructive tendencies, they may be more likely to have an addiction problem.

Drink or Use More than Intended: These patients have consumed more than their intended amount of alcohol or prescribed medication. As a physician, if your patient comes to the office asking for a refill before they are scheduled for one, it may be a sign of they are using far too often.

Look ill Earlier in the Day: As an addict, morning headaches, nausea, and dizziness are common in the mornings. These patients will constantly appear lethargic, pale and foggy during early doctors visits.

Have No Interests or Personal Hobbies: Because they are focused on their next fix, there is no room for hobbies. They work to maintain a false identity. Physicians can suggest therapy or counseling services to persuade patients into their old routine.


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