The terms dependence and addiction are often used interchangeably, but there are distinctions. Dependence is an adaptation to repeated exposure to some drugs and medicines, usually characterised by tolerance and withdrawal. It can be regarded as an inevitable and often acceptable consequence of long-term use of some medicines, such as antidepressants.^1,2

Definitions for addiction or substance misuse disorder, reflect a stepping-up of dependence due to an additional “compulsive preoccupation to seek and take a substance despite consequences.” There are several key elements to addiction:^1-5

·       it is a chronic, relapsing disorder;

·      -  it involves compulsive drug/substance seeking and use;

·     -  there is a loss of control in limiting intake despite the adverse consequences;

·     - a negative emotional state will develop, typically dysphoria, anxiety or irritability;

·    -  there is a motivational withdrawal syndrome when access to the drug is prevented

·    - there are long-lasting effects on the brain.

In lay terms, addiction may be explained as “not having control over doing, taking or using something to the point where it could be harmful to you.” Withdrawal can refer to the physiological reactions when a drug or medicine that has been taken repeatedly is removed.^2,6