Hi gbonger,
To my understanding, dependence does not "depend" ;) on increasing dosages, but on having either a physical or mental need to continue using the drug. Dependence is defined as: the state of relying on or needing something for aid, support or the like.
The easiest way to tell if you have dependence on a drug is to stop taking it. (although this can be dangerous, so discuss it with a doctor if you want to do this.) If you stop, and your body or mind reacts, craving it or needing it, then you are dependent. Dependence is rather common. Most people are dependent on some substance, be it sugar, caffeine, salt or some other, less commonly used substance. The idea of dependence is not negative in itself; one could be dependent on exercise for clear thinking and stress-relief, for example. The problem comes in when the substance or action to which one is addicted is actually harmful to the user. Assessing harmfulness is up to the user and it should be made with an understanding of the causes that led to the use of the drug or activity in the first place. It can often be helpful to get a doctor's or psychologist's advice when making these kinds of assessments. Sometimes addressing the root cause of the disease, discomfort, or difficulty that led to drug use and dependence in the first place will eliminate the need for the drug or confirm its necessity. I hope that this clarifies things a little. :) Good luck to you, gbonger.
According to the DSM-IV-TR, the following criteria is used to make a diagnosis of substance dependence:
A maladaptive pattern of substance use, leading to clincially significant impariment or distress as manifested by three or more of the following, occuring at any time in the same 12 month period:
1. Tolerance, as defined by either of the following:
a) a need for markedly increased amounts of the substance to achieve intoxification or desired effect.
b) markedly diminished effect with continuded use of the same amount of the substance.
2. Withdrawal, as manifested by either of the following:
a) the characterstic withdrawl syndrome for the substance.
b) the same (or closely related substance) is taken to relive or avoid withdrawal symptoms.
3. The substance is often taken in larger amounts or over a logner period than was intended.
4. There is a persistent desire or unsucessful efforts to cut down or control substance use.
5. A geat deal of time is spent in activites necssary to obtain the substance, use the substance or recover from its effects.
6. Important social, occupational or recreational activities are given up or reduced because of substance use.
7. The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is liketly ot have been caused or exacerbated by the substance.
So, it is possible to be dependent on a substance without increasing the dose. You could meet criteria 4, 5, 6 or 7, which does not involve increasing the dose, as long as three of them occur within the same 12 month period.
(I am a counselor and work with adolescents who suffer from substance abuse/dependence).
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