Definition - Relationships and Distinctions: Addiction, Physical Dependence & Tolerance Per the most recently published consensus document from AAPM/APS/ASAM

Addiction » A primary, chronic neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Physical Dependence » A state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

Tolerance » A state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug's effects over time.

"The defining characteristic of addiction is compulsive, out-of-control drug use despite serious negative consequences. . . . "Effective management depends on conceptualizing addiction as a chronic, relapsing medical illness. . . . "Tolerance and dependence are neither necessary nor sufficient for addiction. Indeed, withdrawal symptoms from cessation of addiction drug use tend to resolve within days to weeks and therefore cannot account for the profound persistence of relapse risk, which has been well documented in addicted populations."
Nov. 28, 2002, JAMA (vol. 286, No. 20,pp 2586-2594)

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