Moreover, with the term “dependence” in the medical definition of addiction itself, it became very difficult to teach people that needing a drug to function isn’t the essence of addiction. The misdefinition encapsulated the idea that suffering withdrawal—rather than compulsive use despite negative consequences—was fundamental to the problem. That meant that the drive to take drugs—now demoted to being called merely “psychological dependence”—was less important than getting sick if you couldn’t get the drug. In reality, this desire—and related repetitive drug-taking—matters far more than how sick you get when you try to stop. In fact, with heroin withdrawal, the severity of symptoms like vomiting and diarrhea isn’t particularly linked to relapse risk, which is far more associated with how much the person wants the drug. With cocaine, which doesn’t make you sick at all if you quit abruptly, the entire addiction is “in your head” or “psychological”—but that obviously doesn’t make crack not addictive!
— Scientists Unveil a Bold New Definition of Addiction | The Fix
