What does the term 'dependence' refer to in the context of drug use?

The term 'dependence' in the context of drug use primarily refers to the physiological and psychological adaptations that occur in response to the continual presence of a substance. This includes the inability to control drug use, which is indicative of a more significant challenge such as addiction. Once an individual develops dependence on a substance, they often find it difficult to stop using the drug despite negative consequences to their health, social life, or responsibilities.

This understanding aligns well with the nature of dependence, which encapsulates both a strong desire (or craving) for the substance and the inability to cease usage, leading to a cycle of continued consumption. The chronic use of the substance alters brain chemistry, creating a condition where the user feels compelled to use the drug to avoid withdrawal symptoms or to function normally. Therefore, this inability to control drug use is a critical aspect of dependence as it reflects the compulsion and impaired control that accompany it.

While the other options touch on relevant aspects of drug use or behavioral changes, they do not capture the full meaning of dependence. For example, a temporary change in mental state refers more to a transient condition rather than the chronic and ongoing nature of dependence. Physiological adaptation is essential, but it is only a component of the overall dependence framework.