Yes, that is correct. To run the code at
Issue packing a Tk::Adjuster, I installed Active State and then used the graphical package manager (ppm) to install Tk. This installed all the widgets needed for the OP's demo program to run on a "virgin laptop". No problem. Listbox, Adjuster, ROtext were all there. For another project, I wanted the TableMatrix widget, but I was able to find the .ppd file on another AS repository (Bribes) and install it with a single command line command. Literally thousands of modules are pre-compiled for the AS distribution(s).
I have never built an AS module myself as that so far hasn't been necessary, but I hear that this is easier than it used to be.
I have an Active State Dev Kit license. My most used application in that suite is the ability to make .exe files. This so far has worked very well for me. There are ways to do this with Strawberry, but not all of the AS features are available.