Substance dependence can be diagnosed with physiological dependence Physical dependence refers to a state resulting from chronic use of a drug that has produced tolerance and where negative physical symptoms of withdrawal result from abrupt discontinuation or dosage reduction. Physical dependence can develop from low-dose therapeutic use of certain medications as well as misuse of recreational drugs such as, evidence of tolerance or withdrawal, or without physiological dependence.
The related concept of drug addiction has many different definitions. Some writers give in fact drug addiction the same meaning as substance dependence, others for example provides drug addiction a narrower meaning which excludes drugs without evidence of tolerance or withdrawal symptoms.
Contents |
DSM-IV substance dependencies
- 303.90 Alcohol dependence Alcohol dependence, as described in the DSM-IV, is a psychiatric diagnosis describing an entity in which an individual uses alcohol despite significant areas of dysfunction, evidence of physical dependence, and/or related hardship
- 304.00 Opioid dependence Opioid dependency is a medical diagnosis characterized by an individual's inability to stop using opioids even when objectively it is in his or her best interest to do so. In 1964 the WHO Expert Committee on Drug Dependence introduced "dependence" as “A cluster of physiological, behavioural and cognitive phenomena of variable intensity,
- 304.10 Sedative A sedative is a substance that induces sedation by reducing irritability or excitement, hypnotic The benzodiazepine and nonbenzodiazepine hypnotic medications also have a number of side effects such as daytime fatigue, motor vehicle crashes, cognitive impairments, and falls and fractures. Elderly people are more sensitive to these side effects and a meta analysis found that the risks generally outweigh any marginal benefits of hypnotics in, or anxiolytic An anxiolytic is a drug used for the treatment of symptoms of anxiety. Anxiolytics have been shown to be useful in the treatment of anxiety disorders dependence (including benzodiazepine dependence Benzodiazepine dependence or benzodiazepine addiction is the condition when a person is dependent on benzodiazepine drugs. Dependence can either be a psychological dependence or a physical dependence or a combination of the two. Physical dependence occurs when a person becomes tolerant to benzodiazepines and as a result of the physiological and barbiturate dependence With regular use of barbituates, barbiturate dependence develops. This in turn may lead to a need for increasing doses of the drug to get the original desired pharmacological or therapeutic effect. Barbiturate use can lead to both psychological and physical dependence and the drugs have a high abuse liability. Psychological addiction to)
- 304.20 Cocaine dependence Cocaine dependence is psychological dependency on the regular use of cocaine. It can result in severe physiological damage, psychosis, schizophrenia, lethargy, depression, or a potentially fatal overdose
- 304.30 Cannabis dependence
- 304.40 Amphetamine dependence (or amphetamine-like)
- 304.50 Hallucinogen These classes of psychoactive drugs have in common that they can cause subjective changes in perception, thought, emotion and consciousness. Unlike other psychoactive drugs, such as stimulants and opioids, the hallucinogens do not merely amplify familiar states of mind, but rather induce experiences that are qualitatively different from those of dependence
- 304.60 Inhalant Inhalants are a broad range of drugs whose volatile vapors are taken in via the nose and trachea dependence
- 304.80 Polysubstance Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or dependence
- 304.90 Phencyclidine Phencyclidine (a complex clip of the chemical name 1-piperidine, commonly initialized as PCP), also known as angel dust and other street names, is a recreational, dissociative drug formerly used as an anesthetic agent, exhibiting hallucinogenic and neurotoxic effects. Developed in 1926, it was first patented in 1952 by the Parke-Davis (or phencyclidine-like) dependence
- 304.90 Other (or unknown) substance dependence
- 305.10 Nicotine dependence
Drug addiction
Drug addiction is a pathological or abnormal condition In medicine, pathology is the study and diagnosis of disease. The related scientific study of disease processes is called "general pathology". Medical pathology is divided into two main branches, anatomical pathology and clinical pathology. Medical pathologists work through examination of organs, tissues, bodily fluids, and whole bodies which arises due to frequent drug A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulations, medicine, and colloquial usage use. The disorder of addiction involves the progression of acute drug use Recreational drug use is the use of a psychoactive substance with the intention of creating or enhancing recreational experience. Such use is controversial, however, often being considered to be also drug abuse, and it is often illegal. Also, it may overlap with other uses, such as medicinal , performance enhancement, and entheogenic (spiritual) to the development of drug-seeking behavior, the vulnerability to relapse, and the decreased, slowed ability to respond to naturally rewarding stimuli. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, (DSM-IV) has categorized three stages of addiction: preoccupation/anticipation, binge/intoxication, and withdrawal/negative affect. These stages are characterized, respectively, everywhere by constant cravings and preoccupation with obtaining the substance; using more of the substance than necessary to experience the intoxicating effects; and experiencing tolerance, withdrawal symptoms, and decreased motivation for normal life activities.[2] By the American Society of Addiction Medicine definition, drug addiction differs from drug dependence The related concept of drug addiction has many different definitions. Some writers give in fact drug addiction the same meaning as substance dependence, others for example provides drug addiction a narrower meaning which excludes drugs without evidence of tolerance or withdrawal symptoms and drug tolerance In physiology, physiological tolerance or drug tolerance is commonly encountered in pharmacology, when a subject's reaction to a drug decreases so that larger doses are required to achieve the same effect. Drug tolerance can involve both psychological drug tolerance and physiological factors. Characteristics of drug tolerance: it is reversible,.[3] Several theories of drug addiction exist, some of the main ones are genetic predisposition, the self medication theory, and factors involved with social/economic development.
Epidemiological studies estimate that genetic factors account for 40-60% of the risk factors for alcoholism. Similar rates of heritability for other types of drug addiction have been indicated by other studies (Kendler,1994). Knestler hypothesized in 1964 that a gene or group of genes might contribute to predisposition to addiction in several ways. For example, altered levels of a normal protein due to environmental factors could then change the structure or functioning of specific brain circuits during development. These altered brain circuits could change the susceptibility of an individual to an initial drug use experience. In support of this hypothesis, animal studies have shown that environmental factors such as stress can affect an animal's genotype (Knestler,1996).
The self-medication hypotheses espoused by both psychoanalysts and biological researcher, predicts that certain individuals abuse drugs in an attempt to self-medicate their unique and seemingly intolerable states of mind (Khantzian,1985). The self medication theory has a long history. Freud in 1884, first raised this concept in noting the anti-depressing properties of cocaine. Stress has long been recognized as a major contributor for drug cravings and relapse and is therefore supportive of the self-medication theory. In line with this theory, a person's use of a particular drug of choice is not an accident, but rather it is chosen for its pharmacological affect in relieving stressful symptoms or unwanted feelings. Research has shown that people who survive disasters are prone to stress related disorders such as Post Trauma Stress Disorder (PTSD) and depression. People who experience major trauma in their life experiences may self-medicate with drugs or alcohol to relieve the symptoms of PTSD and depression (Vlahov,2002).
Kendler, K.S., et al., (1994). A twin family study of alcoholism in women. In: Am J. Psychiatry 151, (pp707-715).
Khantzian, E.J. (1985). The Self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence. In: Am. L. Psychiatry 142: (pp. 1259-1264).
Vlahov, D., et al. (2002). Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11 terrorist attacks. American Journal of Epidemiology 155(11): 988-996, (2002).
It is, both among scientists and other writers, quite usual to allow the concept of drug addiction to include persons who are not drug abusers according to the definition of the American Society of Addiction Medicine. The term drug addiction is then used as a category which may include the same persons who, under the DSM-IV The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies,, can be given the diagnosis of substance dependence or substance abuse Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or. (See also DSM-IV Codes Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, also known as DSM-IV-TR, is a manual published by the American Psychiatric Association that includes all currently recognized mental health disorders. The coding system utilized by the DSM-IV is designed to correspond with codes from the International Classification)
Classification
Definitions
The terms abuse and addiction have been defined and re-defined over the years. The 1957 World Health Organization The World Health Organization is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. Established on 7 April 1948, and headquartered in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health Organization, which had been an agency of the (WHO) Expert Committee on Addiction-Producing Drugs defined addiction and habituation as components of drug abuse Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or:
Drug addiction is a state of periodic or chronic intoxication produced by the repeated consumption of a drug (natural or synthetic). Its characteristics include: (i) an overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means; (ii) a tendency to increase the dose; (iii) a psychic (psychological) and generally a physical dependence Physical dependence refers to a state resulting from chronic use of a drug that has produced tolerance and where negative physical symptoms of withdrawal result from abrupt discontinuation or dosage reduction. Physical dependence can develop from low-dose therapeutic use of certain medications as well as misuse of recreational drugs such as on the effects of the drug; and (iv) detrimental effects on the individual and on society.
Drug habituation (habit) is a condition resulting from the repeated consumption of a drug. Its characteristics include (i) a desire (but not a compulsion) to continue taking the drug for the sense of improved well-being which it engenders; (ii) little or no tendency to increase the dose; (iii) some degree of psychic dependence on the effect of the drug, but absence of physical dependence and hence of an abstinence syndrome [withdrawal], and (iv) detrimental effects, if any, primarily on the individual.
In 1964, a new WHO committee found these definitions to be inadequate, and suggested using the blanket term "drug dependence":
The definition of addiction gained some acceptance, but confusion in the use of the terms addiction and habituation and misuse of the former continued. Further, the list of drugs abused increased in number and diversity. These difficulties have become increasingly apparent and various attempts have been made to find a term that could be applied to drug abuse generally. The component in common appears to be dependence, whether psychic or physical or both. Hence, use of the term 'drug dependence', with a modifying phase linking it to a particular drug type in order to differentiate one class of drugs from another, had been given most careful consideration. The Expert Committee recommends substitution of the term 'drug dependence' for the terms 'drug addiction' and 'drug habituation'.
The committee did not clearly define dependence, but did go on to clarify that there was a distinction between physical and psychological ("psychic") dependence. It said that drug abuse was "a state of psychic dependence or physical dependence, or both, on a drug, arising in a person following administration of that drug on a periodic or continued basis." Psychic dependence was defined as a state in which "there is a feeling of satisfaction and psychic drive that requires periodic or continuous administration of the drug to produce pleasure or to avoid discomfort" and all drugs were said to be capable of producing this state:
There is scarcely any agent which can be taken into the body to which some individuals will not get a reaction satisfactory or pleasurable to them, persuading them to continue its use even to the point of abuse — that is, to excessive or persistent use beyond medical need.
The 1957 and 1964 definitions of addiction, dependence and abuse persist to the present day in medical literature. It should be noted that at this time (2006) the Diagnostic Statistical Manual (DSM-IV-TR) now spells out specific criteria for defining abuse and dependence. (DSM-IV-TR) uses the term substance dependence instead of addiction; a maladaptive pattern of substance abuse, leading to clinically significant impairment or distress, as manifested by three (or more) specified criteria, occurring at any time in the same 12-month period. This definition is also applicable on drugs with smaller or nonexistent physical signs of withdrawal, e.g., cannabis.
In 2001, the American Academy of Pain Medicine, the American Pain Society, and the American Society of Addiction Medicine jointly issued "Definitions Related to the Use of Opioids for the Treatment of Pain", which defined the following terms:[3]
Addiction is 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 Physical dependence refers to a state resulting from chronic use of a drug that has produced tolerance and where negative physical symptoms of withdrawal result from abrupt discontinuation or dosage reduction. Physical dependence can develop from low-dose therapeutic use of certain medications as well as misuse of recreational drugs such as is 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 In physiology, physiological tolerance or drug tolerance is commonly encountered in pharmacology, when a subject's reaction to a drug decreases so that larger doses are required to achieve the same effect. Drug tolerance can involve both psychological drug tolerance and physiological factors. Characteristics of drug tolerance: it is reversible, is the body's physical adaptation to a drug: greater amounts of the drug are required over time to achieve the initial effect as the body "gets used to" and adapts to the intake.
Pseudo addiction is a term which has been used to describe patient behaviors that may occur when pain is undertreated. Patients with unrelieved pain may become focused on obtaining medications, may "clock watch," and may otherwise seem inappropriately "drug seeking." Even such behaviors as illicit drug use and deception can occur in the patient's efforts to obtain relief. Pseudoaddiction can be distinguished from true addiction in that the behaviors resolve when pain is effectively treated.
The Diagnostic and Statistical Manual of Mental Disorders The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies,, DSM-IV-TR doesn't use the word addiction at all. Instead it has a section about substance dependence
"When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with Substance Abuse Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or are considered Substance Use Disorders...." [1]
A definition of addiction proposed by professor Nils Bejerot Nils Bejerot was a Swedish psychiatrist and criminologist best known for coining the phrase, Stockholm syndrome:
"An emotional fixation (sentiment) acquired through learning, which intermittently or continually expresses itself in purposeful, stereotyped behavior with the character and force of a natural drive, aiming at a specific pleasure or the avoidance of a specific discomfort."[4]
Sat, 04 Sep 2010 23:08:02 GMT+00:00
The Guardian Built during the second world war, the wards of wing 21B are these days committed to the treatment of drug addiction . Susannah is a long-term drug user and ... Britain looks at Portugal's success story over decriminalising personal drug use The Guardian
Sat, 15 Dec 2007 02:36:52 PST
Drug Addiction in US Military this has happened in every war so why should this one be any different. youtube.com.
