Physical dependence refers to a state resulting from chronic use of a drug that has produced 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, [1] and where negative physical symptoms[2] of withdrawal Withdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and/or alcohol. In order to experience the symptoms of withdrawal, one must have first developed a physical result from abrupt discontinuation or dosage reduction.[3] Physical dependence can develop from low-dose therapeutic use of certain medications as well as misuse of recreational drugs such as alcohol. The higher the dose used typically the worse the physical dependence and thus the worse the withdrawal symptoms. Withdrawal symptoms can last days, weeks or months or occasionally longer and will vary according to the dose, the type of drug used and the individual person.[4]
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Symptoms
Physical dependence can manifest itself in the appearance of both physical and psychological symptoms but which are caused by physiological adaptions in the central nervous system and the brain due to chronic exposure to a substance. Symptoms which may be experienced during withdrawal or reduction in dosage include increased heart rate and/or blood pressure, sweating, and tremors. More serious withdrawal Withdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and/or alcohol. In order to experience the symptoms of withdrawal, one must have first developed a physical symptoms such as confusion Confusion of a pathological degree usually refers to loss of orientation (ability to place oneself correctly in the world by time, location, and/or personal identity) sometimes accompanied by disordered consciousness and often memory (ability to correctly recall previous events or learn new material). Confusion as such is not synonymous with, seizures An epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness. It can manifest as an alteration in mental state, tonic or clonic, and visual hallucinations A hallucination, in the broadest sense, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space. The latter indicate a serious emergency and the need for immediate medical care. Sedative hypnotic drugs such as alcohol Ethanol, also called ethyl alcohol, pure alcohol, grain alcohol, or drinking alcohol, is a volatile, flammable, colorless liquid. It is a powerful psychoactive drug and one of the oldest recreational drugs. It is best known as the type of alcohol found in alcoholic beverages and thermometers. In common usage, it is often referred to simply as, benzodiazepines A benzodiazepine is a psychoactive drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring. The first benzodiazepine, chlordiazepoxide (Librium), was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed diazepam (Valium) since 1963, and barbiturates Barbiturates are drugs that act as central nervous system depressants, and, by virtue of this, they produce a wide spectrum of effects, from mild sedation to total anesthesia. They are also effective as anxiolytics, as hypnotics, and as anticonvulsants. They have addiction potential, both physical and psychological. Barbiturates have now largely are the only commonly available substances that can be fatal in withdrawal due to their propensity to induce withdrawal convulsions. Abrupt withdrawal from other drugs, such as opioids An opioid is a chemical that works by binding to opioid receptors, which are found principally in the central nervous system and the gastrointestinal tract. The receptors in these organ systems mediate both the beneficial effects and the side effects of opioids or psychostimulants Stimulants produce a variety of different kinds of effects by enhancing the activity of the central and peripheral nervous systems. Common effects, which vary depending on the substance in question, may include enhanced alertness, awareness, wakefulness, endurance, productivity, and motivation, increased arousal, locomotion, heart rate, and blood, can exaggerate mild to moderate neurotoxic Neurotoxicity occurs when the exposure to natural or artificial toxic substances, which are called neurotoxins, alters the normal activity of the nervous system in such a way as to cause damage to nervous tissue. This can eventually disrupt or even kill neurons, key cells that transmit and process signals in the brain and other parts of the side effects due to hyperthermia Hyperthermia is an elevated body temperature due to failed thermoregulation. Hyperthermia occurs when the body produces or absorbs more heat than it can dissipate. When the elevated body temperatures are sufficiently high, hyperthermia is a medical emergency and requires immediate treatment to prevent disability and death and generation of free radicals In chemistry, radicals are atoms, molecules, or ions with unpaired electrons on an open shell configuration. The unpaired electrons cause them to be highly chemically reactive. Radicals play an important role in combustion, atmospheric chemistry, polymerization, plasma chemistry, biochemistry, and many other chemical processes, including human[5], but life-threatening complications are very rare.
Treatment
Treatment for physical dependence depends upon the drug being withdrawn and often includes administration of another drug, especially for substances that can be dangerous when abruptly discontinued. Physical dependence is usually managed by a slow dose reduction over a period of weeks, months or sometimes longer depending on the drug, dose and the individual.[4] A physical dependence on alcohol is often managed with a cross tolerant drug, such as long acting benzodiazepines A benzodiazepine is a psychoactive drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring. The first benzodiazepine, chlordiazepoxide (Librium), was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed diazepam (Valium) since 1963 to manage the alcohol withdrawal Alcohol withdrawal syndrome is the set of symptoms seen when an individual reduces or stops alcohol consumption after prolonged periods of excessive alcohol intake. Excessive abuse of alcohol leads to tolerance, physical dependence, and an alcohol withdrawal syndrome. The withdrawal syndrome is largely due to the central nervous system being in a symptoms.
Drugs that cause physical dependence
- nicotine Nicotine is an alkaloid found in the nightshade family of plants that constitutes approximately 0.6–3.0% of dry weight of tobacco, with biosynthesis taking place in the roots and accumulation occurring in the leaves. It functions as an antiherbivore chemical with particular specificity to insects; therefore nicotine was widely used as an[6]
- opioids An opioid is a chemical that works by binding to opioid receptors, which are found principally in the central nervous system and the gastrointestinal tract. The receptors in these organ systems mediate both the beneficial effects and the side effects of opioids[7]
- barbiturates Barbiturates are drugs that act as central nervous system depressants, and, by virtue of this, they produce a wide spectrum of effects, from mild sedation to total anesthesia. They are also effective as anxiolytics, as hypnotics, and as anticonvulsants. They have addiction potential, both physical and psychological. Barbiturates have now largely
- benzodiazepines A benzodiazepine is a psychoactive drug whose core chemical structure is the fusion of a benzene ring and a diazepine ring. The first benzodiazepine, chlordiazepoxide (Librium), was discovered accidentally by Leo Sternbach in 1955, and made available in 1960 by Hoffmann–La Roche, which has also marketed diazepam (Valium) since 1963 (see 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 benzodiazepine withdrawal syndrome Benzodiazepine withdrawal syndrome—often abbreviated to benzo withdrawal—is the cluster of symptoms which appear when a person who has taken benzodiazepines long term and has developed benzodiazepine dependence stops taking benzodiazepine drug or during dosage reductions. Benzodiazepine withdrawal is similar to alcohol withdrawal syndrome and)
- nonbenzodiazepines The nonbenzodiazepines, also called benzodiazepine-like drugs, are a class of psychoactive drugs whose pharmacological actions are similar to those of the benzodiazepines, but are structurally distant or unrelated to the benzodiazepines on a chemical level. They have similar side effects and benefits and risks as the benzodiazepines, such as zopiclone Zopiclone, is a non-benzodiazepine hypnotic agent used in the treatment of insomnia. In the United States, zopiclone is not commercially available, although its active stereoisomer, eszopiclone, is sold under the names Lunesta (see History). Zopiclone is a controlled substance in the United States, Canada, Japan, Brazil and some European countries,[8]
- ethyl alcohol Ethanol, also called ethyl alcohol, pure alcohol, grain alcohol, or drinking alcohol, is a volatile, flammable, colorless liquid. It is a powerful psychoactive drug, best known as the type of alcohol found in alcoholic beverages and in modern thermometers. Ethanol is one of the oldest recreational drugs. In common usage, it is often referred to (alcoholic beverage An alcoholic beverage is a drink containing ethanol . Alcoholic beverages are divided into three general classes: beers, wines, and spirits)[9]
- GHB GHB has been used in a medical setting as a general anesthetic, to treat conditions such as insomnia, clinical depression, narcolepsy, and alcoholism, and to improve athletic performance. It is also used as an intoxicant or as a date rape drug. GHB is naturally produced in the human body's cells and is structurally related to the ketone body beta-[10]
- methaqualone Methaqualone is a sedative-hypnotic drug that is similar in effect to barbiturates, a general central nervous system depressant. Its use peaked in the 1960s and 1970s as a hypnotic, for the treatment of insomnia, and as a sedative and muscle relaxant. It has also been used illegally as a recreational drug, commonly known as Quaaludes or Sopors ( (Quaalude)
- caffeine Caffeine is a bitter, white crystalline xanthine alkaloid that is a psychoactive stimulant drug. Caffeine was discovered by a German chemist, Friedlieb Ferdinand Runge, in 1820. He coined the term kaffein, a chemical compound in coffee (the German word for which is Kaffee), which in English became caffeine (and changed to Koffein in German)[11]
- blood pressure medications such as beta blockers Beta blockers is a class of drugs used for various indications, but particularly for the management of cardiac arrhythmias, cardioprotection after myocardial infarction (heart attack), and hypertension. As beta adrenergic receptor antagonists, they diminish the effects of epinephrine (adrenaline) and other stress hormones. Invented by Sir James W[12][13]
- androgenic-anabolic steroids[14][15]
- glucocorticoids Glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor (GR), which is present in almost every vertebrate animal cell. The name glucocorticoid (glucose + cortex + steroid) derives from their role in the regulation of the metabolism of glucose, their synthesis in the adrenal cortex, and their steroidal structure ([16]
Rebound syndrome
Main article: Rebound effect Rebound effect is the tendency of a medication, when discontinued, to cause a return of the symptoms being treated to be more severe than before . Medications with a known rebound effect can be withdrawn gradually or in conjunction with another medication which does not exhibit a rebound effectA wide range of drugs whilst not causing a true physical dependence can still cause withdrawal Withdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and/or alcohol. In order to experience the symptoms of withdrawal, one must have first developed a physical symptoms or rebound effects Rebound effect is the tendency of a medication, when discontinued, to cause a return of the symptoms being treated more severe than before. Medications with a known rebound effect can be withdrawn gradually or in conjunction with another medication which does not exhibit a rebound effect. The symptom will be more pronounced after the medication is during dosage reduction or especially abrupt or rapid withdrawal.[17] These can include stimulants,[18][19][20][21], antidepressants,[22][23] anticonvulsants,[24][25][26] steroidal A steroid is a type of organic compound that contains a specific arrangement of four rings that are joined to each other. Examples of steroids include cholesterol, the sex hormones estradiol and testosterone, and the anti-inflammatory drug dexamethasone drugs and antiparkinsonian An antiparkinson, or antiparkinsonian, is a type of drug which is intended to treat and relieve the symptoms of Parkinson's disease or Parkinsonism. Most of these agents act by either increasing dopamine activity or reducing acetylcholine activity in the central nervous system (CNS) drugs.[27] Antipsychotics An antipsychotic is a tranquilizing psychiatric medication primarily used to manage psychosis (including delusions or hallucinations, as well as disordered thought), particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s. Most of the drugs in the second are another drug class that do not cause true physical dependency[28] but if discontinued too rapidly can cause an acute withdrawal syndrome Withdrawal can refer to any sort of separation, but is most commonly used to describe the group of symptoms that occurs upon the abrupt discontinuation/separation or a decrease in dosage of the intake of medications, recreational drugs, and/or alcohol. In order to experience the symptoms of withdrawal, one must have first developed a physical.[29] Drugs like cocaine Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic. Specifically, it is a serotonin-norepinephrine-dopamine, marijuana Cannabis, also known as marijuana, marihuana, among many other namesa[›], refers to any number of preparations of the Cannabis plant intended for use as a psychoactive drug. The word marijuana comes from the Mexican Spanish mariguana. According to the United Nations, cannabis "is the most widely used illicit substance in the world.", amphetamines Amphetamine or amfetamine (INN) is a psychostimulant drug that is known to produce increased wakefulness and focus in association with decreased fatigue and appetite. Amphetamine is chemically related to methamphetamine and lisdexamfetamine, a class of potent drugs that act by increasing levels of dopamine and norepinephrine in the brain, inducing, and hallucinogens The general group of pharmacological agents commonly known as hallucinogens can be divided into three broad categories: psychedelics, dissociatives, and deliriants. 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 can be associated with minimal physical dependence[30] but can still cause withdrawal or rebound symptoms. However, with sustained and heavy cocaine abuse signs of physiological dependence may occur.[31] When talking about illicit drugs rebound withdrawal is, especially with stimulants, sometimes referred to as "coming down" or "crashing".
Some drugs, like anticonvulsants The anticonvulsants are a diverse group of pharmaceuticals used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder, since many seem to act as mood stabilizers. The goal of an anticonvulsant is to suppress the rapid and excessive firing of neurons that start a seizure and antidepressants An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. Drugs including the monoamine oxidase inhibitors , tricyclic antidepressants (TCAs), tetracyclic antidepressants (TeCAs), selective serotonin reuptake inhibitors (SSRIs), and, describe the drug category and not the mechanism. The individual agents and drug classes in the anticonvulsant drug category act at many different receptors and it is not possible to generalize their potential for physical dependence or incidence or severity of rebound syndrome Rebound effect is the tendency of a medication, when discontinued, to cause a return of the symptoms being treated to be more severe than before . Medications with a known rebound effect can be withdrawn gradually or in conjunction with another medication which does not exhibit a rebound effect as a group so need to be looked at individually. Anticonvulsants The anticonvulsants are a diverse group of pharmaceuticals used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder, since many seem to act as mood stabilizers. The goal of an anticonvulsant is to suppress the rapid and excessive firing of neurons that start a seizure as a group however are known to cause tolerance to the anti-seizure effect.[32] SSRI Selective serotonin reuptake inhibitors or serotonin-specific reuptake inhibitor are a class of compounds typically used as antidepressants in the treatment of depression, anxiety disorders, and some personality disorders. They are also typically effective and used in treating premature ejaculation problems as well as some cases of insomnia drugs, which have an important use as antidepressants, are not considered to cause physical dependence, but it's generally accepted that they cause a discontinuation syndrome SSRI discontinuation syndrome is a syndrome that can occur following the interruption, dose reduction, or discontinuation of SSRI (selective serotonin re-uptake inhibitor) or SNRI antidepressant medications. The condition often begins between 24 hours to 10 days after reduction in dosage or complete discontinuation, depending on the elimination. Due to this, in Europe these drugs cannot be advertised as "non-habit forming".[citation needed] There has however been case reports of dependence with venlafaxine Venlafaxine is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. It is prescribed for the treatment of major depression and anxiety disorders, among other uses. In 2007, venlafaxine was the sixth most commonly prescribed antidepressant on the U.S. retail market, with 17.2 million (Effexor).[33]
See also
- Addiction Historically, addiction has been defined with regard solely to psychoactive substances which cross the blood-brain barrier once ingested, temporarily altering the chemical milieu of the brain[disambiguation needed]
- Addiction recovery groups
- Alcohol withdrawal syndrome
- Benzodiazepine dependence
- Benzodiazepine withdrawal syndrome
- Discontinuation syndrome
- Drug and Alcohol Dependence
- Drug tolerance
- Rebound insomnia
- Substance dependence
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Thu, 12 Aug 2010 19:22:03 GMT+00:00
East Bay Express Nicotine, alcohol, and prescription drugs all cause physical dependence and withdrawal. Long-term marijuana use may cause psychological dependence. ...
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that might be addictive habit forming and have possible side effects You want an all natural solution with no risk of physical or psychological dependence and no side effects
MasterBlaster
Fri, 13 Aug 2010 21:47:23 GM
A person with addiction may, or may not, develop . physical dependence. and experience physical withdrawal symptoms upon stopping use; . physical dependence. usually requires use of alcohol or other drugs many times a day, every day, ...
