Physical dependence

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview[edit | edit source]

Physical dependence (or drug dependence) refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation.^[1] From the point of view of the dependent person, "dependence is duress," argues addiction researcher Griffith Edwards.^[2]

Symptoms[edit | edit source]

Increased heart rate and/or blood pressure, sweating, and tremors are common signs of withdrawal. More serious symptoms such as confusion, seizures, and visual hallucinations indicate a serious emergency and the need for immediate medical care. Alcohol, benzodiazepines, and barbiturates are the only commonly abused substances that can be fatal in withdrawal. Abrupt withdrawal from other drugs, such as opioids or psychostimulants, can exaggerate mild to moderate neurotoxic side effects due to hyperthermia and generation of free radicals^[3], but life-threatening complications are very rare.

Treatment[edit | edit source]

Treatment for physical dependence depends upon the drug being withdrawn and often includes administration of another drug, especially for substances that can be dangerous when abruptly discontinued. Treatment usually requires the initiation and then tapering of a medication that has a similar action in the brain but a longer half-life.

Difference from Addiction[edit | edit source]

Physical dependence is different from drug addiction. The latter is often characterized by a psychological need for a drug, while the former can often be the result of legal, long-term use of medicine.^[4]

Drugs that cause physical dependence[edit | edit source]

References[edit | edit source]

↑ "Drug Addiction". CNN.
↑ Griffith Edwards. Alcohol: The World's Favourite Drug. 1st US ed. Thomas Dunne Books: 2002. ISBN 0-312-28387-3. P 72.
↑ Sharma HS, Sjöquist PO, Ali SF. "Drugs of abuse-induced hyperthermia, blood-brain barrier dysfunction and neurotoxicity: neuroprotective effects of a new antioxidant compound H-290/51." Current Pharmaceutical Design. 2007;13(18):1903-23. PMID 17584116
↑ "Drug Abuse - Addiction vs. Dependence". Our Chronic Pain Mission.

v t e WHO ICD-10 mental and behavioral disorders (F · 290–319)
Neurological/symptomatic	Dementia (Alzheimer's disease, multi-infarct dementia, Pick's disease, Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease, AIDS dementia complex, Frontotemporal dementia) · Delirium · Post-concussion syndrome
Psychoactive substance	Intoxication (drunkenness) · Physical dependence (alcohol dependence, opioid dependency, cocaine dependence) · Withdrawal (benzodiazepine withdrawal, delirium tremens) · Amnesic: (Korsakoff's syndrome)
Psychotic disorder	Schizophrenia (disorganized schizophrenia) · Schizotypal personality disorder · Delusional disorder · Folie à deux · Schizoaffective disorder
Mood (affective)	Mania · Bipolar disorder · Clinical depression · Cyclothymia · Dysthymia
Neurotic, stress-related and somatoform	Agoraphobia · Anxiety disorder · Panic disorder · Generalized anxiety disorder · Social Anxiety Disorder · OCD · Acute stress reaction · PTSD · Adjustment disorder · Conversion disorder (Ganser syndrome) · Somatoform disorder · Somatization disorder · Neurasthenia
Physiological/physical behavioural	Eating disorder (anorexia nervosa, bulimia nervosa) · Sleep disorder (dyssomnia, insomnia, hypersomnia, parasomnia, night terror, nightmare) · Sexual dysfunction (erectile dysfunction, premature ejaculation, vaginismus, dyspareunia, hypersexuality) · Postpartum depression
Adult personality and behaviour	Personality disorder · Passive-aggressive behavior · Kleptomania · Trichotillomania · Voyeurism · Factitious disorder · Munchausen syndrome · Ego-dystonic sexual orientation
Mental retardation	Mental retardation
Psychological development (developmental disorder)	Specific: speech and language (expressive language disorder, aphasia, expressive aphasia, receptive aphasia, Landau-Kleffner syndrome, lisp) · Scholastic skills (dyslexia, dysgraphia, Gerstmann syndrome) · Motor function (developmental dyspraxia) Pervasive: Autism · Rett syndrome · Asperger syndrome
Behavioural and emotional, childhood and adolescence onset	ADHD · Conduct disorder · Oppositional defiant disorder · Separation anxiety disorder · Selective mutism · Reactive attachment disorder · Tic disorder · Tourette syndrome · Speech (stuttering · cluttering)