Physical dependence is a physical condition caused by chronic use of a tolerance-forming drug, in which abrupt or gradual drug withdrawal causes unpleasant physical symptoms. Physical dependence can develop from low-dose therapeutic use of certain medications such as benzodiazepines, opioids, stimulants, antiepileptics and antidepressants, as well as the recreational misuse of drugs such as alcohol, opioids and benzodiazepines. The higher the dose used, the greater the duration of use, and the earlier age use began are predictive of worsened physical dependence and thus more severe withdrawal syndromes. Acute withdrawal syndromes can last days, weeks or months. Protracted withdrawal syndrome, also known as post-acute-withdrawal syndrome or "PAWS", is a low-grade continuation of some of the symptoms of acute withdrawal, typically in a remitting-relapsing pattern, often resulting in relapse and prolonged disability of a degree to preclude the possibility of lawful employment. Protracted withdrawal syndrome can last for months, years, or depending on individual factors, indefinitely. Protracted withdrawal syndrome is noted to be most often caused by benzodiazepines as well as opioids. To dispel the popular misassociation with addiction, physical dependence to medications is sometimes compared to dependence on insulin by persons with diabetes.
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- ⭐ Core Definition: Physical dependence
- Physical dependence in the context of Drug withdrawal
- Physical dependence in the context of Alcohol dependence
- Physical dependence in the context of Health problems of smoking
- Physical dependence in the context of Alcohol withdrawal
- Physical dependence in the context of NicVAX
- Physical dependence in the context of Health effects of tobacco
Physical dependence in the context of Drug withdrawal
Drug withdrawal, drug withdrawal syndrome, or substance withdrawal syndrome is the group of symptoms that occur upon the abrupt discontinuation or decrease in the intake of pharmaceutical or recreational drugs.
In order for the symptoms of withdrawal to occur, one must have first developed a form of drug dependence. This may occur as physical dependence, psychological dependence, or both. Drug dependence develops from consuming one or more substances over a period of time.
Physical dependence in the context of Alcohol dependence
Alcohol dependence is a previous (DSM-IV and ICD-10) psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol (also chemically known as ethanol).
In 2013, it was reclassified as alcohol use disorder in DSM-5, which combined alcohol dependence and alcohol abuse into this diagnosis.
Physical dependence in the context of Health problems of smoking
Tobacco products, especially when smoked or used orally, have serious negative effects on human health. Smoking and smokeless tobacco use are the single greatest causes of preventable death globally. Half of tobacco users die from complications related to such use. Current smokers are estimated to die an average of 10 years earlier than non-smokers. The World Health Organization estimates that, annually, about 8 million people die from tobacco-related causes, including 1.3 million non-smokers due to secondhand smoke. It is further estimated to have caused 100 million deaths in the 20th century.
Tobacco smoke contains over 70 chemicals, known as carcinogens, that cause cancer. It also contains nicotine, a highly addictive psychoactive drug. When tobacco is smoked, the nicotine causes physical and psychological dependency. Cigarettes sold in least developed countries have higher tar content and are less likely to be filtered, increasing vulnerability to tobacco smoking-related diseases in these regions.
Physical dependence in the context of Alcohol withdrawal
Alcohol withdrawal syndrome (AWS) is a set of symptoms that can occur following a reduction in or cessation of alcohol use after a period of excessive use. Symptoms typically include anxiety, shakiness, sweating, vomiting, fast heart rate, and a mild fever. More severe symptoms may include seizures, and delirium tremens (DTs); which can be fatal in untreated patients. Symptoms start at around 6 hours after the last drink. Peak incidence of seizures occurs at 24 to 36 hours and peak incidence of delirium tremens is at 48 to 72 hours.
Alcohol withdrawal may occur in those who are alcohol dependent. This may occur following a planned or unplanned decrease in alcohol intake. The underlying mechanism involves a decreased responsiveness of GABA receptors in the brain. The withdrawal process is typically followed using the Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA-Ar).
Physical dependence in the context of NicVAX
NicVAX is an experimental conjugate vaccine intended to reduce or eliminate physical dependence to nicotine. According to the U.S. National Institute of Drug Abuse, NicVAX can potentially be used to inoculate against nicotine addiction. This proprietary vaccine is being developed by Nabi Biopharmaceuticals of Rockville, MD. with the support from the U.S. National Institute on Drug Abuse. NicVAX consists of the hapten 3'-aminomethylnicotine which has been conjugated (attached) to Pseudomonas aeruginosa exotoxin A.
Early trials of NicVax were promising; two successive phase III trials showed results no better than placebo, and a more recent study showed that the drug decreased subjects' cravings for cigarettes.
Physical dependence in the context of Health effects of tobacco
Tobacco products, especially when smoked or used orally, have serious negative effects on human health. Smoking and smokeless tobacco use are the single greatest causes of preventable death globally. Half of tobacco users die from complications related to such use. Current smokers are estimated to die an average of 10 years earlier than non-smokers. The World Health Organization estimates that, annually, more than 7 million people die from tobacco-related causes, including 1.6 million non-smokers due to secondhand smoke. It is further estimated to have caused 100 million deaths in the 20th century.
Tobacco smoke contains over 70 chemicals, known as carcinogens, that cause cancer. It also contains nicotine, a highly addictive psychoactive drug. When tobacco is smoked, the nicotine causes physical and psychological dependency. Cigarettes sold in least developed countries have higher tar content and are less likely to be filtered, increasing vulnerability to tobacco smoking-related diseases in these regions.