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Drug dependence is substance addiction which is the physical and/or psychological need for a drug. When using drugs becomes the focus of a person's life and interferes with his or her ability to cope without the drug, dependence is likely. A dependency on drugs tends to involve the user associating with other drug abusers as well as behavioral and health changes. When an addict tries to stop using the substance, withdrawal symptoms result, so treatment is usually done gradually with medical supervision.
When drug taking is repeated beyond prescribed usage, it often leads to a pattern of drug dependence and tolerance. Tolerance is the body's need for larger or more frequent doses of a substance to achieve the same effect. It occurs when the body has learned to tolerate, or become used to, the substance. Taking a prescribed drug in the doses recommended by a doctor for a short period of time for a certain purpose is not dependence, but going beyond that usage could easily lead to a dependency.
When dependency or addiction is reached, stopping the drug or not getting large enough doses will result in withdrawal. Specific withdrawal symptoms depend on each drug, but anxiety, sweating, shaking, nausea, vomiting and muscle pain are commonly experienced by addicts. Several withdrawal symptoms may include confusion and hallucinations. Hallucinations are the experience of seeing, feeling or hearing things not actually there.
Not all medications are addictive and not all drugs are addictive in the same way. Some drugs cause physical dependency, while others cause a more psychological addiction. Still others have both properties in terms of drug dependence. Alcohol can be both psychologically and physically addictive. Heroin and morphine are severely physically addictive, while marijuana, cocaine and ecstasy are thought to cause a more psychological dependence.
Treatment for drug dependence must be done on an individual basis. Substance addiction treatment may consist of a combination of counseling, drug therapy and self-help techniques. Self-help possibilities include the addict seeking help from sources such as treatment centers and books. Drug therapy, or pharmacotherapy, is a controlled amount of drugs that is gradually decreased and given to an addict to help prevent strong withdrawal symptoms. Counseling for drug dependency is available in different types and may involve family therapy and behavioral therapy to help the addict learn to live without drugs.
What are some pain options I can discuss with my doctor that do not involve taking narcotics? I clench and grind my teeth, which causes severe jaw, head, and neck pain and swelling for weeks at a time. When it gets really bad, I go see my doctor, but he always just writes me a narcotics prescription and tells me there is not much else I can do. When I stop taking the medication, I always feel miserable for a couple of days. Should I get a referral to see a specialist, what are my options?
@ Anon131744- you make a very good point about the difference between addiction and dependence. I have always thought of this as a fascinating subject; why some people take heavy doses of painkillers and can wean themselves off while others spiral into addiction. I believe that there is a lack of understanding in this somewhat gray area of medicine. I don't think that modern medicine is as close to understanding the brain as it thinks it is. The fact that there is so much debate over the way to prescribe addictive medications as well as the debate over treatments in psychopharmacology (even amongst the most heralded professionals in the field) is proof of this. We will not be able to fully understand pain and alcohol and drug addiction treatment until there are some major breakthroughs in understanding how the brain works.
There is a difference between drug addiction and drug dependence, as one of my addiction doctors explained to me. For a person to be an addict she has to be dependent, yet, if person is only dependent, he/she is not necessarily an addict.
Dependence requires that the body physiologically needs the drug. Without them, the dependent person might have serious withdrawals. Dependence is a component of addiction, while addiction has a serious psychological component. The reasons for dependence are simple, for instance:
You had a car crash and broke some ribs, and the doctor prescribed you some sort of opiates for pain. You use it for a while, let´s say a month, maybe less, maybe more. At the end of
this period, given the highly addictive nature of opiates, the patient will be dependent. That doesn't require a state of mind. It's a fact. After a while using opiates everyday, anyone is dependent. The doctor tapers you off, and you stay off.
When the talk is addiction, the person will always go back, sometimes before, during and after the 'tapering off period.; The reasons for addiction are four only: 1. Inability to cope with life's past events;
2. Inability to cope with the present; 3. Chemical imbalance (which is what happens when a person becomes dependent and wants to get off the meds. It takes a bit, but the body self regulates. It can also be some form of mental illness, like bipolar, schizophrenia, etc. The drug use is a desperate attempt to feel better).
4. Beliefs that you hold against yourself that don´t hold truth with the universe (ex:a person who was abused and sees herself as ugly, or stupid, or any other obvious untruth, only apparent to the person, the addict.
So, if you became dependent, your doctor will taper you off and you will not go back to it. If you are an addict, no matter how many times the doctor tapers you off, if you don't get treatment, you will always go back to it!
There is a whole other side of the issue, which is a predisposition for addiction as far as personality goes. I might say for myself, I am a compulsive person. If one is good, than 10 is better.
I believe most doctors don´t consider that as a factor. But, if you have a compulsive personality, than you will know too well that it plays a major role in becoming an addict and staying there.
A friend once told me: I didn't drink for two days, so I know I am not an addict. I replied: The only thing that it proves, is that you are not dependent.
An addict will always go back, as opposed to our friend in the example above who broke some ribs, took the medicine and it was done and over.
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