Physical dependence
dependencedrug dependencyphysicaldependencychemical dependencydependentaddictedchemical dependencedrugdrug addicts
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.wikipedia
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Drug withdrawal
withdrawalwithdrawal symptomswithdrawal syndrome
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. A wide range of drugs whilst not causing a true physical dependence can still cause withdrawal symptoms or rebound effects during dosage reduction or especially abrupt or rapid withdrawal.
This may occur as physical dependence, psychological dependence or both.
Opioid
opioidsopioid-induced constipationopioid analgesic
Abrupt withdrawal from other drugs, such as opioids can cause an extremely painful withdrawal that is very rarely fatal in patients of general good health and with medical treatment, but is more often fatal in patients with weakened cardiovascular systems; toxicity is generally caused by the often-extreme increases in heart rate and blood pressure (which can be treated with clonidine), or due to arrhythmia due to electrolyte imbalance caused by the inability to eat, and constant diarrhea and vomiting (which can be treated with loperamide and ondansetron respectively) associated with acute opioid withdrawal, especially in longer-acting substances where the diarrhea and emesis can continue unabated for weeks, although life-threatening complications are extremely rare, and nearly non-existent with proper medical management.
Long-term use can cause tolerance, meaning that increased doses are required to achieve the same effect, and physical dependence, meaning that abruptly discontinuing the drug leads to unpleasant withdrawal symptoms.







Substance abuse
drug abusedrug useabuse
Physical dependence can develop from low-dose therapeutic use of certain medications such as benzodiazepines, opioids, antiepileptics and antidepressants, as well as the recreational misuse of drugs such as alcohol, opioids, amphetamines and benzodiazepines.
Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.





Alcohol dependence
alcohol dependencyalcoholalcohol dependent
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).

Codeine
codeine phosphatecodeine hydrochlorideCod'ine
As with other opiate-based pain killers, chronic use of codeine can cause physical dependence.
Alcoholic drink
alcoholic beveragealcoholalcoholic beverages
Long-term use can lead to alcohol abuse, cancer, physical dependence, and alcoholism.









Benzodiazepine dependence
dependencean addiction to the sleeping drug BenzodiazepineBarbiturate type dependence
It is necessary to distinguish between addiction and drug abuse of benzodiazepines and normal physical dependence on benzodiazepines.

Benzodiazepine
benzodiazepinesbenzodiazapinesbenzo
Protracted withdrawal syndrome is noted to be most often caused by benzodiazepines. A physical dependence on alcohol is often managed with a cross tolerant drug, such as long acting benzodiazepines to manage the alcohol withdrawal symptoms.
Long-term use is controversial because of concerns about decreasing effectiveness, physical dependence, withdrawal, and an increased risk of dementia.








Lorazepam
Ativanbenzodiazepine lorazepamdrug of the same name
Physical dependence and psychological dependence may also occur.


Benzodiazepine withdrawal syndrome
benzodiazepine withdrawalwithdrawal syndromebenzodiazepine
Chronic exposure to benzodiazepines causes neural adaptations that counteract the drug's effects, leading to tolerance and dependence.


Loperamide
Imodiumloperamide (Imodium)loperamide hydrochloride
Abrupt withdrawal from other drugs, such as opioids can cause an extremely painful withdrawal that is very rarely fatal in patients of general good health and with medical treatment, but is more often fatal in patients with weakened cardiovascular systems; toxicity is generally caused by the often-extreme increases in heart rate and blood pressure (which can be treated with clonidine), or due to arrhythmia due to electrolyte imbalance caused by the inability to eat, and constant diarrhea and vomiting (which can be treated with loperamide and ondansetron respectively) associated with acute opioid withdrawal, especially in longer-acting substances where the diarrhea and emesis can continue unabated for weeks, although life-threatening complications are extremely rare, and nearly non-existent with proper medical management.
Loperamide has been shown to cause a mild physical dependence during preclinical studies, specifically in mice, rats, and rhesus monkeys.

Nicotine
nicotine addictionnicotine sulfateaddicted to nicotine
Nicotine dependence involves tolerance, sensitization, physical dependence, and psychological dependence.







Zolpidem
AmbienStilnoxZolpidem Tartrate
When drug tolerance and physical dependence to zolpidem develop, treatment usually entails a gradual dose reduction over a period of months to minimize withdrawal symptoms, which can resemble those seen during benzodiazepine withdrawal.




Buprenorphine
SubutexSuboxoneProbuphine
Physical dependence and withdrawal from buprenorphine itself remain important issues since buprenorphine is a long-acting opioid.


Alprazolam
XanaxCalmaxXanny
Alprazolam and other benzodiazepines may also cause the development of physical dependence, tolerance, and benzodiazepine withdrawal symptoms during rapid dose reduction or cessation of therapy after long-term treatment.



Nonbenzodiazepine
nonbenzodiazepinesbenzodiazepine-likenon benzodiazepine
They are safer than the older barbiturates especially in overdosage and they may, when compared to the benzodiazepines, have less of a tendency to induce physical dependence and addiction, although these issues can still become a problem.
Pregabalin
Lyrica
Following abrupt or rapid discontinuation of pregabalin, some people reported symptoms suggestive of physical dependence.



Alcohol withdrawal syndrome
alcohol withdrawalwithdrawalalcohol
A physical dependence on alcohol is often managed with a cross tolerant drug, such as long acting benzodiazepines to manage the alcohol withdrawal symptoms.
Alcohol withdrawal may occur in those who are alcohol dependent.
Caffeine
caffeinatedHealth effects of caffeineNo-Doz
These can include caffeine, stimulants, steroidal drugs and antiparkinsonian drugs.
Mild physical dependence and withdrawal symptoms may occur upon abstinence, with greater than 100 mg caffeine per day, although these symptoms last no longer than a day.







Psychological dependence
psychologicalpsychological dependencypsychological or behavioral dependence
Psychological dependence is not to be confused with physical dependence, which induces physical withdrawal symptoms upon discontinuation of use.
Rebound effect
rebound insomniareboundrebound effects
A wide range of drugs whilst not causing a true physical dependence can still cause withdrawal symptoms or rebound effects during dosage reduction or especially abrupt or rapid withdrawal.
Regular use of these substances can cause a person to become dependent on its effects in order to fall asleep.
Substance dependence
addictiondependencedrug dependence
The withdrawal state may include physical-somatic symptoms (physical dependence), emotional-motivational symptoms (psychological dependence), or both.
Nicotine withdrawal
withdrawalwithdrawal symptomsnicotine depletion
The onset of this opposing force and the fact that the brain becomes used to and dependent on nicotine to function normally is known as physical dependence.
Clomethiazole
chlormethiazoleHeminevrinHeminevrin/Distraneurin
Long term and frequent use of chlomethiazole can cause tolerance and physical dependence.
Antidepressant discontinuation syndrome
withdrawal syndromediscontinuation syndromeSSRI discontinuation syndrome
SSRI drugs, which have an important use as antidepressants, engender a discontinuation syndrome that manifests with physical side effects; e.g., there have been case reports of a discontinuation syndrome with venlafaxine (Effexor).
As such, some researchers advocate the term withdrawal over discontinuation, to communicate the similar physiological dependence and negative outcomes.