Substance dependence

addictiondependencedrug dependencejunkiedrug addictionaddictionsaddictchemical dependencyaddictedaddicts
Substance dependence, also known as drug dependence, is an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use.wikipedia
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Drug withdrawal

withdrawalwithdrawal symptomswithdrawal syndrome
Substance dependence, also known as drug dependence, is an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences.
In order for the symptoms of withdrawal to occur, one must have first developed a form of drug dependence.

Neonatal withdrawal

neonatal abstinence syndromeneonatal withdrawal syndromewithdrawal symptoms in the newborn
Infants also suffer from substance withdrawal, known as Neonatal Abstinence Syndrome (NAS), which can have severe and life-threatening effects.
Neonatal withdrawal or neonatal abstinence syndrome (NAS) is a withdrawal syndrome of infants after birth caused by in utero exposure to drugs of dependence.

Addiction

drug addictiondrug addictdrug addicts
Substance dependence, also known as drug dependence, is an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences.
The term addiction is misused frequently to refer to other compulsive behaviors or disorders, particularly dependence, in news media.

Reinforcement

positive reinforcementnegative reinforcementreinforcing
An addictive drug is a drug which is both rewarding and reinforcing.
Reinforcement is the central concept and procedure in special education, applied behavior analysis, and the experimental analysis of behavior and is a core concept in some medical and psychopharmacology models, particularly addiction, dependence, and compulsion.

Alcohol (drug)

alcoholdrinkingdrink
Alcohol can be addictive to humans, as in alcoholism, and can result in dependence and withdrawal.

Benzodiazepine

benzodiazepinesbenzodiazapines1,4-benzodiazepine
Some examples are using benzodiazepines for alcohol detoxification, which prevents delirium tremens and complications; using a slow taper of benzodiazepines or a taper of phenobarbital, sometimes including another antiepileptic agent such as gabapentin, pregabalin, or valproate, for withdrawal from barbiturates or benzodiazepines; using drugs such as baclofen to reduce cravings and propensity for relapse amongst addicts to any drug, especially effective in stimulant users, and alcoholics (in which it is nearly as effective as benzodiazepines in preventing complications); using clonidine, an alpha-agonist, and loperamide for opioid detoxification, for first-time users or those who wish to attempt an abstinence-based recovery (90% of opioid users relapse to active addiction within eight months or are multiple relapse patients); or replacing an opioid that is interfering with or destructive to a user's life, such as illicitly-obtained heroin, dilaudid, or oxycodone, with an opioid that can be administered legally, reduces or eliminates drug cravings, and does not produce a high, such as methadone or buprenorphine – opioid replacement therapy – which is the gold standard for treatment of opioid dependence in developed countries, reducing the risk and cost to both user and society more effectively than any other treatment modality (for opioid dependence), and shows the best short-term and long-term gains for the user, with the greatest longevity, least risk of fatality, greatest quality of life, and lowest risk of relapse and legal issues including arrest and incarceration.
Tolerance can develop to their effects and there is also a risk of dependence, and upon discontinuation a withdrawal syndrome may occur.

Heroin

diamorphinediacetylmorphinesmack
Some examples are using benzodiazepines for alcohol detoxification, which prevents delirium tremens and complications; using a slow taper of benzodiazepines or a taper of phenobarbital, sometimes including another antiepileptic agent such as gabapentin, pregabalin, or valproate, for withdrawal from barbiturates or benzodiazepines; using drugs such as baclofen to reduce cravings and propensity for relapse amongst addicts to any drug, especially effective in stimulant users, and alcoholics (in which it is nearly as effective as benzodiazepines in preventing complications); using clonidine, an alpha-agonist, and loperamide for opioid detoxification, for first-time users or those who wish to attempt an abstinence-based recovery (90% of opioid users relapse to active addiction within eight months or are multiple relapse patients); or replacing an opioid that is interfering with or destructive to a user's life, such as illicitly-obtained heroin, dilaudid, or oxycodone, with an opioid that can be administered legally, reduces or eliminates drug cravings, and does not produce a high, such as methadone or buprenorphine – opioid replacement therapy – which is the gold standard for treatment of opioid dependence in developed countries, reducing the risk and cost to both user and society more effectively than any other treatment modality (for opioid dependence), and shows the best short-term and long-term gains for the user, with the greatest longevity, least risk of fatality, greatest quality of life, and lowest risk of relapse and legal issues including arrest and incarceration.
With physical dependence, the body adapts to the presence of the drug, and withdrawal symptoms occur if use is reduced abruptly.

MDMA

ecstasymethylenedioxymethamphetamineE
One study found approximately 15% of chronic MDMA users met the DSM-IV diagnostic criteria for substance dependence.

Alcohol dependence

alcohol dependencyalcoholalcohol dependent
303.90 Alcohol dependence
Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol (also known formally as ethanol).

Hypnotic

sleeping pillssleeping pillsoporific
304.10 Sedative, hypnotic, or anxiolytic dependence (including benzodiazepine dependence and barbiturate dependence)
A review of the literature regarding benzodiazepine hypnotics and Z-drugs concluded that these drugs can have adverse effects, such as dependence and accidents, and that optimal treatment uses the lowest effective dose for the shortest therapeutic time period, with gradual discontinuation in order to improve health without worsening of sleep.

Nicotine dependence

tobacco use disorderAddictionnicotine
305.10 Nicotine dependence
Nicotine dependence is a state of dependence upon nicotine.

Benzodiazepine dependence

dependencebenzodiazepine dependentan addiction to the sleeping drug Benzodiazepine
304.10 Sedative, hypnotic, or anxiolytic dependence (including benzodiazepine dependence and barbiturate dependence)
Tobacco and alcohol are the most common substances that elderly people get a dependence on or misuse.

Amphetamine dependence

amphetamine use disorder
304.40 Amphetamine dependence (or amphetamine-like)
In individuals with substance use disorder (problematic use or abuse with dependence), psychotherapy is currently the best treatment option as no pharmacological treatment has been approved.

Twelve-step program

12-step12-step programtwelve steps
One of many recovery methods are 12-step recovery programs, with prominent examples including Alcoholics Anonymous, Narcotics Anonymous, Drug Addicts Anonymous and Pills Anonymous.
Twelve-step methods have been adapted to address a wide range of alcoholism, substance-abuse and dependency problems.

Drug rehabilitation

rehabrehabilitationdrug rehab
Substance-abuse rehabilitation (rehab) centers offer a residential treatment program for some of the more seriously addicted, in order to isolate the patient from drugs and interactions with other users and dealers.
The general intent is to enable the patient to confront substance dependence, if present, and cease substance abuse to avoid the psychological, legal, financial, social, and physical consequences that can be caused, especially by extreme abuse.

Opioid use disorder

heroin addictionopioid addictionheroin addict
Some examples are using benzodiazepines for alcohol detoxification, which prevents delirium tremens and complications; using a slow taper of benzodiazepines or a taper of phenobarbital, sometimes including another antiepileptic agent such as gabapentin, pregabalin, or valproate, for withdrawal from barbiturates or benzodiazepines; using drugs such as baclofen to reduce cravings and propensity for relapse amongst addicts to any drug, especially effective in stimulant users, and alcoholics (in which it is nearly as effective as benzodiazepines in preventing complications); using clonidine, an alpha-agonist, and loperamide for opioid detoxification, for first-time users or those who wish to attempt an abstinence-based recovery (90% of opioid users relapse to active addiction within eight months or are multiple relapse patients); or replacing an opioid that is interfering with or destructive to a user's life, such as illicitly-obtained heroin, dilaudid, or oxycodone, with an opioid that can be administered legally, reduces or eliminates drug cravings, and does not produce a high, such as methadone or buprenorphine – opioid replacement therapy – which is the gold standard for treatment of opioid dependence in developed countries, reducing the risk and cost to both user and society more effectively than any other treatment modality (for opioid dependence), and shows the best short-term and long-term gains for the user, with the greatest longevity, least risk of fatality, greatest quality of life, and lowest risk of relapse and legal issues including arrest and incarceration. 304.00 Opioid dependence
Addiction and dependence are components of a substance use disorder.

Mental disorder

mental illnessnervous breakdownmentally ill
Other countries, particularly in Europe, argue the aims of treatment for drug dependence are more complex, with treatment aims including reduction in use to the point that drug use no longer interferes with normal activities such as work and family commitments; shifting the addict away from more dangerous routes of drug administration such as injecting to safer routes such as oral administration; reduction in crime committed by drug addicts; and treatment of other comorbid conditions such as AIDS, hepatitis and mental health disorders.
The DSM incorporates such conditions under the umbrella category of substance use disorders, which includes substance dependence and substance abuse.

Pills Anonymous

One of many recovery methods are 12-step recovery programs, with prominent examples including Alcoholics Anonymous, Narcotics Anonymous, Drug Addicts Anonymous and Pills Anonymous.
P.A. describes addiction as a progressive disease with no known cure, which affects every area of a pill addict's life: physical, mental, emotional, and spiritual.

Self-administration

self-administeredintracranial self-stimulationself-administering
In rat models, the separate use of CRF inhibitors and CRF receptor antagonists both decreased self-administration of the drug of study.
Self-administration of putatively addictive drugs is considered one of the most valid experimental models to investigate drug-seeking and drug-taking behavior.

Pregabalin

Lyrica
Some examples are using benzodiazepines for alcohol detoxification, which prevents delirium tremens and complications; using a slow taper of benzodiazepines or a taper of phenobarbital, sometimes including another antiepileptic agent such as gabapentin, pregabalin, or valproate, for withdrawal from barbiturates or benzodiazepines; using drugs such as baclofen to reduce cravings and propensity for relapse amongst addicts to any drug, especially effective in stimulant users, and alcoholics (in which it is nearly as effective as benzodiazepines in preventing complications); using clonidine, an alpha-agonist, and loperamide for opioid detoxification, for first-time users or those who wish to attempt an abstinence-based recovery (90% of opioid users relapse to active addiction within eight months or are multiple relapse patients); or replacing an opioid that is interfering with or destructive to a user's life, such as illicitly-obtained heroin, dilaudid, or oxycodone, with an opioid that can be administered legally, reduces or eliminates drug cravings, and does not produce a high, such as methadone or buprenorphine – opioid replacement therapy – which is the gold standard for treatment of opioid dependence in developed countries, reducing the risk and cost to both user and society more effectively than any other treatment modality (for opioid dependence), and shows the best short-term and long-term gains for the user, with the greatest longevity, least risk of fatality, greatest quality of life, and lowest risk of relapse and legal issues including arrest and incarceration.
It appears to have anxiolytic effects similar to benzodiazepines with less risk of dependence.

Disease model of addiction

disease modeldiseaseaddictive diseases
In a survey of treatment providers from three separate institutions, the National Association of Alcoholism and Drug Abuse Counselors, Rational Recovery Systems and the Society of Psychologists in Addictive Behaviors, measuring the treatment provider's responses on the "Spiritual Belief Scale" (a scale measuring belief in the four spiritual characteristics of AA identified by Ernest Kurtz); the scores were found to explain 41% of the variance in the treatment provider's responses on the "Addiction Belief Scale" (a scale measuring adherence to the disease model or the free-will model of addiction).
The disease model of addiction describes an addiction as a disease with biological, neurological, genetic, and environmental sources of origin.

Tobacco

snufftobacco leavestobacco dryers
Users may develop tolerance and dependence.

Physical dependence

Physicaldependencedrug dependency
The withdrawal state may include physical-somatic symptoms (physical dependence), emotional-motivational symptoms (psychological dependence), or both.
Substance dependence

Cocaine dependence

cocaine addictioncocaine addictcocaine abuse
304.20 Cocaine dependence
It was found that the risk of becoming dependent on cocaine within two years of first use was 5–6%.

DSM-5

Diagnostic and Statistical Manual of Mental Disordersmental health disordersDSM-V
DSM-5 substance dependencies include:
Substance abuse and substance dependence from DSM-IV-TR have been combined into single substance use disorders specific to each substance of abuse within a new "addictions and related disorders" category. "Recurrent legal problems" was deleted and "craving or a strong desire or urge to use a substance" was added to the criteria. The threshold of the number of criteria that must be met was changed and severity from mild to severe is based on the number of criteria endorsed. Criteria for cannabis and caffeine withdrawal were added. New specifiers were added for early and sustained remission along with new specifiers for "in a controlled environment" and "on maintenance therapy".