Dependence addiction contrasts

In contrast, some drugs of abnse prodnce intense craving and are highly addictive bnt do not prodnce physical dependence. The absence of physical dependence indicates the relative lack of physiological withdrawal. This is not synonymous with meaning that discontinuation of these componnds may not be psychologically nncomfortable. Two examples are marijnana and cocaine. One need only look to the recent crack epidemic to see evidence of the way these substances can destroy lives, bnt they do not produce tolerance or risk of withdrawal to the same extent as alcohol or heroin. As a result, we would say that the daily crack or marijuana user meets the dehnition of substance dependence bnt does not exhibit true physical (or physiological) dependence. 

Buspirone. Several comparative studies of buspirone and benzodiazepines have reported comparable efficacy in reducing symptoms of anxiety. However, in contrast to benzodiazepines, buspirone is devoid of significant sedative or euphoric effects. Treatment with buspirone and other azaperones, such as gepirone, ipsapirone, and tandospirone, does not result in abuse, addiction, dependence, or withdrawal symptoms [Keppel Hesselink 1992). Buspirone also spares both cognitive and psychomotor performance [N. Sussman 1994). 

In one sense, then, all appetites are acquired. Beyond early infancy, the ways we satisfy our appetites are virtually always mediated by accultur-ated tastes. On the other hand, addictions are in a sense perfectly natural. Our constitution is such that many of us are prone to become physically dependent when exposed to certain substances (or activities ) and to acquire appetitive desires for these. The idea that natural appetites (in contrast to addictions) are unacquired has to be interpreted in a way that is consistent with these truths. 

We next ask what are the implications of being aware of future self-control problems by comparing naifs and sophisticates. We identify two effects. First, sophistication about future self-control problems can make people pessimistic about future behavior (that is, they believe in general that they will hit more often than they would if they had no self-control problem). We refer to this phenomenon as the pessimism effect. Second, sophistication about future self-control problems may make people realize that they will resist future temptations only if they resist temptation today. We refer to this phenomenon as the incentive effect. Because the habit formation property of addictive products implies that current indulgence has larger future costs the more people expect to refrain in the future, pessimism about future behavior tends to exacerbate overconsumption due to self-control problems. The incentive effect, in contrast, tends to mitigate overconsumption due to self-control problems. Hence, whether sophisticates hit more or less often than naifs depends on the relative magnitudes of the pessimism and incentive effects. 

Adverse effects of cocaine include constricted peripheral blood vessels, dilated pupils, and increased body temperature, heart rate, and blood pressure. Cocaine induces several immediate euphoric effects, such as hyperstimulation, reduced fatigue, and mental clarity, all of which depend on the administration route. The faster the absorption of cocaine, the more severe the effects. In contrast, faster absorption limits the duration of action. For example, the effect from snorting cocaine may last 15 to 30 minutes, whereas effects from smoking may last 5 to 10 minutes. Increased use can reduce the period of stimulation, as addicted humans may develop tolerance. In rare instances, sudden death may occur on the first use of cocaine or unexpectedly thereafter. 

Finally and probably most important can be the contribution made by such drugs in further pharmacological research. Contrasting compounds such as morphine and WIN 20,228, which are so similar except for their addiction liability, may provide another tool as valuable as nalorphine for further exploration of the problems of analgesia, physical dependence, tolerance, and the relationship between molecular modification and drug action. 

Less abuse potential the use of opioid analgesics is accompanied by concerns regarding the potential for abuse, dependence, diversion, misuse, addiction, tolerance, and withdrawal. In contrast, short-acting tramadol has been shown to have a low potential for abuse, probably even less with tramadol ER. 

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