Psychologic dependence

Dependence is a somatic state which develops after chronic administration of certain dtugs. This condition is characterized by the necessity to continue administration of the drug to avoid the appearance of withdrawal symptoms. Withdrawal symptoms are relieved by the administration of the drug upon which the body was dependent . Psychological dependence is due to (e.g., social) reinforcement processes in the maintenance of drug-seeking behavior. 

Schedule IV. These drugs supposedly have a lower potential for abuse than schedule III drugs, with only a limited possibility of physical dependence, psychologic dependence, or both. Examples include certain antianxiety drugs (meprobamate), certain barbiturates (barbital, phenobarbital), and a variety of other depressants and stimulants. 

Dependence Psychologic and physical dependence is part of the basis for the abuse lia-... 

Chronic administration of opiates and alcohol leads to physical dependence a phenomenon, which is only weakly expressed following chronic administration of psychostimulants or other drugs of abuse. Physical dependence results from neuroadaptive intracellular changes to an altered pharmacological state. Abstinence from chronic opiate or alcohol use leads to a variety of physiological and psychological withdrawal symptoms based on these adaptations of the neuronal system. 

Controlled substances are the most carefully monitored of all drugs. These drags have a high potential for abuse and may cause physical or psychological dependence Physical dependency is a compulsive need to use a substance repeatedly to avoid mild to severe witii-drawal symptoms it is die body s dependence on repeated administration of a drug. Psychological dependency is a compulsion to use a substance to obtain a pleasurable experience it is die mind s dependence on the repeated administration of a drag. One type of dependency may lead to die odier typa... 

The Controlled Substances Act of 1970 regulates die manufacture, distribution, and dispensing of drugs that have abuse potential (see information under Federal Drag Legislation and Enforcement in diis chapter). Drag under the Controlled Substances Act are divided into five schedules, based on their potential for abuse and physical and psychological dependence Display 1-2 describes the five schedules. 

Potential for high abuse with severe physical or psychological dependence... 

Like the barbiturates, the miscellaneous drugp sedative or hypnotic effects diminish after approximately 2 weeks. Ffersons taking these dragp for periods longer than 2 weeks may have a tendency to increase the dose to produce the desired effects (eg, sleep, sedation). Physical and psychological dependence may occur, especially after prolonged use of high doses. However, their addictive potential appears to be less than that of the... 

The amphetaminesand anorexiants have abuse and addiction potential. Long-term use of amphetaminesfor obesity may result in tolerance to the drug and a tendency to increase the dose. Extreme psychological dependency may also occur. 

Warns about possible addiction, drug tolerance, and psychological dependency. 

Dependence and withdrawal can occur with all of the stimulants. Cocaine is one of the most strongly reinforcing drugs in self-administration paradigms in animals and also has a psychological withdrawal syndrome. A typical pattern of withdrawal includes a ravenous appetite, exhaustion, and mental depression, which may last for several days after the drug is withdrawn. Because tolerance develops quickly, abusers may take large doses, compared with those used medically, for example, as anorexiants. 

A comprehensive assessment of the stimulant-dependent patients psychological, medical, forensic, and drug use history may be difficult, because information may be incomplete or unreliable. In recognition of this deficiency, it is important that the patient receives a thorough physical examination, as well... 

Finally, there is little or no clinical evidence that morphine causes psychological dependence or drug-seeking behaviour, tolerance or problematic respiratory depression in patients. These events simply do not occur when opioids are used to control pain. The reason is likely to be that the actions of morphine and the context of its use in a person in pain are neurobiologically quite different from the effects of opioids in street use. These actions of opioids are described in more detail in Chapter 23. 

Figure 23.1 The diagram shows the stages that may occur after administration of a non-medical drug. The details of each of the potential consequences are given in the text but note that whereas all drugs must have some psychological effect and so may trigger psychological ( ) dependence, physical dependence is only obvious with depressant drugs...

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