Dependency Addiction

Individuals with a pattern of chronic use of commonly abused substances should be assessed to determine if they meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for substance dependence (addiction). 

To facilitate recovery from addiction it is necessary to utilize a comprehensive biopsychosocial assessment that includes the motivation for change. Pharmacologic treatments are always adjunctive to psychosocial therapy. It is important to remember that mere treatment of withdrawal is not sufficient treatment of DSM-IV-TR dependence (addiction), and that medications are always adjunctive to psychosocial therapy. Comorbid psychiatric... 

Bafour DJ. (1994). Neural mechanisms underlying nicotine dependence. Addiction. 89(11) 1419-23. Bafour DJ, Benwell ME, Birrell CE, Kelly RJ, Al-Aloul M. (1998). Sensitization of the mesoaccumbens dopamine response to nicotine. Pharmacol Biochem Behav. 59(4) 1021-30. 

Lerman C, Audrain J, Orleans CT, Boyd R, Gold K, Main D, Caporaso N. (1996). Investigation of mechanisms linking depressed mood to nicotine dependence. Addict Behav. 21(1) 9-19. 

Drug abuse and dependence Addiction to (dependence on) difenoxin is theoretically possible at high dosage. Therefore, do not exceed recommended dosage. 

ATOS). Addiction, 98, 1129-35 Darke S, Ross J, Williamson A, Mills KL, Harvard A Teesson M (2007). Borderline personality disorder and persistently elevated levels of risk in 36 month outcomes for the treatment of heroin dependence. Addiction, 102, 1140-6... 

Kampman KM (2008). The search for medications to treat stimulant dependence. Addiction Science Clinical Practice, 4, 28-35... 

Miotto K, McCann M, Basch J, Rawson R ling W (2002). Naltrexone and dysphoria fact or myth American Journal of Addictions, 11, 151-60 Mitchell TB, White JM, Somogyi AA Bodmer F (2003). Comparative pharmacodynamics and pharmacokinetics of methadone and slow-release oral morphine for maintenance treatment of opioid dependence. Drug and Alcohol Dependence, 11, 85-94 Mitchell TB, White JM, Somogyi AA Bochner F (2004). Slow-release oral morphine versus methadone a crossover comparison of patient outcomes and acceptability as maintenance pharmacotherapies for opioid dependence. Addiction, 99, 940-5 Mitka M (2003). Office-based primary care physicians called on to treat the new addict. Journal of the American Medical Association, 290, 735-6... 

For detoxification of a heroin-dependent addict, low doses of methadone (5-10 mg orally) are given two or three times daily for 2 or 3 days. Upon discontinuing methadone, the addict experiences a mild but endurable withdrawal syndrome. 

I am not arguing that addictions of any kind should be valued in the way we value the attachments just mentioned. Perhaps we are right as a culture to disrespect addiction. That deserves a separate discussion. My point is that these forms of dependency cannot be disparaged solely on the grounds that they diminish self-control, that is, simply because they are dependencies. Addictions must be shown in some further way to reduce the value of human experience or agency. Obviously, countless lives have been ruined by devotion to drugs. On the other hand, addictive substances help many of us to endure what would otherwise be rather bleak prospects. 

Doctors are most likely to prescribe morphine or other opiates when pain is severe and expected to be short-lasting (a few days to a week), such as after injury or major surgery. This is because short-term use of opiates is less likely to lead to tolerance (loss of potency with repeated use of the drug) and dependence (addiction). However, the problem becomes more complex when the severity of the pain requires the use of pain-relieving medication for more than a few weeks, because this is when tolerance and addiction to opiates tend to develop (see the section on Opiate Addiction on page 48). 

All are Drug Enforcement Administration (DEA) Schedule II narcotics, indicating the highest risk of tolerance and dependence (addiction). 

Buckett WR (1964) A new test for morphine-like physical dependence (addiction liability) in rats. Psychopharmacolo-gia 6 410-416... 

Chronic use of inhalants can lead to the body s physical need for a drug, which is called dependence. Addiction is a psychological and physical disease, and dependence is a physical manifestation of the disease. The body adapts to the presence of the drug, and heavy users experience withdrawal if they stop using inhalants abruptly. Withdrawal symptoms indicate an abuser is physically dependent on inhalants. These symptoms have been reported to occur in approximately 50% to 60% of inhalant users. When they quit inhaling, withdrawal symptoms appear. The body has... 

It has been suggested that the risk of producing opioid dependence in the medical setting is greater in those who prescribe and administer them than in those who receive them (8). The likelihood of dependence in patients treated with opioids has been examined. In the treatment of cancer pain, tolerance and physical dependence occur but psychological dependence (addiction) is rare (9,10). 

There are no specific antidotes for ecstasy or LSD. Treatment is supportive and includes fluid replacement, seizure, and temperature control. Keeping patients in a dark quiet room with decreased stimulation may help lessen anxiety. The risk of longterm dependence, addiction, or withdrawal of MDMA is unclear. Growing evidence is that MDMA can affect memory. LSD is not known to be addicting and is not known to cause withdrawal. 

Karpyak VM, Winham SJ, Biernacka JM, Cunningham JM, Lewis KA, Geske JR, Colby CL, Abulseoud OA, Hall-Flavin DK, Loukianova LL, Schneekloth TD, Frye MA, Heit JA, Mrazek DA (2012) Association of GATA4 sequence variation with alcohol dependence. Addict Biol 19(2) 312-315... 

Budney AJ, Novy PL, Hughes JR (1999) Marijuana withdrawal among adults seeking treatment for marijuana dependence. Addiction 94 1311-1322... 

Voss, I., and Steinbtichel, A. (2006) Application of a KDPG-aldolase gene-dependent addiction system for enhanced production of cyanophycin in Ralstonia eutropha strain H16. Metab. Eng., 8, 66-78. 

The APA defines substance dependence (addiction) as a cluster of symptoms indicating that the individual continues use of the substance despite significant substance-related problems. Evidence of tolerance and withdrawal symptoms are included in the list of symptoms, but neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of substance dependence. Dependence (addiction) requires three or more of the symptoms, whereas abuse can be diagnosed when only one or two symj)-toms are present. The chronic, relapsing nature of dependence (addiction) fulfills criteria for a chronic disease, but because of the voluntary component at initiation, the disease concept is controversial. 

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