Talk:Physical dependence

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How is physical dependence distinct from chemical dependence? The article for chemical dependence doesn't sound very encyclopedic, and this one isn't very specific. Turly-burly 06:47, 20 June 2006 (UTC)

Just noticed that chemical dependence is at chemical dependency. These articles should either be merged with a redirect OR should be given parallel names. Any preferences?

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[edit] Increasing tolerance automatically part of physical dependence?

I'm not sure that increasing tolerance is necessarily part of physical dependence. I think a person -can- be physically dependent on a drug (and will suffer physical withdrawl if it is suddenly stopped), without being caught in the vicious circle of increased tolerance leading to increasing dosage resulting in further tolerance. - Pacula 17:10, 31 October 2006 (UTC)

[edit] This article is extremely poor.

Amphetamines? I have yet to find a good reference on physical dependence and I’m tempted to remove it. They are EXTREMELY physiologically addictive in a large segment of the population but I don’t think they belong in this article. I have yet to find one good reference on a scale even approaching narcotics, barbs, benzos, or even alcohol.

The general understanding of addiction (of all types) is framed largely by prohibitionists and is extremely complex and widespread. People laugh about internet, (Wikipedia?), video game, food or even caffeine addictions but where exactly should we draw the line? Wikipedia articles should be factual in nature and not represent government propaganda or even popular opinion. The fact that a substance or behavior is accepted or legal should have no bearing on the true nature of the issue. The sunscreen article is a good example of an article which adds balance against popular perception.71.92.107.39 (talk) 09:05, 1 March 2008 (UTC)

From the caffeine article:
In large amounts, and especially over extended periods of time, caffeine can lead to a condition known as caffeinism. Caffeinism usually combines caffeine dependency with a wide range of unpleasant physical and mental conditions including nervousness, irritability, anxiety, tremulousness, muscle twitching (hyperreflexia), insomnia, headaches, respiratory alkalosis and heart palpitations.
With "dependency" linking to this page. Is that a mistake? Or should caffeine be mentioned somewhere in this article? 96.237.166.25 (talk) 23:48, 28 March 2008 (UTC)

[edit] Special Case

I've researched a few cases where patients claimed to only take the prescribed dose of opioids (i.e., Vicodin, Lortab) and had withdrawal symptoms after discontinuing the drug. (No immediate citation available.) What we must remember is that every human body is different, and just because a doctor thinks that 7.5 mg of hydrocodone may benefit a patient more than it may harm them, we can't necessarily assume that the prescribed dose is the best. Doctors usually prescribe these types of medications based on body-weight and/or severity of the case, not on the patient's history of physical tolerance to the drug. Quite often, pain medications, namely, opioids, find their way into emergency care and are used "on-the-spot" based on the severity of the pain or suffering that is being treated (i.e., symptomatic treatment). Many other factors that cannot usually be measured, such as drug tolerance (or initial INtolerance), and patient-drug history, NEED to be considered in prescribing these dependence-inducing drugs, but they often CANNOT be considered in "on-the-spot" situations. Therefore, some patients may be initially prescribed an excessively high dose of a medication that could normally be assumed to be an "abusive" dose which could induce tolerance and later dependance. Now, the question is, in this case, is that person "physically" dependent, or is he/she "chemically" dependent? Is it a sudden reversal of an adaptive response that triggers withdrawal, or could we simply attribute the withdrawal to a reverse in "excess" dosing? If the person had taken half the amount that he/she had been taking all along, could the withdrawal have been mitigated or even eliminated? "Physical dependence," to me, implies an adaptive response with or without abuse (i.e., the antidepressant case), whereas "chemical dependance" implies that abuse has occurred and the individual has developed excessive tolerance to the drug, and thus needs more and more of the drug to inadvertently obtain less and less effects.

[edit] Poor distinction

Cut:

Physical dependence is distinguished from addiction. While addiction tends to describe psychological and behavioral attributes, physical dependence is defined primarily using physical and biological concepts.

What's the difference between dependence and addiction? Is it a matter of degree, or what? These 2 sentences are not adequate reference material.

Sounds like an assertion that "addiction is psychological" (it's all in your head) and a denial that anything can be "physically addictive". Indeed, the physical addiction page redirected me here. --Uncle Ed 16:25, 31 January 2007 (UTC)

The term "addiction" is used to mean different things by different people, even professionals. This ambiguity is responsible for all sorts of confusion. Physical dependence on the other hand, does have a specific meaning that people agree upon. Mental health professionals and researchers often refer to things such as "internet addiction" and compare them to "substance addiction." In the former case, addiction is used to mean "behavioral compulsion" and in the latter case it is used to mean "physical dependence." Such sloppy use of terminology gives the impression that compulsive behavior and physical dependence are the same thing, when in fact, they are very different. Whenever possible, a more specific term than "addiction" should be used (i.e. "compulsive internet use" or "opiate dependence"). --Elplatt 00:25, 1 February 2007 (UTC)
So you're saying that compulsive behavior and physical dependence are distinct, well understood concepts, while the meaning "addiction" of addiction varies with the user of the term? --Uncle Ed 14:33, 1 February 2007 (UTC)
Correct. There is some useful info about this on the addiction page.

[edit] Difference from Addiction

Physical dependence is a symptom of some addictions. The fact is this is an attempted to separate the dirty street addict who uses heroin from the well to do mothers of 2 who uses Oxycontin from a doctor with some uses of the word. The effort to make people who despise addicts but are ones themselves feel better that in some way they only have a physical need and otherwise they do not use for the same reason people who are black poor or city folk do . Physical dependence does not mean there is no psychological need for drugs. Physical dependence and the withdrawal from such dependence is very, very psychological the head aches the sleeplessness certainly causes psychological effects . The idea that with psychoactive drugs the physical dependence can be separated from the psychological effect is just well umm OK stupid. Maybe use heroin for a few year withdraw then go to rehab and get clean and try not to relapse when you can go down street that is a drive threw open air drug market. I think there is something about using and not and understanding such things and I know everyone will say no it is science not experience or feelings it is try it!!!! N. Riley Friday November 18 2007 10:54PM

I enjoyed a particular reference to NSAID addiction. Commonly cited “accepted” societal addictions such as nicotine or caffeine are usually not debated. This particular reference however describes “massive” NSAID addiction which is not commonly known. Such drugs show no physical addiction or “rewarding” brain pathways but are in fact considered highly “abused”. Such use is the compulsion out of habit (hate to use the cliché) but not for pleasurable effects. Suppose one has a headache and takes as aspirin. The headache is persistent even after the aspirin is metabolized so another is consumed. Eventually this becomes a compulsion out of “fear” that the headache will return after the drug wears off or perhaps to avoid a rebound headache. Acetaminophen (or paracetamol for our overseas friends) is highly toxic and arguably taken in excessive amounts. There is in fact a difference between physical and physiological addiction although I wouldn’t debate the use of physical addiction as a cover in order to avoid the guilt or even to avoid addressing a physiological addition. 71.92.107.39 (talk) 08:46, 1 March 2008 (UTC)

This section needs to be written on the whole, as it does not make a difference on a) How it developed? b) How is the person's medical conditions at the moment? The text should make it clear that there are several different definitions of the term in the scientific world. The substance of the text is, for example, not true at all, compared with DSM-IVDala11a (talk) 07:46, 21 May 2008 (UTC)

[edit] Treatment

The sentence:

Treatment usually requires the initiation and then tapering of a medication that has a similar action in the brain but a longer half-life.

is incorrect, besides being uncited. The most common drug for which withdrawl is treated is alcohol and, at present, only rarely is alcohol used during medically-supervised withdrawl.Desoto10 (talk) 21:53, 11 April 2008 (UTC)