Dependence occurs when an individual has used a drug with enough frequency and dosage as to become reliant upon the continued use of the drug in order to avoid discomfort or effects of withdrawal[1]. The effects of reducing dosage or ending use while dependent are conditional based on the drug used, the potency of the drug, and the length of time the drug was used. Dependence can occur even if taking medication as prescribed by a physician and therefore does not necessarily mean someone experiencing the effects of dependence is an addict[2]. However, dependence and addiction are often correlated with one another

Types of Dependence
There are two forms of dependence:

  • Physiological-Physiological dependence occurs after extended periods of heavy drug use to the point that observable, measurable physical withdrawal symptoms occur if user tries reduce the amount of the drug used or stop using it all together. It is the result of the drug reducing the sensitivity of receptors in the brain, such as the opioid receptors. This makes the individual require larger doses of the drug to achieve the same effect. The body will attempt to balance out the effect of the failing receptors in the brain by maximizing production of the chemical for that receptor.
    If use continues to grow in dose and time used the body will no longer create enough of the chemical naturally to register with the desensitized receptors. When this point is reached the body will now require an external supply of the chemical through the continued use of the drug in order to satisfy the receptors. At this point the brain will function more or less a normal brain when the drug is used but will face effects of withdrawal that can continue to grow in severity for as long as the addiction keeps going.[3]
    If use, and therefore extra supply of the chemical ends, the body will not be producing
    enough to keep up with the massive demand of the repectors and will set itself into a shock and during this the individual will experience withdrawal symptoms. This dependence is a result of a real, physiological changes in the brain[4]. No personal strength or power of will can prevent the user from experiencing the symptoms if they become physically dependent.
    The withdrawal symptoms of physical dependence have a large range of severity depending on what drug the user is dependant on, how long they were using, and how heavily their use was. Some examples include headaches, tremors, seizures, and in some cases, death[5][6]. If physical dependence is causing withdrawal symptoms the individual should seek medical attention to assist with the detoxification process. There are various different medications available to help alleviate the more severe symptoms ranging from methadone for opiate abuse to benzodiazepines for alcoholism.
  • Psychological-Psychological dependence is when a user becomes emotionally reliant on the use of a drug in order to function properly in daily life.

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