Substance Dependence: Symptoms, Causes, and Treatment

Therefore, the abuse potential of central nervous system depressants is relatively high. Many of these drugs, and their relationships, are shown in Table 4.2. According to the American Psychiatric Association (APA), addictive substances like alcohol and drugs cause changes in the brain that trigger intense cravings for the substance.

Some commonly inhaled substances include glue, paint thinners, correction fluid, felt tip marker fluid, gasoline, cleaning fluids and household aerosol products. Due to the toxic nature of these physiological dependence on alcohol substances, users may develop brain damage or sudden death. Examples include methylenedioxymethamphetamine, also called MDMA, ecstasy or molly, and gamma-hydroxybutyric acid, known as GHB.

Psychological dependence

In severe cases of intoxication or overdose, a person may require emergency care. Dependence can happen with many drugs, even when a person takes them as per their doctor’s instructions. Addiction causes cravings, compulsive behavior, and changes in the brain. Although they may seem similar, addiction and dependence are distinct concepts. For example, we have long been told that people need to hit “rock bottom” before they’ll get help, but this isn’t true.

Drugs change the way the brain works, disrupting how nerve cells (neurotransmitters) send, receive, and process information. Drugs have the ability to imitate the brain’s natural messengers and overly reinforce positive reactions. The drugs accomplish this by crossing the blood brain barrier (Lumen). The blood brain barrier (National Cancer Institute, 2022), typically prevents toxic substances from entering our brains, but because drugs bear a similar molecular structure as our neurotransmitters, they are able to slip through the barrier unnoticed. Psychoactive drugs actually promote equilibrium in our brains, specifically the CNS.

Psychological dependence only

Numerous drugs of abuse are described as having both physical and psychological withdrawal symptoms and fostering both forms of dependence. Currently, in the United States, a lot of media attention is being given to a rising tide of opioid addiction and overdose deaths. Opioids are drugs derived from the opium poppy or synthetic https://ecosoberhouse.com/ versions of such drugs. They include illegal drug heroin and prescription painkillers such as codeine, morphine, hydrocodone, oxycodone, and fentanyl. In 2016, fentanyl received wide media attention when it was announced that an accidental fentanyl overdose was responsible for the death of rock-music icon Prince.

New drugs or drug combinations, delivery systems, and routes of administration emerge, and with them new questions for public health. For example, concern is growing that increasing use of marijuana extracts with extremely high amounts of THC could lead to higher rates of addiction among marijuana users. Concerns also are emerging about how new products about which little is known, such as synthetic cannabinoids and synthetic cathinones, affect the brain. Additional research is needed to better understand how such products – as well as emerging addictive substances – affect brain function and behavior, and contribute to addiction. Continued advances in neuroscience research will further enhance our understanding of substance use disorders and accelerate the development of new interventions.

Meth, cocaine and other stimulants

Other examples include ketamine and flunitrazepam or Rohypnol — a brand used outside the U.S. — also called roofie. These drugs are not all in the same category, but they share some similar effects and dangers, including long-term harmful effects. As time passes, you may need larger doses of the drug to get high. As your drug use increases, you may find that it’s increasingly difficult to go without the drug. Attempts to stop drug use may cause intense cravings and make you feel physically ill.

While it is probably the most commonly used drug in the world, the potency of this particular drug pales in comparison to the other stimulant drugs described in this section. Generally, people use caffeine to maintain increased levels of alertness and arousal. Caffeine is found in many common medicines (such as weight loss drugs), beverages, foods, and even cosmetics (Herman & Herman, 2013). While caffeine may have some indirect effects on dopamine neurotransmission, its primary mechanism of action involves antagonizing adenosine activity (Porkka-Heiskanen, 2011). Caffeine is an adenosine antagonist, so caffeine inhibits the adenosine receptors, thus decreasing sleepiness and promoting wakefulness. Drug withdrawal is usually an aversive experience, and it can be a life-threatening process in individuals who have a long history of very high doses of alcohol and/or barbiturates.

For example, if a person with drug sensitivity uses cocaine, electrical signals from the brain to the heart cease to occur and the person dies. An individual’s brain chemistry is unique, so it will determine how sensitive a person is to environmental stressors, drugs, and inheritable characteristics (SAMHSA, 2022). Drug addiction can start with experimental use of a recreational drug in social situations, and, for some people, the drug use becomes more frequent. For others, particularly with opioids, drug addiction begins when they take prescribed medicines or receive them from others who have prescriptions. Cannabinoids such as delta-9-tetrahydrocannabinol (THC), the primary psychoactive component of marijuana, target the brain’s internal or endogenous cannabinoid system. This system also contributes to reward by affecting the function of dopamine neurons and the release of dopamine in the nucleus accumbens.

• While no longer separate diagnoses, it can be helpful to understand the differences between the two.
• Anxiety disorders may also be treated with anxiolytics, such as buspirone and diazepam.
• Users can experience physical symptoms that include nausea, elevated blood pressure, and increased heart rate.
• Dendrites branch out from the cell body and receive messages from the axons of other neurons.
• A type of study in which data on a particular group of people are gathered repeatedly over a period of years or even decades.

Contact emergency services immediately if you experience symptoms such as fever, involuntary muscle contractions, seizures, delusions, hallucinations, or rapid mood swings as you withdraw from alcohol. A doctor may also prescribe medications to help you manage withdrawal symptoms and support you in your effort to stop drinking. Benzodiazepines can help alleviate withdrawal symptoms, while naltrexone may help you manage alcohol cravings.

In other words, physical dependence in and of itself is of limited utility in determining whether or not someone has a substance use disorder. As with other diseases, individuals vary in the development and progression of substance use disorders. Not only are some people more likely to use and misuse substances than are others and to progress from initial use to addiction differently, individuals also differ in their vulnerability to relapse and in how they respond to treatments. For example, some people with substance use disorders are particularly vulnerable to stress-induced relapse, but others may be more likely to resume substance use after being exposed to drug-related cues. Developing a thorough understanding of how neurobiological differences account for variation among individuals and groups will guide the development of more effective, personalized prevention and treatment interventions.