What is physical dependence?

Physical Dependence

Physical dependence refers to a state resulting from chronic use of a drug that has produced tolerance and where negative physical symptoms of withdrawal result from abrupt discontinuation or dosage reduction. Physical dependence can develop from low-dose therapeutic use of certain medications such as benzodiazepines, opioids, antiepileptics and antidepressants, as well as misuse of recreational drugs such as alcohol, opioids and benzodiazepines. The higher the dose used, the greater the duration of use, and the earlier age use began are predictive of worsened physical dependence and thus more severe withdrawal syndromes. Acute withdrawal syndromes can last days, weeks or months, and protracted withdrawal syndrome, also known as "post-acute withdrawal syndrome" or "PAWS" - a low-grade continuation of some of the symptoms of acute withdrawal, typically in a remitting-relapsing pattern, that often results in relapse in to active addiction and prolonged disability of a degree to preclude the possibility of lawful employment - can last for months, years, or, in relatively common to extremely rare cases, depending on individual factors, indefinitely. Protracted withdrawal syndrome is noted to be most often caused by benzodiazepines, but is also present in a majority of cases of alcohol and opioid addiction, especially that of a long-term, high-dose, adolescent-beginning, or chronic-relapsing nature (viz. a second or third addiction after withdrawal from the self-same substance of dependence). Withdrawal response will vary according to the dose used, the type of drug used, the duration of use, the age of the patient, the age of first use, and the individual person.

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Some articles on physical dependence:

Temazepam - Tolerance and Physical Dependence
... The paper concluded that due to concerns about long term use both toxicity and tolerance and dependence as well as controversy over long term efficacy that wise ... Physical dependence Temazepam like other benzodiazepine drugs can cause physical dependence and addiction ...
Removal Of Cannabis From Schedule I Of The Controlled Substances Act - Background
... other substances may lead to severe psychological or physical dependence ... Abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence ... Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule III ...
Politics Of Drug Abuse - World Health Organization
... ii) a tendency to increase the dose (iii) a psychic (psychological) and generally a physical dependence on the effects of the drug and (iv) detrimental ... no tendency to increase the dose (iii) some degree of psychic dependence on the effect of the drug, but absence of physical dependence and hence of an abstinence syndrome, and (iv) detrimental effects, if any ... to be inadequate, and suggested using the blanket term 'drug dependence' The definition of addiction gained some acceptance, but confusion in the use of the terms addiction and habituation and misuse of ...
Physical Dependence - Rebound Syndrome
... A wide range of drugs whilst not causing a true physical dependence can still cause withdrawal symptoms or rebound effects during dosage reduction or especially abrupt or rapid withdrawal ... is debated if the entire antipsychotic drug class causes true physical dependency, if only a subset do, or if none do, but all, if discontinued too rapidly, cause an acute withdrawal ... like cocaine, marijuana, amphetamines, and hallucinogens can be associated with minimal physical dependence but can still cause withdrawal or rebound symptoms ...
Withdrawal From Drugs of Abuse
... However, addiction is to be carefully distinguished from physical dependence ... compulsion to use a drug despite harm that often persists long after all physical withdrawal symptoms have abated ... On the other hand, the mere presence of even profound physical dependence does not necessarily denote addiction, e.g ...

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