Drug Tolerance, Dependence And Addiction, Why Does It Occur?
Drug tolerance, dependence and addiction are increasingly frequent phenomena. Although many times they are linked, they do not mean the same thing. We explain their differences to you.
Medicines are substances that are used and prescribed to treat conditions. There are different types, since they can serve many purposes and exercise variable mechanisms of action.
The problem is that all of them are associated with a series of adverse effects. Today, the terms “tolerance”, “dependence” and “addiction” are increasingly used and concern about these phenomena grows.
However, it is essential to know the difference between all these phenomena. Although it is true that, many times, they go hand in hand, the repercussion is different in each one. The same is true of your treatment.
What is drug tolerance?
Drug tolerance is defined as a decrease in sensitivity to a drug after it has been administered continuously. That is, it consists in that with the same dose, the drug produces less and less effects.
As the Merck Manual explains, tolerance is developed by two phenomena. The first is that the metabolism of the drug is accelerated. That is, it degrades faster and faster in the body, so its effect is reduced.
The second phenomenon is that both the binding strength and the number of binding of the drug to its respective receptor decrease. Each drug needs to bind to a specific one in cells in order to exert its effect.
Drug tolerance is a very common phenomenon. It seems that genetics are involved in its development. It is not necessary for a person to be exposed for very long. In fact, there are drugs capable of developing tolerance after few administrations.
When tolerance appears, it is usually necessary to modify the dose of the medications to achieve the desired effect. It can also be replaced by a different one. This phenomenon is a problem.
People with chronic pain are often impaired by tolerance to pain relievers. It also occurs in some diseases related to mental health or the immune system.
How does drug dependence occur?
Drug dependence is a different phenomenon from tolerance and addiction. In some cases, they all go together. Higher and higher doses are often needed in an attempt to achieve the desired effect.
According to the InfoDrogas.org page, based on the international classification of diseases, dependency is defined by the following:
- The intense desire to consume a substance.
- Decreased ability to control consumption.
- Withdrawal syndrome symptoms.
- Tolerance.
- Progressive abandonment of other sources of pleasure. It takes longer to obtain or ingest the substance, in addition to recovering from its effects.
- Persistence of substance use despite the consequences.
The problem is that dependence on drugs kills the body’s malfunctions when the substance is not present. Therefore, when the dose is suddenly reduced or consumption is stopped, withdrawal is common.
Withdrawal will depend on what the medicine is. In some cases, the symptoms may be mild and temporary. However, nausea, vomiting, tremors, and chills are common.
Nervousness is one of the main side effects. Some people go on to experience seizures or episodes of psychosis. When there is dependence, certain techniques must be used to reduce this problem.
Drug addiction
Drug addiction is also known as substance use disorder . It is considered a disease. According to an article from the Recal Addiction Treatment Clinic, addiction to benzodiazepines or opioids has become a very important problem.
Addiction is defined as the urgent need to consume a substance, despite the damage it causes. For example, without taking into account the impact on a physical, occupational or social level. It makes the whole life of those who suffer from this disorder turn in relation to said drug or substance.
It can be influenced by many factors. The main one is the type of drug. However, genetics and one’s own or family history of addiction are determining factors. Also personality and mental state. It appears that the mechanism of addiction development involves changes in brain activity. The neurotransmitter most involved is dopamine, which is part of the reward circuit.
As an article by the Bolena Institute explains, the consumption of some medications increases the concentration of dopamine in said circuit. That is why the feeling of pleasure increases and the desire to continue consuming is reinforced.
How can these problems be avoided?
Both tolerance, dependence and addiction to drugs are serious problems. Doctors, when establishing any approach, must take into account the possibility of any of these phenomena appearing.
Tolerance, in most cases, cannot be prevented. When it appears, it is essential to adjust the dose or change the drug. Dependence and addiction must be treated. According to an article by the National Institute on Drug Abuse , the treatment will depend on what the drug is and how the person is.
In general, detoxification programs, strong psychological support and therapy are required. In some cases, drug dependence and addiction require the use of other drugs to alleviate the withdrawal syndrome or prevent relapses.
When there is addiction to opioids, methadone or naltrexone is prescribed. They are drugs that help reduce the desire to consume the substance and alleviate part of the withdrawal symptoms.
At present it is considered that the most effective therapy is cognitive-behavioral therapy. It seeks to modify harmful habits of thought and behavior that intensify the need for medications. He also develops coping strategies to avoid relapse.
When to talk to a doctor
According to specialists from the Mayo Clinic, it is essential to seek medical help when considering a problem with medications. There is no need to be ashamed, as it is not just a personal matter, but is influenced by many other factors.
Dependence and addiction, in most cases, prevent the patient from seeking help. It is a vicious circle in which the supposed relief or benefit of consumption tends to be above the notion of harm.
For this reason, anyone close to them should also contact a specialist when they suspect that there may be tolerance, dependence or addiction. You have to try to end the problem before it becomes serious.
Medicines can be dangerous
We often tend to underestimate the effect that medications can have on the body. However, it is essential to remember that tolerance, dependence and addiction are increasingly frequent phenomena.
Therefore, it is essential that both patients and healthcare professionals are aware of this fact. Before any treatment, the ideal is to follow up and assess the risk of these phenomena happening.
