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Addiction
Last reviewed: 23.04.2024
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Dependence - a chronic recurrent disorder associated with excessive use of certain substances. Most often, the dependence is caused by nicotine, alcohol, opioids, psychostimulants (in particular cocaine). The transition from consumption to abuse of one or another substance and further to the formation of dependence on it is associated with several factors: individual predisposition, activity of the substance, social conditions. Clinical manifestations of various forms of dependence are determined by the pharmacological features of the drugs the patient is abusing. Accordingly, the clinical picture of opioid dependence differs from the manifestations of cocaine, alcohol or nicotine dependence. However, there are features common to all kinds of dependence: uncontrolled acquisition and use of a substance, a tendency to relapse even after prolonged abstinence. Treatment of dependence presupposes a long-term correction of behavior. The results of treatment can be improved with medications that reduce withdrawal symptoms and help prevent relapse. Since dependence is a chronic recurrent disorder, the main goals of therapy are to improve the quality of life, reduce symptoms, increase the duration of periods of abstinence, or at least moderate use of a substance that causes addiction. From this point of view, the treatment of dependence is similar in nature to the treatment of other chronic disorders.
Causes of dependence
When drug addicts are asked why they take this or that substance, most respond that they want to get a "buzz". By this means an altered state of consciousness characterized by sensations of pleasure or euphoria. The nature of the sensations obtained varies considerably depending on the type of substances used. Some people report that they are taking drugs in order to relax, get rid of stress or depression. Very rarely there is a situation where the patient takes analgesics for a long time to get rid of chronic headache or back pain, and then loses control over their use. Nevertheless, if each case is analyzed more carefully, then one simple answer is impossible. Almost always you can find several reasons that led to the formation of dependence. These factors can be divided into three groups: related to the substance itself, the person consuming it (the "master"), and external circumstances. It resembles infectious diseases, when the possibility of infection of a person in contact with the pathogen depends on several factors.
Dependence - Causes of development
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Symptoms of dependence
Dependence is a complex biopsychosocial problem, the specifics of which are poorly understood not only by the general public, but also by many public health workers. The main symptom of this disorder is behavior characterized by compulsive acquisition and consumption of psychoactive substances. The diagnosis of addiction (also called addiction) is set in accordance with the criteria of the American Psychiatric Association. These criteria are applicable to any dependency vial and suggest the presence of behavioral symptoms associated with the production and use of psychoactive substances. According to these criteria, a diagnosis of dependence can be established if there are at least three of these symptoms. These behavioral symptoms are drug-taking activities that are built into routine daily activities. Although the diagnosis takes into account the presence of tolerance and abstinence, in themselves they are not sufficient to establish a diagnosis. Tolerance is characterized by the need for a substantial increase in the dose of the substance to achieve the desired effect or a pronounced weakening of the effect with the constant administration of the same dose.
Diagnostic criteria of dependence (according to DSM-IV)
The nature of the use of substances causes clinically significant disorders or discomfort, which is manifested by at least three of the symptoms listed below, present simultaneously for 12 months.
- Tolerance
- Abstinence syndrome
- The substance is often taken at a higher dose or longer than intended
- Constant aspiration or unsuccessful attempts to reduce or control substance use
- Actions to obtain a substance (for example, visiting a multitude of physicians or traveling over long distances), substance use or recovery after its action take a significant part of the time