Substance dependencealso known as drug dependenceis an adaptive state that develops from repeated drug administration, and which results in withdrawal upon cessation of drug use. Within the framework of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-IVsubstance dependence is redefined as Addictiion drug addiction, and can be diagnosed without the occurrence of a withdrawal syndrome.
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Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. Withdrawal is the body's reaction to abstaining from a substance upon which a person has developed a dependence syndrome. When dependence has developed, cessation of substance-use produces an unpleasant state, which promotes continued drug use through negative reinforcement ; i.
The withdrawal state may include physical-somatic symptoms physical dependenceemotional-motivational symptoms psychological dependenceor both. Chemical and hormonal imbalances may arise if the substance is not re-introduced.
Psychological stress may also result if the substance is not re-introduced. Infants also suffer from substance withdrawal, known as neonatal abstinence syndrome NASwhich can have severe and life-threatening effects. The dependence potential of a drug varies from substance to substance, and from individual to individual.
Dose, frequency, pharmacokinetics of a particular substance, route of administration, and time are critical factors for developing a drug dependence.
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An article in The Lancet compared the harm and dependence liability of 20 drugs, using a scale from zero to three for physical dependence, psychological dependence, and pleasure to create a mean score for dependence. Selected results can be seen in the chart below. Capture Alcohol And Drug Addiction Drugs enumerate the percentage of users who reported that they had become dependent Adn their respective drug at some point. Two factors have been identified as playing pivotal roles in psychological dependence : the neuropeptide " corticotropin-releasing factor " CRF and the gene transcription factor " cAMP response element binding protein " CREB. In the NAcc, CREB is activated by cyclic adenosine monophosphate cAMP immediately after a high and triggers changes in gene expression that affect proteins such as dynorphin ; dynorphin peptides reduce dopamine release into the NAcc by temporarily click the reward pathway.]
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