Physical dependence
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Understanding Physical Dependence: Insights from Recent Research
Physical Dependence in Drug Abuse Liability Assessment
Physical dependence is a critical factor in the abuse liability assessment of central nervous system-active drugs. Preclinical studies, particularly the withdrawal test in rats, are highly predictive models for studying physical dependence. These tests are essential for the safety evaluation of drug candidates and are conducted under strict regulatory guidelines and Good Laboratory Practices 1. The withdrawal test helps in understanding the potential for physical dependence, which is a mandatory part of the drug development process.
Physical Dependence and Tolerance
Tolerance and physical dependence are closely related phenomena in the context of drug use. Tolerance refers to the body's adaptation to a drug, requiring higher doses to achieve the same effect, while physical dependence involves physiological adaptations that lead to withdrawal symptoms upon cessation of the drug. These two processes are often intertwined, as seen in the homeostat hypothesis of drug addiction, which suggests that both tolerance and physical dependence are adaptive responses to maintain internal balance 5. Studies have shown that physical dependence can develop without tolerance and vice versa, indicating that these processes can occur independently under certain conditions 5.
Measuring Physical Dependence in Tobacco Smoking
The Tolerance Questionnaire has been validated as a tool to measure physical dependence on nicotine. This questionnaire assesses withdrawal responses, such as changes in body temperature and heart rate, to estimate the degree of physical dependence. The results from these measurements can help in individualizing smoking cessation treatments, making them more effective 6.
Physical Dependence in Caffeine Use
Research has demonstrated that physical dependence significantly increases the reinforcing effects of caffeine. In a study where subjects were exposed to chronic caffeine and placebo phases, those maintained on caffeine showed a higher preference for caffeine over placebo, even when it meant forfeiting money. This preference was accompanied by typical withdrawal symptoms like fatigue and mood disturbances, highlighting the role of physical dependence in reinforcing caffeine use 7.
Physical Dependence in Alcoholism
The role of physical dependence in alcoholism has been critically examined, particularly in animal models. It has been argued that physical dependence, which requires continuous high blood-alcohol levels, cannot coexist with the intermittent alcohol presentation needed to develop a preference for alcohol. This suggests that physical dependence may not be a necessary attribute for developing high alcohol intake in animals, and by extension, in humans 9.
Physical and Mental Factors in Dependency Among the Elderly
In elderly populations, physical dependence is often intertwined with mental factors. Studies have shown that physical impairments, such as mobility and upper limb function, and cognitive impairments due to dementia, are strongly related to the level of dependency. These factors are equally significant in determining the dependency levels among elderly patients, whether they are in institutions or receiving home care 2.
Conceptual Model of Physical Independence and Dependence
A conceptual model of physical independence and dependence for adults with chronic physical illness and disability highlights that these constructs are continuous and influenced by multiple determinants. Factors such as the physical and social environment, personal resources, attitudes, and coping mechanisms play significant roles in determining the level of physical dependence or independence 4.
Conclusion
Physical dependence is a multifaceted phenomenon that plays a crucial role in drug abuse, smoking, caffeine use, and alcoholism. It is closely linked with tolerance and can significantly influence drug consumption behaviors. Understanding the mechanisms and factors contributing to physical dependence is essential for developing effective treatment and management strategies for various forms of substance dependence and chronic illnesses.
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Most relevant research papers on this topic
Dependency in old age: A comparison of mental and physical factors
Mental and physical impairments are equally strongly related to dependency in elderly patients, with central nervous system disease being associated with greater dependency.
Observational StudyTolerance and Physical Dependence
Tolerance and physical dependence significantly influence drug consumption, with opiates showing the strongest positive relationship with physical dependence.
Literature ReviewA conceptual model of independence and dependence for adults with chronic physical illness and disability.
Physical independence and dependence in adults with chronic physical illness and disability are multi-determined constructs influenced by factors such as disability domains, personal resources, and assistive relationships.
Highly CitedPhysical dependence on ethanol: its relation to tolerance.
Physical dependence on ethanol is linked to functional tolerance, but tolerance and dependence may arise through diverse mechanisms, with different withdrawal signs showing different degrees of dependence or having different time courses.
Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment.
The Tolerance Questionnaire effectively measures physical dependence to nicotine, which can be used to individualize smoking withdrawal treatment.
Non-RCTHighly CitedPhysical dependence increases the relative reinforcing effects of caffeine versus placebo
Chronic caffeine use increases the reinforcing effects of caffeine, leading to increased willingness to forfeit money and withdrawal symptoms.
RCTHighly CitedASPECTS OF DEPENDENCY
Dependency conflict in alcohol studies has evolved from its traditional use to encompass a variety of phenomena, including physiological disturbances, psychological symptoms, and economic dependence.
The role of physical dependence in animal models of human alcoholism.
Physical dependence is not necessary for animal models of human alcoholism, as it requires continuous high blood-alcohol levels and intermittent alcohol presentation, contradicting its role in high alcohol intake development.
Literature ReviewDrug dependence: its significance and characteristics.
Drug dependence can be better understood by using specific terms for different types of chemical agents, rather than a single definition for all forms of addiction and habituation.
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