17.1.1 Physical Dependence

• What is physical dependence in addiction?

  Need for substance to function normally
• The key characteristic of physical dependence called tolerance involves needing increasing amounts of the substance to achieve the same effect
• Withdrawal symptoms occur when substance use is stopped or reduced.
• What physiological changes occur in physical adaptation during dependence?

  Changes accommodate the substance
• The neurobiological basis of physical dependence involves changes in the brain due to chronic substance use
• What happens to dopamine receptors during substance dependence?

  They become less sensitive
• Brain regions like the prefrontal cortex and amygdala are affected by chronic substance use.
• Withdrawal symptoms occur because the brain is trying to revert to its normal state
• What is tolerance in the context of physical dependence?

  Increased dosage for same effect
• Withdrawal symptoms from physical dependence include tremors, sweating, nausea, and irritability
• How does physical adaptation contribute to physical dependence?

  It causes disruption if substance is removed
• Chronic dopamine release leads to tolerance in physical dependence.
• What is receptor desensitization in physical dependence?

  Reduced receptor response
• Withdrawal symptoms occur because the brain is trying to revert to its normal state
• The neurobiological basis of physical dependence involves changes in brain regions like the prefrontal cortex.
• Why do higher doses of a substance become necessary in physical dependence?

  To compensate for tolerance
• Withdrawal symptoms occur because the brain is trying to return to its normal state after chronic substance use.
• What is the neurobiological basis of physical dependence primarily related to?

  Physiological changes in the brain
• Substances increase dopamine release, leading to a reward effect. Over time, receptors become less sensitive
• Receptor desensitization requires higher doses for the same effect.
• What occurs when substance use is stopped abruptly in physically dependent individuals?

  Withdrawal symptoms
• Tolerance in physical dependence means needing increasing amounts of a substance to achieve the desired effect
• Withdrawal symptoms include both physical and psychological distress.
• What is the primary difference between physical and psychological dependence?

  Physical vs. emotional need
• Physical dependence involves tolerance and withdrawal symptoms, while psychological dependence involves cravings and compulsive use
• Order the physiological symptoms of physical dependence from mild to severe:

  1️⃣ Tremors

  2️⃣ Sweating

  3️⃣ Nausea

  4️⃣ Seizures

  5️⃣ Delirium tremens
• What is the underlying mechanism of psychological dependence?

  Psychological associations
• Someone physically dependent on alcohol experiences withdrawal symptoms upon abstaining.
• Someone psychologically dependent on alcohol experiences intense cravings and anxiety
• What are withdrawal symptoms experienced upon cessation of substance use?

  Physical and psychological discomfort
• Match the category of withdrawal symptoms with their examples:

  Physical Symptoms ↔️ Tremors, nausea

  Psychological Symptoms ↔️ Anxiety, irritability
• Alcohol withdrawal symptoms can escalate to delirium tremens.
• Physical dependence is characterized by tolerance, withdrawal symptoms, and physical adaptation
• What are unpleasant physical symptoms that occur when substance use is stopped in physically dependent individuals?

  Withdrawal symptoms
• Physical adaptation refers to physiological changes that accommodate the substance, causing disruption if the substance is removed
• In a dependent state, the effects of the substance are normal.

  False
• Order the neurobiological changes in the brain due to chronic substance use.

  1️⃣ Dopamine system alteration

  2️⃣ Receptor desensitization

  3️⃣ Brain rewiring

  4️⃣ Withdrawal symptoms
• What does the equation $Dosage \uparrow \Rightarrow Effect \uparrow$ represent in physical dependence?


  Tolerance
• Withdrawal symptoms occur when substance use is abruptly stopped
• In a normal state, receptor sensitivity is reduced.

  False