Physical vs Psychological Substance Dependence

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  • 0:04 Substance Abuse & Dependence
  • 1:42 Physical Substance Dependence
  • 2:57 Psychological…
  • 4:02 Lesson Summary
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Instructor: Ashley Dugger

Ashley has a JD degree and is an attorney. She has taught and written various law courses.

Substance abuse can include physical dependence, psychological dependence, or both. This lesson explains the difference between physical substance dependence and psychological substance dependence.

Substance Abuse & Dependence

Paul had knee surgery a few months ago and has a prescription for painkillers, but he sometimes takes a few more pills than he's supposed to take. Paul also sometimes takes the pills when he's not in pain. Since Paul has a prescription, he doesn't think he has a substance abuse problem.

Annie is a college student. When she goes to dance clubs and concerts with her friends she uses Acid or Ecstasy. Annie feels like she needs the drugs to have fun. However, since she doesn't take the drugs every day, Annie doesn't think she has a substance abuse problem.

So what is substance abuse? It's important to note that 'abuse' is a broader term than 'dependence.' The World Health Organization defines substance abuse as any 'harmful or hazardous use of psychoactive substances,' including misuse or overuse. Note that the term psychoactive substances is also fairly broad. The term refers to all substances that affect the user's mental functioning or cognitive processing. This includes alcohol and illegal drugs like cocaine and heroin. It also includes many legal drugs, like prescription painkillers, ADHD medications, and even some cough suppressants. Substance dependence, on the other hand, refers to the user's physical or psychological reliance on the substance involving habitual use. Many people refer to 'dependence' as 'addiction.' Note that substance abuse can lead to substance dependence, but it doesn't always.

There are two different types of substance dependence. Let's take a look at each type.

Physical Substance Dependence

First, let's examine physical dependence. Physical substance dependence refers to the human body's reliance on a substance to the point that the body cannot function properly without the substance. When the user goes without the substance, his or her body will experience painful and uncomfortable symptoms.

The symptoms are known as physical withdrawal effects, which are negative reactions that tell the body it needs more of the drug. They can include nausea, vomiting, sweating, chills, headaches, and overall pain.

Physical dependence normally requires a detoxification process. Detoxification is a method for slowly weaning the body off a substance. Detoxification typically takes places at a medical facility or in-patient facility specializing in substance abuse disorders. The process takes several days, and sometimes several weeks, depending on the substance and the depth of the user's dependence.

Paul may very well have a physical dependence on his painkillers, leading him to take more than prescribed. It's somewhat common for the human body to develop a physical tolerance to painkilling medicine. This means the user needs more of the drug in order to attain the desired effect. This tolerance can lead to physical dependence on the drug.

Psychological Substance Dependence

Now let's take a look at psychological dependence. Psychological substance dependence refers to the user's perceived need for a substance, based on a strong compulsion or urge to use the substance. The user's body may not physically depend on the drug, but the mind does. However, note that physical and psychological dependence can sometimes occur together.

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