Physical Dependence

16 May

As with many other drugs, the continuous application of opioids over of longer periods of time produces physical (and psychological) dependence. Stopping the drug abruptly causes a stereotypical withdrawal syndrome that includes restlessness, mydriasis, gooseflesh, runny nose, diarrhea, shaking chills, and drug seeking (Heit 2003). The rate of onset of these symptoms depends upon the rate at which the opioid is eliminated.  Administration of an opioid an- tagonist can cause an immediate  “precipitated”  withdrawal. The symptoms of withdrawal are terminated  rapidly by administering  opioid agonists. Phys- ical dependence  must  be distinguished  from  psychological dependence  or addiction, which includes the dimension of compulsive drug-seeking behavior (Enck 1991). However, some investigations  suggest that addiction  resulting from appropriate medical treatment  is a very unusual event (Porter and Jick 1980).

Acknowledgements   We thank Dr. Stefan Schulz for critical reading of the manuscript.


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