Aches and pains Quote by Gabor Maté
““And then there’s physical dependence. As defined in medical terms, physical dependence is manifested when a person stops taking a substance and, due to changes in the brain and body, she experiences withdrawal symptoms. Those temporary, drug-induced changes form the basis of physical dependence. Although a feature of drug addiction, a person’s physical dependence on a substance does not necessarily imply that he is addicted to it. The withdrawal syndrome is different for each class of drug — in the case of opiates such as morphine or heroin it includes nausea, diarrhea, sweats, aches and pains and weakness, as well as severe anxiety, agitation and depressed mood. But you don’t have to be addicted to experience withdrawal — you just have to have been taking a medication for an extended period of time. As many people have discovered to their chagrin, with abrupt cessation it’s quite possible to suffer highly unpleasant withdrawal symptoms from drugs that are not addictive: the antidepressants paroxetine (Paxil) and venlafaxine (Effexor) are but two examples. Withdrawal does not mean you were addicted; for addiction, there also needs to be craving and relapse. In fact, in the case of narcotics, it turns out that the addictive, “feel good” effect of these drugs seems to act in a different part of the brain than the effects that lead to physical dependence. When morphine is infused only into the “reward” circuits of a rat’s brain, addiction-like behaviour results, but there’s no physical dependence and no withdrawal. “Dependence” can also be understood as a powerful attachment to harmful substances or behaviours, and this definition gives us a clearer picture of addiction. The addict comes to depend on the substance or behaviour in order to make himself feel momentarily calmer or more excited or less dissatisfied with his life.””
About This Quote
Physical dependence is a physiological response to cessation, distinct from addiction which involves craving and relapse.
In simple terms: Dependence ≠ addiction; withdrawal can happen without addiction.
Recognize the difference between dependence and addiction.
Themes
Mood
Type
When to use this quote
- medical treatment
- patient counseling
- drug tapering
Key Concepts
Questions to Reflect On
- How can clinicians differentiate dependence from addiction?
- What strategies reduce withdrawal discomfort?
Withdrawal symptoms can be severe, requiring careful management.