1. Addiction vs. Physical Dependence Katie Ulrich Clinical Psychologist

2. What is Addiction?... ▪ “Addiction is a primary, chronic, neurobiological disease with genetic, psychosocial and environmental factors that influence its development and manifestations” (CAMH, 2014) ▪ Addiction is characterized by behaviors that include: (1)Loss of control over drug (2)Continued use despite harm (3)Compulsive use and craving

3. The 4 C’s of Addiction... Control… ▪ “Every time I try to limit my use to only once a week, I end up using everyday” ▪ “I try to limit myself to one drink per day but once I start, I cant seem to stop until I pass out” Consequences… ▪ “I know my drug use caused HIV but I cant stop using” ▪ “I have to stop using because my life is out of control, but using is the only option for me”

4. The 4 C’s of Addiction (Cont.)... Compulsion… ▪ “All I do is think about how I am going to score” ▪ “No matter what I do, I cant get drugs out of my mind and I feel like I have to use and use a lot, once I use my body goes into autopilot, and ill do anything to get drugs” Craving ▪ “Its like a physical drive or urge to use, I get sweaty just thinking about it, or passing the corner where my dealer hangs out”

5. Two Ways Drugs Work in the Brain...  Imitating the brains natural chemical messengers  Over stimulating the reward circuit of the brain

6. What is Physical Dependence?... Physical dependence is how the body experiences psychological adaptation in response to chronic use of a drug (Alcohol Rehab, 2014).

7. Tolerance... ▪ Developing a physical dependence will result in the development of tolerance to the drug ▪ Tolerance differs from addiction because it is dealing with the individuals psychological state, whereas addiction is a dysfunctional behavioral syndrome ▪ The majority of addicts will develop a tolerance to their drug

8. Withdrawal... ▪ As humans become more adaptive to addictive substances, they suffer negative consequences when the drug is stopped abruptly. ▪ The acute withdrawal for the majority of drugs begins within a half-life of the drug. There are peaks within 3-5 lives and then resolves within a week or two ▪ An individual may experience intense cravings, mood changes and other symptoms that may cause the individual to relapse

9. Conclusion... Addiction can occur without physical dependence… ▪ “Consider cocaine or methamphetamine both have little outwardly apparent withdrawal syndrome but addiction to either can devastate lives” (naabt, 2014). ▪ Unnatural cravings is what prompts the compulsive behaviors. Physical dependence can occur without addiction… ▪ “The common experience of most chronic pain patients who are able to take their opioid medication as prescribed for pain but don't develop the uncontrollable compulsion and loss of control” (naabt, 2014). ▪ A desire to avoid withdrawal is not addiction.

10. References ▪ Alcohol Rehab. (2014). Addiction, Dependence, and Tolerance - Alcohol Rehab. Retrieved from http://alcoholrehab.com/addiction- articles/addiction-dependence-and-tolerance/ ▪ CAMH. (2014). Defining addiction, dependence and abuse. Retrieved from http://knowledgex.camh.net/primary_care/guidelines_materials/Pregnancy _Lactation/Pages/defining_addiction.aspx http://knowledgex.camh.net/primary_care/guidelines_materials/Pregnancy _Lactation/Pages/defining_addiction.aspx ▪ Google Images. (2015). Google Images. Retrieved from https://images.google.com/ ▪ Naabt. (2014). Addiction vs Physical Dependence - Important distinction. Retrieved from http://www.naabt.org/addiction_physical-dependence.cfm ▪ NIDA. (2014). Brain and Addiction | NIDA for Teens. Retrieved from http://teens.drugabuse.gov/drug-facts/brain-and-addiction