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Physical Addiction

Physical addiction is biochemical in nature and is independent of social or psychological causes. Physical Addiction occurs when a patient’s body becomes dependent on a particular substance like drugs, alcohol, nicotine and even food. The patient develops a tolerance to the substance and requires a larger dose to get the same effect. When a physically addicted patient stops using the substance, he/she usually experiences symptoms of withdrawal. Depending on the addiction, these symptoms can be severe, and can include tremors, hallucination, diarrhea, among other signs. While Psychological Addiction can occur with Physical Addiction, it is secondary to the actual physical craving or need for the substance and will not cause physical symptoms of withdrawal, but rather an emotional and psychological obsession or persistent thinking about the feeling of being ‘high’ or being satisfied by the substance. Because the symptoms of Physical Addiction are so powerful, the patient may lie or steal to get the substance they need, and the patient’s life will become centered around acquiring and using the substance. In short, when a person no longer has a choice as to whether to take the substance because of the severe symptoms of physical withdrawal that occur without the substance, he/she has become addicted. Tobacco and alcohol addiction can include social components that together with the physical addiction will challenge a patient’s attempts to quit. Studies have shown that tobacco addiction may be even more severe than alcohol addiction and at least as controlling as narcotic addiction. It is important to note that physical addiction and dependency applies not only to illegal drugs but to prescription medication as well. Doctors now define addiction as an uncontrolled, compulsive use, despite harm. Where prescription drugs are involved, doctors will typically define the abuse as ‘physical dependence’. While characteristic withdrawal symptoms can appear with alcohol, illegal drugs and nicotine, they are also evident in withdrawal from barbiturates, pain medication and many other legal medications. Diagnostic instruments now classify many of these conditions as dependencies rather than addictions. The distinction made by the medical community is as follows: Addiction is a primary and chronic neurobiological disease. It is attributable to genetic, psychosocial, and environmental factors and characterized by impaired control over substance use, and compulsive and continued use and craving, in spite of harm. Physical Dependence is an adaptation manifested by substance class specific withdrawal that is produced by abrupt cessation, or rapid dose reduction, causing decreasing substance levels in the blood.

What are the symptoms?

For symptoms of addiction to specific substances, see the related title article. A summary of possible symptoms is provided here.

  • Need for substance regularly, perhaps several times a day
  • Failed attempts to stop using substance
  • Feeling a need for the substance to deal with daily problems
  • Needs substance on hand in good supply
  • Stealing or lying to get the substance
  • Sudden change in appearance or grooming
  • Poor school or work performance
  • Apathy and disinterest in things the patient used to find exciting or pleasurable
  • Driving or doing things under the influence of the substance that will put the patient or others in jeopardy
  • Asks for or steals money to obtain substance, spends inordinate amount of money on substance
  • Exaggerated need for privacy, doing things in secret
  • Increased tolerance to substance, needing more to get the same effect
  • Changes in sleep habits
  • Significant, unexplained weight gain or loss
  • Failed attempts to stop using substance
  • Anxiety, anger, depression
  • Changes in friendships and the people with whom the patient socializes
  • Physical discomfort and withdrawal symptoms when the patient stops using the substance (these will be specific to the substance being used by the patient)

How is it diagnosed and treated?

Doctors may ask about frequency of substance use, whether any family member has criticized the use of this substance, or whether the patient feels they may have a problem. A full medical examination is required to rule out other illness or disease. Definitive diagnosis of addiction usually occurs after evaluation by a psychiatrist, psychologist or a specialized addiction counselor. Blood tests are not always conclusive but these tests can help a doctor detect the presence of certain substances. For information on specific addiction diagnosis and treatment, see the related title article. Treatment for addiction varies with the specific substance. Treatment typically involves withdrawal from the substance, counseling and self-help groups.

Treatment(s) can include:

  • Preoccupation with substance or activity
  • Significant consequences to family, job and lifestyle
  • Withdrawal symptoms when patient attempts to quit
  • Loss of willpower, inability to control behavior or use
  • Increased tolerance to and use of substance or activity

Treatment protocols vary, depending upon the addiction, but in general, medical, educational and social therapeutic modalities are required to address the addiction and the associated and secondary conditions that may exist. Treatments may include one or some of the following therapies:

  • Withdrawal, detoxification
  • Self-Help Groups, 12-Step programs as appropriate
  • Coping Skills Training to prevent relapse
  • Cognitive Behavioral Therapy and Modification
  • Dietary modifications, vitamin therapy, as appropriate
  • Family Therapy and Education
  • Medication as appropriate to addiction: patches or gum for nicotine, anti-depressants, anti-anxiety medications as appropriate to addiction and secondary disorders

Index of Articles


Researchers are just starting to collect statistical data on some addictions, like internet and computer addiction, and sexual addiction.

Nicotine Addiction:

An estimated 57 million Americans smoke, 7.6 million use smokeless tobacco, every day.

Internet/Computer Addiction:

In 1997 51 million Americans were online, and 20% spent 10 or more hours per week online. 40% said they used the computer more in the current month, than in the previous month.

Gambling Addiction:

1% of the American adult population is estimated to meet the diagnostic criteria for Pathological Gambling. Another 2-3% are considered Problem Gamblers.

Drug Addiction:

About 19.5 million Americans over the age of 12 use illegal drugs (3.6 million are teenagers). 19,000 people die each year of drug-related causes.

Alcohol Addiction:

1 in 13 American adults is an alcohol abuser or alcoholic. During the period from 1991 to 2002 the number of people who abuse alcohol or are alcohol dependent rose from 13.8 million to 17.6 million. Alcoholism is one of the most common psychiatric disorders with a prevalence of 8%-14% in American adults.

If you are in a crisis please call:
1-800-SUICIDE (784-2433) or
1-800-273-TALK (8255)

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