The Dope Series: Tolerance and Dependence

If you are reading this, than you have either read the first chapter of The Dope Series or you have simply stumbled upon this randomly. Either way, welcome. This post is the second chapter to my new blog series. Last chapter I kept it simple. I discussed the very definition of what a drug is. I also discussed the levels of availability of drugs. This chapter, I discuss very important aspects of drug consumption. I discuss tolerance and dependence.

Disclaimer. Be aware that the information provided in The Dope Series has been collected from Criminalistics An Introduction to Forensic Science writer by Richard Saferstein. The information provided is subject to change as new evidence and research is collected.

Drugs, if taken for the right reasons, can actually be very beneficial to the human body. Advil and Tylenol are great over-the-counter drugs that are used for the purpose of analgesia. They are the 2 most popular pain killers on the market. Citalopram is a prescribed drug that is given to patients that suffer from anxiety disorders and depression. Citalopram is a selective serotonin reuptake inhibitor (SSRI). SSRI’s are the best known anxiolytics and antidepressants currently on the market. Morphine is another great painkiller. Morphine is an opiate (will be discussed in later chapters) that does an incredible job in reducing pain almost immediately. Morphine is only legally allowed to be used in hospital settings. Marijuana is another drug that has recently seen some light in the medical field. Medical marijuana is used prescribed for treatment of diseases such as glaucoma and is often also prescribed for chronic pain. As we can see, from over-the-counter to illicit, drugs of all kinds can have beneficial effects if used for beneficial purposes. However, a problem may still arise here. You can use certain drugs for beneficial purposes and still experience the severe downfall that only abusers may face (and I’m not talking about their side effects).

Let’s start with drug tolerance, the lesser of two evils (but still quite wicked). Drug tolerance is a phenomenon that occurs with repeated drug use. Before you get the idea that only severe abusers develop tolerance, even everyday people taking their everyday medical prescriptions can develop a tolerance to drugs (their medication). Tolerance is a person’s diminished response to a drug. This does not mean “the more they take it, the less they feel it” rather, it means that a person would have to take more of a drug to experience the same effect. Let me give you an example. Many people who suffer from anxiety or panic attacks, will sometimes be prescribed a benzodiazepine. Benzodiazepines are from a separate family than SSRI’s that are mentioned above. Benzodiazepines are prescribed to be taken when a patient feels a panic attack or anxiety episode emerging. Depending on the dose, a patient may be required to take only 1 pill. If these episodes occur frequently, the patient may come to notice that taking 1 pill (as prescribed) no longer diminishes the feeling of anxiety. Instead, the patient must take 2 to feel the relieving effects that originally only required 1 pill to overcome. This is drug tolerance. Drug tolerance is commonly seen in alcohol users. What may start off as 1 beer to get a buzz, may later turn into 5 shots to get a buzz. As a person takes more of a drug, their metabolism of the drug speeds up. In other words, the body has now been introduced to the drug enough times to know how to work it. Essentially, the drug is processed faster but not necessarily efficiently.

As i mentioned above, tolerance is the lesser of two evils, one of which I will discuss later. Often times, these two evils are used interchangeably. However, this would be a mistake as they are two vey different concepts. Throughout the history of drug use, the very first drugs to be regulated were actually those drugs that had “habit-forming” properties, which usually focused on opium. To this day, many regulated drugs continue to produce dependence, only now we have identified many more factors. The definition of dependence varies whether you’re defining psychological dependence or physical dependence. Psychological dependence is the conditioned use of a drug caused by underlying emotional needs. These emotional needs stem from a persons inner desire to create a sense of well-being or euphoria, or just simply escape from personal problems. The intensity of the psychological dependence depends on the nature of the drug that has been consumed. Heroin and alcohol are examples of drugs that can produce a high degree of dependence, in contrast to marijuana and codeine that have considerably lower potential for dependence. A persons personality may have a large, unpredictable influence on whether someone may develop a drug dependence.

The other kind of dependence, physical dependence, is perhaps the most commonly known of the two. Physical dependence is characterized by withdrawal sickness when administration of a drug is abruptly stopped. When drugs are taken frequently for long periods of time, they are capable of producing physiological changes that encourage continued use. When administration of the drug is stopped, you see the classic “withdrawal sickness” that is characterized by agitation, heart palpitations, sweating, and tremors. Physical dependence develops only when a user adheres to a regular schedule of drug intake. The interval period between consumption needs to be short enough that the effects of the drug never actually subside. The desire to avoid this withdrawal sickness is incentive enough to encourage a person to continue using the drug (and thus become physically dependent). Some drugs have little to no potential of developing physical dependence, such as Tylenol, Advil, and marijuana. Other drugs, such as Morphine, Percocet, and Heroin, are among the highest for potential of developing a dependence.

The concept often (wrongfully) used as synonymous with dependence is Addiction and although these can often go hand in hand, addiction is much more complicated than a person simply “relying on drugs.” Addiction will be discussed in greater detail in a later chapter of this series.

The next chapter of The Dope Series will identify the different classes of drugs, each of which will also have their own chapter.

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