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addiction (psychological dependence)

Repeated use of a substance or engagement in a behavior for which the rewards provide sufficient incentive to repeatedly pursue the behavior despite detrimental consequences. [5] Pathology: - associated with &, at least in part, a manifestation of drug dependence Clinical manifestations: - continued craving for an opioid, alcohol or other depressant, beyond legitimate therapeutic use - need to use the opioid for effects other than pain relief or alcohol in an amount that produces withdrawal symptoms upon cessation - continued use of a substance despite harmful consequences [3] Notes: - new DSM-5 criteria would broaden the definition of addiction to include people who crave alcohol & drink more than they mean to - addtionally, behavioral addiction would include obsession with shopping or sex - addiction as defined [5] would not necessitate drug dependence

Related

drug dependence drug tolerance; drug habituation pseudoaddiction substance abuse

General

psychiatric disease; behavioral disorder drug-seeking behavior

References

  1. SAMHSA. Medication-assisted treatment for opioid addiction in opioid treatment programs
  2. Urbina I Addiction Diagnoses May Rise Under Guideline Changes New York Times, May 11, 2012 http://www.nytimes.com/2012/05/12/us/dsm-revisions-may-sharply-increase-addiction-diagnoses.html
  3. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  4. Volkow ND et al Neurobiologic Advances from the Brain Disease Model of Addiction. N Engl J Med 2016; 374:363-371. January 28, 2016 PMID: 26816013 http://www.nejm.org/doi/full/10.1056/NEJMra1511480
  5. Addiction Psychology Today https://www.psychologytoday.com/basics/addiction
  6. Surgeon General Facing Addiction in America. Surgeon General's Report on Alcohol, Drugs and Health. https://addiction.surgeongeneral.gov/
  7. Caruso Brown AE Perspective. Treating Addiction as a Terminal Disease. N Engl J Med 2020; 382:207-209. Jan 6 PMID: 31940697 https://www.nejm.org/doi/full/10.1056/NEJMp1909298