The idea that certain elements of drug dependence can be separated into wholly different categories, such as being primarily mental or physical, does not coalesce with what health professionals and scientific experts understand about addiction and the many variables that influence it. Moreover, all psycho-emotional processes have physical underpinnings, deep-rooted psychological propensities significantly influence all complex actions.
The classification of an activity as being either entirely physical or purely mental-driven implies a misunderstanding of behavior and the brain and body connection. This presumptive belief is pertinent to the disease model of addiction in that it suggests that addiction is not a choice because people with substance use disorders are capable of enacting decisions regarding their substance abuse, especially when it comes to seeking professional treatment.
However, the alternative view that addiction is entirely a choice is incorrect because those who struggle with substance abuse are highly motivated by many physical/chemical processes and mental health issues that influence their behavior in many ways. Furthermore, almost no one who experiments with drugs or alcohol sets out or chooses to become addicted. It is only the specific behaviors surrounding addiction, such as the willingness to receive or refuse medical help, that suggests a choice is involved.
Therefore, many experts contend that psychological and physical dependence should not be perceived as wholly separate entities, and instead, two sides of the same coin.
Physical dependency is defined as a person’s reliance on an external source of a chemical substance to prevent cravings and withdrawal symptoms. Dependence, when viewed in this way, is predictable, can be efficiently treated with medication, and can sometimes be managed by tapering off the substance or undergoing a medical detox program.
Many substances—including caffeine, nicotine, and antidepressants—can lead to physical dependence. The condition is not, by any means, a consequence unique to illicit drugs and alcohol. In fact, physical dependence can distract from another problem—addiction. Physical dependence is usually referred to as just “dependence.”
Still, this phrasing can lead to confusion because it leaves out deep-rooted psychological factors that contribute to the condition. It also confuses the issue between physical dependence and full-blown addiction, the latter of which is also characterized by tolerance and compulsive drug-seeking behavior.
Psychological vs. Physiological Dependence and Addiction
Unlike physical dependence, addiction is not a normal response to chemical interference and is considered a chronic disease. Addiction is a mental disorder characterized by unmanageable cravings, an inability to control compulsive behaviors surrounding drug use, and the use of intoxicating substances despite the infliction of harm on oneself and others.
The destructive behaviors borne of addiction are mostly a product of uncontrollable cravings and are among the principal motivators of substance abuse itself. Severe drug cravings are hallmarks of all substance-based habits and are the result of adversely altered brain chemistry.
Addiction can occur without the development of physical/chemical dependence. For instance, withdrawal symptoms related to cocaine and methamphetamine may be less intense than, say, heroin or alcohol, but addiction to either of these drugs can destroy lives. And the disease of addiction also consists of significant emotional issues that can persist long after a person has abstained, and physical dependence has been reversed. When this occurs, it is also referred to as post-acute withdrawal syndrome.
Also, behavioral addictions, such as gambling, sex, video games, or porn, have no external chemical reliance associated with them. What is underlying these addictions is abnormal and often all-consuming cravings that motivate people to engage in compulsive drug-seeking behaviors.
Likewise, physical dependence can develop without progressing to full-blown addiction. This phenomenon is not uncommon for chronic pain patients who take their opioid medications as prescribed but don’t experience uncontrollable compulsions or a loss of control regarding painkiller use. It is crucial to realize that a desire to avoid withdrawal symptoms is not necessarily suggestive of addiction.
What Is Psychological Dependence?
Psychological dependence is a term commonly used to describe emotional and mental processes that contribute to the development of a substance abuse disorder or process addiction. Most individuals or sources that use the term “psychological dependence” refer to the cognitive and emotional characteristics of addictive behaviors or the withdrawal process from drugs or alcohol that have psychiatric features, such as depression or anxiety.
The common symptoms associated with emotional aspects of addictive behaviors or with psychological dependence include the following:
- Anxiety that occurs when a person attempts to stop engaging in addictive behavior
- Feelings of depression that occurs when a person cannot use their drug of choice (whether willingly or otherwise) or attempts to mitigate addictive behavior
- Feelings of irritability, agitation, and restlessness that manifest when a person is not using their drug of choice or trying to discontinue use
- Mood swings that emerge when a person is not using his/her substance of choice or trying to quit or cut back
- An increase in or loss of appetite associated with not using the drug of choice
- Sleep problems/disturbances related to attempting to stop using the drug of choice
- Feelings of uncertainty about being able to stop using a substance(s)
- Denial that one has a substance abuse problem or romanticizing substance use/abuse
- Obsessive thoughts, feelings, and behaviors associated with acquiring or using the drug of choice
- Cognitive issues, such as those associated with concentration, memory, decision-making, problem-solving, and judgment
Features associated with physical dependence are mostly related to the development of tolerance and withdrawal symptoms, such as nausea, vomiting, diarrhea, shakiness, seizures, etc. The symptoms most commonly associated with psychological dependence are typically perceived as far more variable in their severity and manifestation than the symptoms linked to primarily physical dependence. However, since there is no completely objective approach to assessing a person’s level of stress or dysfunction emotionally or physically, this assertion cannot be reliably confirmed using clinical observation.
Symptoms believed to be primarily psychological in nature, such as cravings, are also commonly theorized to be driven by physiological processes. Likewise, conditions generally considered to be physiological, such as physical dependence, tolerance, and withdrawal, can be clinically-connected with psychological factors that impact their outward presentation.
Substances Associated with Psychological and Physiological Dependence
The conclusion here is that all instances of substance abuse may be associated with aspects of both psychological and physiological dependence. However, these may not be observable in any given individual concurrently. The following substances have been associated with addiction or “psychological” dependence, but not necessarily a significant chemical or physical addiction:
- Most stimulants, including cocaine, meth, and amphetamines
- Most hallucinogenic drugs, such as LSD, mescaline, and “magic” mushrooms
- Cannabis products
- Many inhalant substances, such as nitrous oxide
- Many psychiatric medications, such as antidepressants
Conversely, substances frequently associated with the development of a significant physiological dependence include the following:
- Opiate/opioid prescription drugs, such as morphine and oxycodone
- Illicit opioids, such as heroin and street fentanyl
- Prescription benzodiazepines, such as Valium and Xanax
- Barbiturates, such as phenobarbital
Many psychoactive drugs are capable of inducing both physical and psychological withdrawal symptoms upon discontinuation of use and promoting both forms of dependence.
Treatment for Substance Use Disorders
Regardless of whether substance abuse behaviors are characterized by abuse/misuse, dependence, tolerance, or all of the above, it can be effectively treated using a comprehensive, evidence-based approach that includes detox services as well as therapeutic services and activities, such as psychotherapy, counseling, mindfulness therapy, and group support.
Just Believe Detox and Just Believe Recovery centers employ caring, professional staff with expertise in addiction who provide those we treat with the tools they need to attain sobriety and enjoy long-lasting wellness free from drugs and alcohol.
Don’t delay—we urge you to contact us now to find out how we can help you on the road to recovery!