Tolerance, Physical Dependence, Addiction: the Differences

For individuals who are seeking intensive treatment but still prefer to live at home, partial hospitalization (PHP) or day treatment programs are also available. PHP typically consists of hospital treatment 5 to 7 days a week, for 4 to 8 hours per day. Like inpatient treatment, clinical staff are on hand to assist with detox, medication management, and withdrawal symptoms. PHP also involves counseling and group therapy, as well as specialized services that focus on skill-building, relapse prevention, and employment assistance. Dependence, on the other hand, is characterized by a physical and psychological loss of control due to substance abuse. For example, physical dependence occurs when the body is reliant on the chemical interactions caused by a drug or substance.

Common medications used to treat drug addiction and withdrawal

Table ​11 provides an alphabetical list of medications tested in randomized placebo-controlled clinical trials for MUD based on the reviews and ClinicalTrials.gov website. METH-induced depressive-anxious symptoms are usually treated with bupropion or a drive-increasing tricyclic antidepressant such as desipramine 1. Sleep disturbances and agitation during METH withdrawal are treated with sedating antidepressants or low-potency sedating antipsychotic drugs. MUD patients with psychotic symptoms are medicated with atypical antipsychotic drugs and, if needed and for a short time only, with benzodiazepines. This review provides an overview of current and emerging treatments for this disorder. During 2015–2018, an estimated 1.6 million U.S. adults aged ≥18 years, on average, reported past-year methamphetamine use; 52.9% had a methamphetamine use disorder, and 22.3% reported injecting methamphetamine within the past year.

• Methamphetamine use and related harms represent a substantial U.S. public health concern.
• In this article, we provide information about what abuse, dependence, and addiction mean, and how you can seek treatment for them.
• This change also provided clarity, since previously, the definition of dependence was narrower and only referred to physiological dependence.
• Adherence was still imperfect, with an average of 28.1–39.5% medication adherence between the two arms.
• Clinical studies suggest that modafinil may be effective in treating cocaine dependence 41–43, and might also be effective for methamphetamine dependence.

Opioid antagonist: naltrexone

Methamphetamine dependence is a growing problem in various areas of the world. The development of effective treatments for methamphetamine dependence has become a pressing concern. Recent improvements in the understanding of the underlying neurobiology of methamphetamine dependence have led to a number of potentially useful pharmacological agents.

Short-Term Effects of Using Meth

Caffeine is an example of a common substance that causes physical dependence. If you can’t function properly in the morning without your cup of coffee, it could be that you are caffeine-dependent. When you miss your morning cup, you might develop physical withdrawal symptoms, like a headache, fatigue, difficulty concentrating, and more. The recent death of pop star Prince from an opioid overdose was one of the 25,000 fatal opioid overdoses in the US every year. What these opioid overdoses show, according to an article in Scientific American, is how increased tolerance of the drug can lead to higher chemical dependence on the side effects.

• The 43 studies examined 23 individual pharmacotherapies, most individually and some in combination.
• To date, there have been very few clinical trials involving people who abuse METH heavily and only recent trials have shown promise for these individuals 35.
• Despite multiple research studies and clinical trials performed, there is no FDA-approved pharmacotherapy for MUD.
• Long-term methamphetamine abuse has many negative consequences, including addiction.
• So unless it is urgent, gradually cutting down on the amount and how often you use it should make it easier.
• We reviewed pexacerfont in one study, a 3-week trial of 51 Iranian men within residential treatment camps where treatment is not normally provided 52.

Video: Why are Drugs So Hard to Quit?

CBT for substance use disorders can be used in many formats, including individual therapy, group therapy and, more recently, computer‐based therapy that are usually delivered during weekly addiction vs dependence 60-min sessions lasting weeks or as a brief CBT (4-8 sessions) 90, 91. Almost two decades have passed since the last methamphetamine (METH) abuse epidemic. In recent years, METH abuse in the United States has been rapidly increasing and is currently one of the leading causes of death in our country. Available statistical data indicates re-emergence of METH popularity and suggest an impending third epidemic of METH abuse. Alarmingly, there is no FDA-approved medication for METH use disorder (MUD).

• Evidence-based prevention and treatment interventions are needed to address surges in methamphetamine use and MUD.
• Ongoing therapy and support groups can help you recover, stay on track, and address symptoms of relapse.
• Studies have found that CBT is effective at reducing meth use, even after only a few sessions.
• For abstinence, urine drug screens (UDS) were used 41 times (80%) and analysed or defined in 16 different ways.
• In recent years, methamphetamine availability and methamphetamine-related harms have been increasing in the United States.

Meth Addiction Symptoms

In this paper, we have reviewed articles using all of the above classifications and sometimes interchangeably and our search included both terms. Most reviewed articles had eligibility criteria that included either the DSM-IV or DSM-V diagnostic criteria, and so we have combined the terms as dependence/use disorder. The effects of topiramate on cognitive performance were also evaluated in both the presence and absence of low and high dose intravenous methamphetamine. Cognitive effects were mixed, with a trend for improvement in attention while there was worsening psychomotor retardation 87. One possible explanation may be that topiramate could increase plasma methamphetamine concentrations 88. As of yet, there have been no reports of clinical trials to determine whether topiramate is effective as a treatment for methamphetamine dependence.

• Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction.
• Doctors may also prescribe certain medications to manage dependence and addiction.
• Some medications tested in clinical trials had dual actions, e.g., as monoamine stimulators and antidepressants.
• This high is addictive and causes people to crave the drug repeatedly in order to achieve it.

Studies conducted in (e.g. men who have sex with men) or excluding (e.g. women) specific populations are limited in their ability to generalise to other populations. For example, no study we reviewed here assessed specific populations such as indigenous peoples. Similarly, while women were often excluded by the study design, no study examined only women. It is unknown how generalisable any of the results reviewed here are outside of the context in which they were conducted, and it is unwise therefore to combine results across populations. A single, recent American study assessed varenicline (1 mg po BD) as a pharmacotherapy for MA dependence 27. There were no differences between treatment and placebo arms for any measures of dependence; however, there was a reduction in cigarettes smoked in the treatment arm (consistent with its licensed indication as a smoking cessation medication).