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Substance Dependence

A guide to substance dependence and treatment options.

Substance dependence and addiction can overlap considerably. In fact, more recently substance dependence and addiction are used interchangeable, but there are subtle differences between the two. You can be dependent on a substance without the presence of addiction.

Substance dependence refers to an adaptation in the body and mind, through repeat exposure to a substance tolerance forms, over time your body adapts to the substance being present in the body and withdrawal symptoms may occur when attempts are made to stop. You don’t have to abuse substances to develop a dependence, this can be observed in many prescription drugs including anti-depressants, benzodiazepines and opiates. If you take prescribed substances as directed over a long period of time, substance dependence can develop.

Those who are substance dependent without the present of addiction would still benefit greatly from a medically supervised detox, since many substances can result in unpleasant withdrawal symptoms when attempting to stop.

The UK’s most comprehensive and forward-thinking substance dependence treatment centres use the most experienced and expert treatment professionals, many of whom specialise in substance dependence. The highly-qualified teams at private centres, such as the Sanctuary Lodge, can deliver clinical treatment for dependence to any substance. One of the widest ranges of proven tools and techniques is available for you and your loved ones, to ensure a sustainable path of recovery.

Why sanctuarylodge
Why Sanctuary Lodge?

We are a secure facility with a modern vision for the way treatment works. If you are looking for a proven, traditional addiction treament – we provide this alongside some of the top contemporary therapies including CBT, DBT and holistic treatments to help you find the pleasure in keeping yourself fit and being creative. When you come to Sanctuary Lodge, you will receive:

  • 24/7 support and assistance
  • A personalised treatment plan
  • Aftercare sessions and counselling
  • Sanctuary Lodge, Hedingham Road
  • Halstead, Essex, CO9 2DW United Kingdom

Email us at

info@ukat.co.uk

Call us now on

02031518101

Signs & Symptoms of Substance Dependence

If you are worried about yourself or a loved one suffering from dependence on a particular substance, you can look out for some of these common signs of dependence:

  • Increased tolerance when using the drug, leading to a desire for stronger doses to feel the effects.
  • Withdrawal symptoms if you reduce or stop your usual intake.
  • Issues in maintaining close relationships or attending work.
  • Continued use of the drug despite negative side effects.
a man on some steps suffering from withdrawal
a blackboard with different drug names labelled

Common Substances That Result in Dependence

  • Alcohol
  • Nicotine
  • Opiates
  • Cocaine/Crack Cocaine
  • Cannabis
  • Spice
  • Legal highs
  • Methamphetamine
  • Prescription medication such as; pain pills, stimulants, benzodiazepines or anxiety/depression pills
  • Hallucinogens
  • MDMA/Ecstasy
  • Inhalants
  • Ketamine

Withdrawal

Withdrawal is a set of symptoms that happen if you try to stop or decrease a substance. For the symptoms of withdrawal to take place, you will have already formed a physical dependence to the substance; psychological dependence can also cause cravings and withdrawal symptoms. You can get symptoms of withdrawal from any substance that has been taken over a prolonged period, regardless of whether it is prescribed medication from the doctor or an illicit substance, the same is true for alcohol.

Dependence syndrome, a form of psychological dependence, is linked to withdrawal, making psychological withdrawal much more difficult when performed in an uncontrolled environment. The syndrome itself is a mixture of behavioural, cognitive and psychological symptoms (1).

a man struggling with withdrawal symptoms

Physical dependence

If you have been using a substance over a long period, you may find that you have become physically dependent on it. This can even happen with prescription drugs taken as instructed. Being physically dependent on a drug doesn’t necessarily mean you’re addicted to that sub-stance; however, physical dependence does often accompany addiction.

What you will find when you use a substance chronically, is that you build up a tolerance to that substance. This is because the more you use a substance, the less sensitive you will become to it. Therefore, you might be finding that you need more and more of the drug to get the same feeling you had when you first started using it.

Common physical withdrawal symptoms include headaches, dizziness, chest tightness, difficulty breathing, racing heart, skipped beats, palpitations, nausea, vomiting, diarrhoea, stomach aches, muscle tension, twitches, tremors, shakes, muscle aches, sweating and tingling.

Psychological dependence

Some drugs may have little to no physical withdrawal but may still carry a significant psychological withdrawal if you have become emotionally, or psychologically, dependent on it and try to stop using it. It is not uncommon to find that you are also psychologically dependent.

Do you feel like you have a strong emotional or mental attachment to a substance, and that when you don’t have it, or haven’t had it in a while, you find yourself desperate to find, and use? Are you becoming extremely agitated and emotionally volatile if you are unable to find what you need?

The common symptoms of psychological withdrawal include anxiety, panic attacks, restlessness, irritability, depression, social isolation, lack of enjoyment, fatigue, no appetite, insomnia, difficulty falling or staying asleep, poor concentration and poor memory.

a man rolling a cannabis cigarette

Which Substances Are the Hardest to Quit?

Whilst some people may find it easier to quit than others, and all will experience different symptoms of withdrawal, certain drugs do have a higher dependency potential than others. Professor David Nutt and colleagues conducted a study, published in the highly regarded medical journal The Lancet (2), which calculated the dependency of the following drugs: heroin, cocaine, tobacco, barbiturates, alcohol, benzodiazepines, amphetamine, cannabis and ecstasy. He was able to demonstrate which drugs would be the hardest to quit by measuring their physical dependence, psychological dependence and pleasure ratio using a scale between one and three, with three being the highest. They then calculated the mean.

The drug with the highest mean score, consequently being the hardest to give up. According to their results, heroin scored three across the board, making it the most difficult substance to quit. Cocaine followed a close second with a mean score of 2.39. Tobacco was third with a mean score of 2.21 and alcohol 5th with a mean score of 1.93. (3)

Is Substance Dependence the Same as Addiction?

No. Substance dependence is not the same as addiction, although some people may use the terms interchangeably, there is a difference. It’s possible to have a dependence on a substance without being addicted.

Addiction is considered more than a physical dependency as it results from a change in bio-chemistry after continued use of a substance. This change in your biochemistry will often mean that you will go to any lengths to obtain the substance, as your system is telling you it requires it for survival. Because of this significant mental switch alongside the physical dependency, the result is an addiction.

How Are Substance Use Disorders Treated?

Substance Use Disorders (SUDs) usually require professional treatment. This is because most SUDs are complex in the way they play out and require a comprehensive treatment programme that looks, not only at the symptoms of the disorder but also the root cause of the addiction.

In order to treat a SUD, typically you would first undergo an assessment. Following the assess-ment, if required, a licensed addiction specialist would evaluate your condition and provide a comprehensive detox regime specific to your needs, taking into account the need for any substitute medications that would ease the discomfort of withdrawal.

Once you have completed the detox programme, or if you don’t require a detox, in order to achieve the best possible outcome of sustained recovery, you may wish to consider a second stage of your healing – residential rehabilitation.

Is Substance Dependence the Same as Addiction?

No. Substance dependence is not the same as addiction, although some people may use the terms interchangeably, there is a difference. It’s possible to have a dependence on a substance without being addicted.

Addiction is considered more than a physical dependency as it results from a change in bio-chemistry after continued use of a substance. This change in your biochemistry will often mean that you will go to any lengths to obtain the substance, as your system is telling you it requires it for survival. Because of this significant mental switch alongside the physical dependency, the result is an addiction.

Which Substances Are Best Treated in a Residential Rehab?

If you are suffering from a substance use disorder, please don’t attempt to detox alone. Several complex psychological issues, alongside possible physiological conditions relating to addiction, will try to stop you from healing. To give you the best chance of maintaining a sustained recovery, Britain’s top rehab facilities will offer a comprehensive, inpatient rehabilitation treatment.

Although some people may be able to get treatment through an outpatient programme, certain substances do require you to enter a rehab. The reason residential rehab is recommended for some people is down to the difficulty and discomfort that can be caused by the withdrawal from the substance.

These are the drugs that are usually associated with having difficult, painful or even dangerous withdrawal symptoms, and which we would suggest you seek help at our medical detox first and then heal your emotions through a follow-up therapy plan. They may be opiates such as heroin, morphine, oxycontin, Vicodin; alcohol; benzodiazepines such as valium, halcyon, Klonopin; cocaine; amphetamines such as crack cocaine, methamphetamine, Ritalin and more.

Medically Assisted Detox for Treating Substance Dependence

A medically assisted detox is the medically supervised process of gradually depriving you of the drug that you are abusing, using a substitute drug. The main benefit of this process is that it will slowly reduce your dependency whilst minimising the withdrawal effects of certain drugs. We understand that often the fear of withdrawal can make it hard for you to stop using.

Therefore, with the implementation of a detox, the withdrawal process can be eased, resulting in a much higher likelihood of recovery. A medically assisted detox would typically last any-where between 3-14 days, depending on individual circumstances. It is strongly recommended that to achieve long-lasting recovery from substance dependence, a medically assisted detox is followed by a prolonged stay in residential treatment, and then enrolment in a comprehensive aftercare programme.

Sources

1) https://www.who.int/substance_abuse/terminology/definition1/en/
2) https://www.thelancet.com/
3) https://www.researchgate.net/publication/6424313_Development_of_a_rational_scale_to_assess_the_harm_of_drugs_of_potential_misuse

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