understanding dependency

• physical dependency, when there are withdrawal symptoms, such as nausea, vomiting or cramping, if the supply of the drug is suddenly withdrawn.

• psychological dependency, when there is a psychological compulsion or need to regularly use a drug. If the drug is withdrawn, there are no physical symptoms but there may be psychological symptoms such as depression, anxiety and irritability.

Dependency does begin with drug abuse, when an individual makes a conscious choice to use drugs, but dependency is not just "a lot of drug use." Recent scientific research provides overwhelming evidence that not only do drugs interfere with normal brain functioning, creating powerful feelings of pleasure, but they also have long-term effects on brain metabolism and activity. At some point, changes occur in the brain that can turn drug abuse into dependency, a chronic, relapsing illness. Those addicted to drugs suffer from a compulsive drug craving and usage and cannot quit by themselves. Treatment is necessary to end this compulsive behaviour.

risks to health

As well as the danger of dependency, drug misuse has serious health risks and is associated with a wide range of conditions and complications, both physical and psychological. 

For example, cocaine can cause heart failure and heroin can cause respiratory failure (loss of normal lung function), both of which can be fatal. Each year in England & Wales, an estimated 2,000 deaths are caused by illegal drug abuse.

If a person uses a needle to inject drugs, they have a high risk of catching a serious blood-borne infection, such as HIV or hepatitis B or C.

The department of health estimates that, in England, injecting drugs causes 90% of all cases of hepatitis C and 6% of all HIV cases.

The American psychiatric association says that a person is dependent if their pattern of substance use leads to clinically significant impairment or distress shown by three or more of the following in a 12-month period;

1. Tolerance as defined by any of the following; a need for markedly increased amounts of the substance to achieve intoxication or desired effect markedly diminished effect with continued use of the same amount of the substance.
2.  Withdrawal, as manifested by either of the following; the characteristic withdrawal symptom of the substance, the same or a closely related substance is taken to relieve or avoid withdrawal symptoms.
3.  The substance is often taken in larger amounts or over a longer period than was intended (loss of control)
4.  There is a persistent desire or unsuccessful efforts to cut down or control substance use (loss of control)
5.  A great deal of time is spent in activities necessary to obtain the substance, use the substance or recover from its effects (preoccupation)
6.  Important social, occupational or recreational activities are given up or reduced because of substance use (continuation despite adverse consequences)
7.  The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (adverse consequences)