- What is the pathogenesis of physical dependence formation?
The pathogenesis of physical dependence involves the integration of the psychoactive substance and its metabolites into the metabolism of neural tissue and organs as necessary components and regulators.
A manifestation of physical dependence is the compulsive need for repeated substance consumption. Upon withdrawal, an abstinence (withdrawal) syndrome develops. It occurs against the background of established physical dependence and presents as a complex of psychological, autonomic, and somatic disorders: anxiety, dysphoria, discomfort, irritability, myalgia, leg muscle cramps, gastrointestinal pain, nausea, vomiting, diarrhea, blood pressure fluctuations, tachycardia, diaphoresis, muscle weakness, and insomnia.
- How does psychological dependence differ from physical dependence?
Psychological dependence manifests as a pathological craving for the substance, whereas physical dependence involves the incorporation of the substance and its metabolites into tissue metabolism.
| Feature | Psychological Dependence | Physical Dependence |
|---|
| Core Nature | Pathological craving defining all aspects of the patient's mental life | Substance and metabolites are integrated into neural and organ metabolism as required components/regulators |
| Manifestations | Thoughts of the drug, daydreams, feeling helpless against the urge, continuous drug-seeking behavior | Compulsive need for repeated substance consumption |
| Upon Withdrawal | Not classified as a mandatory sign of physical dependence in the cited sources | Development of abstinence (withdrawal) syndrome |
- What is the mechanism of action of cocaine on CNS synapses?
The mechanism of action of cocaine derived from the plant Erythroxylon coca is based on the blockade of transmembrane transport of biogenic amines into neurons.
- Dopamine transporter blockade — cocaine blocks transport proteins in the presynaptic membrane, preventing dopamine reuptake and causing it to accumulate in the synaptic cleft.
- Inhibition of catecholamine reuptake — blockade of catecholamine reuptake by adrenergic nerve terminals occurs.
The ultimate result of these processes is the activation of the sympathoadrenal system. Single doses of cocaine lead to improved mood and well-being, increased heart rate, elevated blood pressure, and increased body temperature.
- What are the main stages in the development of substance dependence?
The pathogenesis of drug and substance dependence encompasses three sequentially developing stages.
- Initial Stage — also known as the adaptive stage, stage of psychological dependence, or neurasthenic stage. Its core feature is the development of a need for the psychoactive substance as the primary method to achieve positive emotions, improve mood, relieve anxiety and depression, and increase productivity. The key characteristic is psychological craving.
- Stage of Physical Dependence.
- Final Stage.
- What is polydrug abuse?
It is the simultaneous or alternating use of two or more psychoactive substances.
- Which drugs belong to opioid dependence?
They include morphine, codeine, heroin, and omnopon.
- What determines the classification of substance dependencies?
Classification is based on the type of drug, its dosage, duration of use, and the route of administration into the body.