This article describes a cognitive-behavioral treatment approach designed specifically for problem drinkers with low levels of physical dependence
on alcohol who choose to reduce their drinking.
There is widespread misunderstanding, both among health care professionals and society in general, about the differences between physical dependence
In part they blamed "excessive and unrealistic concern about the danger of addiction," which doctors erroneously equated with tolerance and physical dependence
Yet the Pennsylvania State Board of Medicine guideline says physicians should recognize that tolerance and physical dependence
are normal consequences of sustained use of opioid analgesics and are not synonymous with addiction.
Concerns about physical dependence
, tolerance, and addiction are barriers to the prescription of opioids by primary care physicians for patients with CNMP.
If addiction is driven by physical dependence
on a chemical - in this case, nicotine - relapse should occur during withdrawal, which for nicotine typically lasts a few weeks.
Physicians, however, were concerned with the propensity of barbiturates to induce tolerance, physical dependence
, drug interactions, and potential for a lethal withdrawal syndrome.
If by alcoholism one is referring to alcohol dependence, including significant physical dependence
, studies indicate that few with this problem can adopt controlled drinking.
Okamoto M, Rao S, Walewski JL: Effect of dosing frequency on the development of physical dependence
and tolerance to pentobarbital.
Patients may develop psychological or physical dependence
on them, and tolerance to the drug develops rapidly, Dr.