Characterization of Substance Dependence
The phenomenon of dependence has often been associated exclusively with the severe neurophysiological effects related to severe symptoms of tolerance and withdrawal from certain substances or objects as, for example, illicit drugs or gambling. In recent y
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Characterization of Substance Dependence Lúcio Garcia de Oliveira, Frederico Eckschmidt and Gabriela Arantes Wagner
Introduction The phenomenon of dependence has often been associated exclusively with the severe neurophysiological effects related to severe symptoms of tolerance and withdrawal from certain substances or objects as, for example, illicit drugs or gambling. In recent years, however, a new definition and comprehension appeared, indicating that the several symptoms of this disorder and its multiple expressions actually share a common biopsychosocial etiology (Shaffer et al. 2004; Sussman et al. 2011; Goodman 2008). The conventional view implicitly associates the cause of dependence with the properties of those substances or objects and encourages different treatments for that compulsive behavior (Shaffer et al. 2004). Nevertheless, a more comprehensive view of this disorder is called for, since there is a wide range of common characteristics among addictive behaviors. In this scenario, the individual ends up wasting a lot of time thinking about or engaging in behaviors regarding the consumption of psychoactive substances (PAS) such as tobacco, alcohol, and illicit drugs, and the compulsive ingestion of food or engagement in other objects such as gambling, Internet, pathological love, sex, physical exercise, work, and shopping (Shaffer et al. 2004; Sussman et al. 2011). L.G. de Oliveira (&) F. Eckschmidt Departamento de Medicina Preventiva, Universidade de São Paulo, Av. Dr. Arnaldo, 455 - 2o. andar, São Paulo, SP 01246-903, Brazil e-mail: [email protected]; [email protected] F. Eckschmidt e-mail: [email protected] G.A. Wagner Departamento de Medicina Preventiva, Universidade Federal de São Paulo, Rua Botucatu, 740 5o andar, São Paulo, SP 04023-062, Brazil e-mail: [email protected] © Springer International Publishing Switzerland 2016 A.L.M. Andrade and D. De Micheli (eds.), Innovations in the Treatment of Substance Addiction, DOI 10.1007/978-3-319-43172-7_1
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As regards substance use disorder (SUD), bulimia, pathological gambling, and compulsive sexual behavior, in addition to the suffering inflicted upon the individual, all of them share a series of clinical characteristics, namely (a) the course of the disease, since the disorders generally appear in adolescence or early adulthood, running a chronic course, with remissions and exacerbations; (b) the maintenance of the behavior in spite of the harmful consequences and the narrowing of the repertoire; (c) the subjective experience of the individuals, presenting intense desire, concern, or excitement during the preparatory activity, in addition to the feeling of loss of control; (d) progressive development; (e) tolerance, that is, reduction of strength of the reinforcing effects; (f) withdrawal, with physical or psychological discomfort by the interruption or reduction of the behavior; (g) likelihood of relapses, with the continuous return to harmful patterns after a period of withdrawal or control; (h)
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