The phenomenon of Tolerance emerges as one of the chief characteristics in the physiological and psychological make-up of every abuser, addict, or chemically dependent person. Tolerance, simply put, refers to the process by which the body acclimates to the presence of an abused drug. Occurring simultaneously with Tolerance is another physical phenomenon called Dependence. Dependence emerges alongside Tolerance and is the process by which body requires increasingly larger doses to experience the same results one initially experienced before Tolerance set in. In this regard the two phenomenon’s are not only bound to one another, but predictable hallmarks of addictive pathology, and emerge in virtually every scenario where prolonged abuse exists.
It should be pointed out that the term Tolerance is frequently employed improperly and thus generates as much confusion as it does clarity. A common example of the term Tolerance being misapplied would be to refer to a person’s ability to consume large amounts of a drug and while maintaining an appearance of normality or a semblance of functionality. It is ironic that with regards to this example, it is in some respects not entirely incorrect, but these definitions lack the clinical context that make the term significant with regards to habituated abuse. Tolerance, it should be noted, cuts across drug types without regard for what substance is being abused; e.g., Tolerance can develop from abusing opiates as well as stimulants like Methamphetamine.
Wide Range of Origin
Significantly, one of the most striking features of Tolerance is its consistent presence in all cycle three variations of Abuse. For reasons of treatment protocol it is worth noting that Tolerance also develops regardless whether or not the drug was obtained legally (through a doctor) or purchased illegally (on the street). In other words, the body does not distinguish between opiates legally prescribed to manage post-surgical pain, any more than it distinguishes the effects of ingesting street narcotics such as heroin.
Further Overview of Condition
Before going any further it is necessary to enlarge upon the term and define precisely what Tolerance means. For clarity’s sake, what we mean when we refer to Tolerance is a physical and psychological appetite that develops and eventually emerges as its own distinct illness, complete with predicable symptomology and a fairly common set of stages through which the addict passes. Following prolonged use of certain medications, Tolerance occurs along the entire spectrum of abuse, because it occurs in the wake of prolonged consumption of some medication, be it sedative, Stimulant, and painkiller.
Multiple Routes of Development
As stated previously, Tolerance can manifest via several routes; which means it can develop regardless of whether the person is injecting, snorting, or smoking their drugs. Complicating matters is the fact that physiological Tolerance, which invariably develops in tandem with psychological dependence, frequently manifests as secondary mental health disorders such as Depression, Anxiety, or some form of Mood Disorder (a complete list of co-occurring disorders is outside of the scope of the particular article. Suffice to say where addiction occurs it is not uncommon to find the presence of other mental health conditions. When a person has been diagnosed with one or more co-occurring illnesses they are said to be dual diagnosed – more below). By the time Tolerance has developed, the addict has likely experienced the symptoms of other disorders; which essentially means that the person’s psychology is now compromised by competing disorders. This is clinically significant because it will shape the nature of the treatment administered.
Symptoms of Drug Tolerance
Some of the more common features of Tolerance include:
- Irreversibility, meaning that once this psychic damage has developed, there is no known remedy that will enable the addict to revert back to a time before Tolerance was established.
- Establishment of priorities in which drug-seeking or drug consumption takes precedence over other obligations.
- The frequency of dosing increases, in addition to the quantities consumed, and the addict find themselves in a situation where the amount consumed on Monday no longer works by Friday.
- Physiological tolerance also occurs when an organism builds up a resistance to the effects of a substance after repeated exposure. Ironically this can occur with environmental substances, such as salt or pesticides.
Drug Specific Causes
Complicating matters more deeply still is the fact that Tolerance does not emerge in a standardized way; meaning that the process is as much dependent on the individual as it is the drugs the individual is taking. For example, a person who needs to take morphine to control post-surgical pain will likely develop Tolerance (and Dependence) fairly quickly, without any regard for the intentions of the person taking the drug. The same person, if placed in a situation in which they were required to ingest sedatives such as Benzodiazepines, would develop tolerance as well, but guide the nuances of how the drug affects the body.
Classification of Tolerance Building Substances
It should be noted that all prescription medications are carefully regulated by the Federal Government with regards to prescribing protocols, which must be adhered to. This is especially true when dealing with major painkillers such as Oxycontin or Demerol. The government instituted what is referred to as a Scheduling System, which essentially rates a drug for its abuse potential. Schedule IV medications, which include substances such as blood pressure medication or insulin have virtually no abuse potential. There exist four different stages of scheduling, with I being considered the most addictive. Drugs that are considered to be Schedule I medications are so abusable they are deemed valueless and without medical efficacy. Heroin, Crack and Methamphetamine fall into this category. It should be noted again that drugs designed to treat chronic pain are highly addictive, and that there is a very real ratio between the painkiller’s effectiveness controlling pain and the intensity of the euphoria that is generated. Any analgesic or sedative will be proportionately as addictive as it is effective.
Rapid Tolerance Building Drugs
Opiates, which are the most commonly prescribed drugs to treat pain, generate effects similar to those of opium or morphine and are highly addictive. These drugs include:
- Hydrocodone (brand name Vicodin).
- Codeine, which comes in varying strengths from I to IV.
- Morphine (brand name MS Contin)
- Oxycodone (brand name OxyContin)
- Meperidine (brand name Demerol)
High Risk Populations
A fair question is who is at risk to develop Tolerance. Most individuals who take pain medications in the manner consistent with what the physician orders do not become addicted to drugs nor do they exhibit tolerance (it does, however, happen from time to time). This scenario changes when dealing with someone for whom addiction is part of their history. In cases where a narcotic addict must take a painkiller for some procedure or condition are in for a very difficult time. People who have been addicted to some medication in the past, or those with a family history of addiction to drugs or alcohol may be at increased risk of becoming addicted to narcotics.
- The key to avoiding addiction is to take your medicine exactly as your doctor prescribes; not a moment too soon, and not doubling up on a dose if you missed one at dinner.
- Share with your doctor any personal and/or family history of substance abuse or addiction. Your doctor needs this information to prescribe the medicines that will work best for you. Fears about addiction should not prevent you from using narcotics to effectively relieve your pain.
- Remember, it is common for people to develop a Tolerance to their pain medication and to need higher doses to achieve the same level of pain relief. Such a situation is normal and is not a sign of addiction. However, you should talk to your doctor if this effect becomes troubling.
Drug Tolerance refers to the body’s ability governed by genetic factors and adaptive changes by the body. Adaptive changes occur in response to the repeated exposure to a particular drug. The result is usually a loss of sensitivity to the drug. This decreased response is called Tolerance
Tolerance may be defined as a state of progressively decreased responsiveness to a drug as a result of which a larger dose of the drug is needed to achieve the effect originally obtained by a smaller dose.
There are two types of drug dependence.
Physical dependence is a condition in which the body has adjusted to the presence of a drug, resulting in clear symptoms of withdrawal when its use stops. In extreme cases, the effect of rapid withdrawal can be life threatening because the body has become so dependent on the drug as to interfere with normal body processes.
An individual physically dependent on a drug requires that drug in order to function normally. Physical dependence is associated with Tolerance in most cases. The state of physical dependence is revealed by withdrawing the drug and noting the occurrence of withdrawal symptoms sometime after the drug is withheld. The symptoms of withdrawal can be terminated by re-administration of the drug.
Symptoms of drug withdrawal tend to be the opposite of the effects of the drug. If the effect of the drug is sedation, the withdrawal effect will likely be hyper-excitability. If the effect was stimulation the withdrawal effect will likely be emotional depression.
Longer acting drugs tend to produce less intense withdrawal symptoms because the body has more time to adapt to the decreasing presence of the drug.
This kind of dependence is characterized by emotional and mental preoccupation with the drug’s effects and by a persistent craving for it. The symptoms displayed are not physical symptoms. Craving seems to be the most common withdrawal symptom.
Psychological dependence is usually manifested by compulsive drug-taking, but the frequency and pattern of use can differ considerably from one individual to another.
This is the ability of one drug to suppress the manifestations of physical dependence produced by another and to maintain the physically dependent state. Cross dependence may be partial or complete. One amphetamine will show cross dependence with other amphetamines. Most sedatives show cross dependence with each other and with alcohol. Cross dependence usually occurs among compounds of a given family of drugs but may also occur among drugs of different families that have similar pharmacological effects.
General Information about Addiction
Addiction is a difficult word to define since it can be used in various ways. The World Health Organization (WHO) has provided the following definition: “A behavioral pattern of drug use, characterized by overwhelming involvement with the use of a drug (compulsive use), the securing of the supply, and a high tendency to relapse after withdrawal. Addiction is viewed as an extreme on a continuum of drug use patterns. It refers, in a quantitative rather an a qualitative sense, to the degree to which drug use pervades the total life activity of the user, and to the range of circumstances in which drug use controls his/her behavior.”
Addiction refers to dependent patterns of drug self-administration without making a distinction between physical or psychological dependence. Moral weakness is often implied by the term addiction.
The WHO has suggested that the term “addiction” be replaced with the term “drug dependence.” It is not possible to identify with precision the point where compulsive use should be considered addiction.
The term addiction cannot be used interchangeably with physical dependence since one can be physically dependent on drugs without being addicted and – as stated elsewhere – in some cases, addicted without being physically dependent.
Self-administration of drugs:
- The properties of the drug itself.
- The route of administration.
- The size of the individual dose.
- The amount of work required to obtain a dose.
- The presence of other drugs.
- Previous experience with other drugs.
Scientific studies have shown that pre-existing mental and behavioral disorders are not a prerequisite for drug use and that drugs themselves are powerful reinforces, even in the absence of physical dependence. This discovery radically alters how we treat addiction and many of the assumptions we make with regards to the expression of its pathology.
Call to Learn More about the Authentic Recovery Center
If you are interested in learning more about the Authentic Recovery Center call 1 877 415 4673 now. We offer multiple types of treatment for co-occurring disorders and addiction, including inpatient and outpatient rehab options. With a program focus on the underlying issues that contribute to scenarios from which drug tolerance develops, we provide a platform for sustainable recovery and change. Remember, “The only failure in life is the failure to act.”