This draft guidance reinforces these principles by recommending, for example, that terminology used in the Drug Abuse and Dependence section such as abuse, misuse, addiction, physical dependence
and tolerance be defined in labeling to ensure common understanding.
is demonstrated by the appearance of abstinence syndrome when opioid therapy is abruptly stopped.
Antagonizing effect of aspartic acid on the development of physical dependence
on and tolerance to morphine in the rat.
Biochemically, drugs have been found to alter the structure of the brain in order to create physical dependence
. The result is not just an abstract desire for drugs, but also a physical need for the substance which manifests in severe withdrawal symptoms if the drugs are avoided.
(30) We compared dual users of e-cigarettes and cigarettes to smokers of cigarettes only in terms of demographic characteristics, nicotine physical dependence
, and smoking cessation beliefs, and explored dual smokers' reasons for using both types of cigarettes.
(71) This rescheduling was based on the recommendation of the Department of Health and Human Services that buprenorphine has a lower potential for abuse than Schedule 1 and Schedule II drugs; it has a currently accepted medical use in treatment in the United States, and buprenorphine may lead to "moderate or low physical dependence
or high psychological dependence." (72)
CIIs are those substances that are accepted for medical use in the United States, but are within this class because of their abuse potential and the likelihood of severe psychic or physical dependence
. Examples of CIIs are oxycodone and morphine.
To be eligible for enrollment, patients had to have a DSM-IV diagnosis of opioid dependence, not just physical dependence
Abuse of tramadol may lead to limited physical dependence
or psychological dependence relative to the drugs or other substances in schedule III.
A prodrug of amphetamine, lisdexamfetamine is a Schedule-II controlled substance, with a high potential for abuse and the risk of severe psychological or physical dependence
Many also report they believe that adverse events such as tolerance and physical dependence
occur "often," even when the medications are used as directed.
The American College of Emergency Physicians, the American Pain Society, the Emergency Nurses Association, and the American Society for Pain Management Nursing (ASPMN) have come together to provide clear, working definitions for drug-abuse related terms including tolerance, physical dependence
, and addiction (ASPMN, 2010).