Addiction and Dependence

The core idea here is that drugs and alcohol are not just harmful in the moment — they trap the user through two distinct but linked mechanisms: addiction and dependence. The textbook treats these as separate but sequential stages of a downward spiral.

Addiction is first and foremost a psychological attachment. A person does not simply enjoy a drug; they become mentally hooked on the specific effects it produces — the euphoria, the temporary feeling of well-being. This attachment is so strong that it overrides rational thought. The user continues taking the substance even when it is no longer needed, and even when the behaviour becomes self-destructive. The textbook is very clear on one point: the addictive potential is so high that even a single use can be the starting point of addiction.

The mechanism behind addiction is a change in the body's biology. With repeated use, the tolerance level of the receptors in the body increases. This means the original dose no longer produces the desired effect. The receptors now demand a higher dose to respond. This creates a vicious circle: the user takes more to get the same feeling, which further raises the tolerance, which demands even more. This cycle pulls the user into regular abuse from which escape becomes extremely difficult without guidance or counselling.

Dependence is the next stage, and it is a physical phenomenon. It is defined as the tendency of the body to manifest a characteristic and unpleasant withdrawal syndrome if the regular dose of the drug or alcohol is abruptly discontinued. This is not a matter of willpower; it is a physiological reaction.

The withdrawal syndrome is characterised by a specific set of symptoms:

• Anxiety
• Shakiness
• Nausea
• Sweating

These symptoms are temporarily relieved when the person resumes using the substance. This creates a powerful physical compulsion to keep using, simply to avoid feeling sick. The textbook warns that in some cases, withdrawal symptoms can be severe and even life-threatening, requiring medical supervision.