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occurs
when tissue dependence has developed after chronic use and the body tries to
return to normal too quickly, objective physical signs that are a direct result
of the tissue dependence and are directly observable upon cessation of drug use
by an addict. These include seizures, goose bumps, vomiting, diarrhea, and
tremors.
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Results either from addict manipulation (hence
purposive, or “with purpose”) or from a psychic conversion reaction from the
expectation of the withdrawal process. Psychic conversion is an emotional
expectation of physical effects that have no biological explanation.
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(environmental triggers and cues) A major danger to
maintaining recovery and preventing a drug overdose during relapse. This is a
flashback or recurrence of the addiction withdrawal symptoms; triggers heavy
craving, and often causes recovering addicts to slip
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The persistence of subtle yet significant emotional
and physical problems that can last for thee to six months into recovery. i.e.
unclear thinking and cognitive impairment, memory problems, emotional
overreaction, sleep disturbances, motor coordination/dizziness problems, and
difficulty managing stress; also drug cravings
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The metabolic transformation of drugs that enter the bloodstream to
metabolites
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Drugs are metabolized principally by the liver and eliminated through
the kidneys, sweat glands, and lungs. No matter how a drug enters the
circulatory system, it is eventually distributed by the bloodstream to the rest
of the body. The actual amount of drug that reaches the brain depends, among other
things, on the bioavailablility of the drug, which is defined as the degree to
which a drug becomes available to the target tissue after administration. After
the drug has had its effect, it is eliminated form the body through metabolism
or excretion. Metabolism is the body’s mechanism for processing, using, and
inactivating a foreign substance that has been taken into the body. Excretion
is the process of eliminating those foreign substances and their metabolites
from the body
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Any substance that directly alters the normal functioning of the central
nervous system when it is injected, ingested, smoked, snorted, or absorbed into
the blood. Drugs can activate a genetic/environmental susceptibility to drug
abuse and addiction. They cause alterations in brain chemistry, structure, and
function, which can intensify drug-using behavior
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Any substance that directly alters the normal functioning of the central
nervous system when it is injected, ingested, smoked, snorted, or absorbed into
the blood. Drugs can activate a genetic/environmental susceptibility to drug
abuse and addiction. They cause alterations in brain chemistry, structure, and
function, which can intensify drug-using behavior
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Nerve cells become less sensitive to the effects of
the drug and even produce an antidote or antagonist to it. With opioids the
brain will generate more opioid receptor sites, down-regulate them, and produce
its own antagonist, cholecystokinin.
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The brain learns to compensate for the effects of
the drug by using parts of the brain not affected. A drunken person can make
himself appear sober when confronted by police but might be staggering again a
few minutes later
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Initially, one becomes less sensitive to the drug
(regular tolerance); but as it destroys certain tissues and/or as one grows
older, the trend is reversed and the user becomes more sensitive and therefore
less able to handle even moderate amounts. This is particularly true in
alcholics when, as the liver is destroyed, it loses the ability to metabolize
the drug. An alcoholic with cirrhosis of the liver can stay drunk all day long
on a pint of wine because the raw alcohol passes through the body repeatedly,
unchanged.
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In these cases the brain and the body begin to adapt
almost instantly to the toxic effects of the drug. With tobacco, for example,
tolerance and adaptation begin with the first puff. Somone who tries suicide
with barbiturates can develop an acute tolerance and survive the attempt, with
twice the lethal dose in their system, even if they’ve never taken barbiturates
before.
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The body develops tolerance to mental and physical
effects at different rates. With opiates and depressants, the does needed to
achieve an emotional high comes closer to the lethal physical dose of that
drug. For example, a barbiturate induces sleep and causes slight euphoria on
the first day it is taken. Within a few months, it still induces sleep but no
longer causes euphoria, so the user needs five pills to feel good. The user has
not developed tolerance to the respiratory depression effects, however, so that
effect is more severe and can be potentially lethal.
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Also kindling; the person becomes more sensitive to
the effects of the drug as the brain chemistry changes. Initially, a marijuana
or cocaine user after months of getting a minimal effect from the drug will
suddenly get an intense reaction. A cocaine or meth addict becomes more
sensitive to the toxic effects after continued use, thus developing a greater
risk of heart attack or stroke.
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-Tolerance
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As a person develops tolerance to one drug, he
develops tolerance to other drugs as well. A heroin addict will also be
tolerant to doses of morphine, codeine, or methadone even if he has never taken
other opioids, because the same biologic mechanisms that establish tolerance to
one opioid will be in place to proved tolerance to others as well. Someone
tolerant to the effects of alprazolam (Xanax) will also have a tolerance to the
effects of other benzodiazepine sedatives and even alcohol.
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