In describing disorders involving alcohol , heroin and a variety of other substancesDSM111 distinguishes between wo levels of substances misuse ; abuse and dependence . Abuse , the milder level , involves some maladaptive use pattern – remaining intoxicated through out the day , for example –and some impairement in social or job functioning . Dependence a state of physical addiction , which involves tolerance – increasing amount of the substance are needed to achieve the desired effect and withdrawal symptoms – when the substance use is stopped or reduced unpleasant physical need has developed and that there are actual alterations in the body’s physiology , in some cases , brain impairement occurs . Addicts who are withdrawn symptoms may include tremor – the shakes , delirium , convulsions , these symptoms are collectively called delirium tremens . note however that a number of the drug or substance habits that people form do not involve any real physical dependence , in these cases – for example , marijuana and lsd habits – what develops is a strong physiological need for the substance – it helps the person relieve tension or feel better in some other way – this physiological need can produce a craving that , for some people , is as strong as physical dependence
ORIGINS OF HERION AND ALCOHOLDEPENDANCE
Even for substances like heroin and alcohol , psychological factors play a major role . the dreamy euphoric state produced by heroin is used by many people as a way to reduce their anxiety and tension . for instance , when supplies of heroin were readily available to soldiers in the Vietnam war , men who would not other wise have used it were drawn to it , both because .their cultural norms also play a large role in heroin addiction ; heroin used may be accepted , and even accepted , in certain sub cultures and kick the habit are very likely to start using heroin again if they return to their cultural groups , in the case of alcoholism , a number of explanations have been proposed for the physiological craving that develops . our possibility is that alcohol , like heroin claims anxiety and helps people relax . of course most people who use alcohol to relax do not become alcoholics . perhaps as some research indicates , people’s inborn response differ , which some people inheriting a capacity to drink more before vomiting or passing out of a tendency to experience higher levels of euphoria from alcohol , such people would be especially susceptible to alcohol dependence . Another idea is that since it reduces social inhibitions , alcohol permits people to act out their hostilities and sexual wishes . still another idea is that some people makes them feel powerful .
Dr B S Suvarna, B.A, D.I.Hom [Lond.], M.I.H, PhD, PGDPC(Psychotherapy & Counselling, USA)
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