Drugs of dependence

Dependence on a drug means that your body has become so used to having that drug regularly that you need that particular drug to function normally, and if it were stopped you would feel unwell. People who have drug dependence may have psychological dependence and/or physical dependence and/or tolerance to a particular drug.

Psychological dependence

Psychological dependence means that you have a craving or are compelled to use a particular drug to give you pleasure or to stop you from feeling bad – even though it may be dangerous to take the drug.

Physical dependence

Physical dependence means that if the drug is stopped suddenly you get withdrawal symptoms.

Tolerance

Tolerance is usually a part of dependence. It means that you need more and more of the same drug to give you the same feeling as the smaller amount you used when you first started taking that drug.

Examples of some drugs that cause dependence include nicotine, morphine, heroin (also known as diamorphine), cocaine, amfetamine and alcohol. Some people can also become dependent on medicines that are on prescription. Examples are:

• Z drugs (called this because they begin with the letter Z: zopiclone, zolpidem and zaleplon).
• Benzodiazepines (for example, lorazepam, lormetazepam, diazepam)
• Codeine
• Opioids (such as morphine)
• Other medicines that can be bought from pharmacies – for example, over-the-counter painkillers

Addiction

Addiction is slightly different to dependence although the words are sometimes used interchangeably. If you are addicted to a drug, there is an excessive craving, and uncontrollable and compulsive use of that drug. People who are addicted still get cravings for drugs such as opioids even after they have reduced them slowly so that they are no longer dependent. Some people are more likely to develop addiction than others and seem to be particularly sensitive to the cravings. People can develop dependence on a drug but not be addicted.

The Mid and South Essex Pharmacy and Medicines Optimisation Team develop resources to help clinicians (doctors, nurses, pharmacists, etc.) to support people prescribed drugs of dependence. If you would like more information on the resources that the Pharmacy and Medicines Optimisation Team produce, please contact mseicb.enquiries@nhs.net

If you think you are dependent on or addicted to a medicine, please speak to your GP practice.