Addiction, Dependence, and

Tolerance
Theoretical Constructs
 Addiction - Definition
Repetitive, compulsive, deleterious drug
self-administration for non-medical
purposes
Obsession and preoccupation with drug use
 Addiction is not dependence
Dependence: A state (physical or
psychological) produced by drug exposure
that is revealed by physical or psychological
abnormalities upon abstinence
Addiction can occur in the absence of
dependence and vise versa
 Addiction is not tolerance
Tolerance: Reduction of potency, efficacy,
or duration of a drug effect due to prior
exposure
Tolerance to different effects of a
drug may vary
 Related Concepts
Acute tolerance (tachyphylaxis)
Cross tolerance
Reverse tolerance (sensitization)
Homeostasis
Opponent processes
Homeostatic (opponent process)
model of dependence & tolerance
Drug effect only
Non tolerant/non dependent individual
Drug effect
Low Normal High
Body Temperature

Drug effect plus opponent process

Tolerant individual
Drug effect

Opponent process

Opponent process only

Dependent individual

Opponent process
 Relation between tolerance and
dependence
A dependent person is tolerant
A tolerant person is not necessarily
dependent
There are mechanisms that produce
tolerance without initiating opponent
processes
 Types of tolerance

Pharmacodynamic, ex. - receptor down-

regulation
Metabolic (pharmacokinetic), ex. enzyme
induction
Behavioral (context specific)
Habituation
Operant conditioning
Classical conditioning
Classical Conditioning
Demonstration of Behavioral
Tolerance
 Classical Conditioning
Explanation of Behavioral
Tolerance
One explanation
Drug (UCS)
Drug effect (UCR)
Opponent process (CR)
Environmental cues (CS)
Another explanation
Drug effect (UCS)
Opponent process (UCR)
Opponent process (CR)
Environmental cues (CS)
Conditioned Withdrawal
 Models of addiction
Moral
Social
Psychological
Pharmacologic/medical
 Old Medical Model
Drugs are self administered to avoid
withdrawal
Simple dependence model
Dependence (Negative Reinforcement)
Model of Addiction
Negative reinforcement response that
terminates an aversive stimulus or state is
strengthened

Aversive State Response Consequence

Termination
Withdrawal Drug self-administration
of withdrawal

reinforcement
Problems With Dependence Model of
Addiction
There are addictive drugs that produce little
apparent physical dependence
Does not account for initiation of drug use
Addiction persists long after detoxification
 Positive Reinforcement Model

http://wings.buffalo.edu/aru/IVSAfacilities.htm
Neural Substrate of Reward
 Problems With the Positive
Reinforcement Model
Operant responding for drugs could be
motivated by withdrawal avoidance
Conditioned place preference

Drug addiction has serious aversive

consequences
 Another Problem
As addiction progress addicts like the drug
less and less, but want the drug more and
more,
Incentive/motivation sensitization models