We review the difference between dependence, withdrawal, tolerance, rebound symptoms and addiction. Often these terms are used interchangeably, but there are differences. These are important to terms to know if you are feeling "stuck" on your medication!
Dependence = Your body is physically adapted to having the drug. If you don't take your medication, you cannot function 'normally' and may experience withdrawal symptoms. Being dependent on a medicine does not mean you are addicted to it.
Withdrawal = Reducing the dose or abruptly stopping a medication can cause negative symptoms. Each person can experience this differently. The severity depends on: the type of drug, how long you have used it, your age, your physical and mental state, and how you reduce or stop it.
An example of this is with sleeping pills. Perhaps you come up against a difficult life circumstance contributing to insomnia, which leads you to start taking a sleeping pill. After steadily taking it more regularly, to the point of using it nightly, your body ends up adapting to having it, creating a dependence. If you don't use the sleeping pill for a night, not only can you have trouble sleeping but also may experience experience other symptoms like anxiety, irritability, sweating, and confusion. These would be considered withdrawal symptoms.
Tolerance = For certain medication, your body can become "used to" the drug. Over time, it will stop having as much of an effect, even at the same dose. You will start needing a higher dose to get the same effects as before.
A common example of this is with benzodiazepines, like lorazepam (Ativan) or alprazolam (Xanax), which can be used for insomnia, anxiety, panic attacks, or seizures. Tolerance can develop in 4 weeks of regular use, needing a higher dose. Tolerance also develops in commonly used substances like cannabis, alcohol, and opioids (whether used by prescription for pain or recreationally).
Rebound Symptoms = If you reduce the dose or stop a medication and get a re-emergence of symptoms, it may be a rebound. This is not because the underlying issue is still there, but because your body got "used to" having the drug around. Your symptoms can even be worse that before you started it!
A common (but little known!) example is with proton-pump inhibitors (PPIs) which are used for stomach ulcers and heartburn. They essentially turn down the acid-making pumps in your stomach, helping with those pesky heartburn symptoms. When used daily, your body gets used to having less acid. If you stop using the drug, your symptoms can come back and often come back much worse! (I wrote a whole blog on this - check it out here).
Addiction = Occurs if you use a medication or substance, despite negative consequences. Addiction typically comes with compulsive behaviours and drug abuse, even if you are experiencing harm from it.
You can develop dependence or tolerance to a medication (...and many do!), but that doesn’t mean you are addicted to it.
Even if you are dependent on medication, it doesn't mean you are stuck on it forever.
You CAN come off the medication safely and effectively, avoiding any nasty withdrawal or rebound symptoms.
At Your Simple Health, we help people do just that through a careful, medically-guided process called Deprescribing.
If you are feeling "stuck" on your medications, or experiencing ANY of these, feel comfort in knowing you have a way out. Book in for a free discovery call to learn more about how we may be able to help.
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