Many factors contribute to the development of substance use dependency. One of those factors is a physiological process that happens over time with continued substance use and may not be noticed by the user because it happens so incrementally. Awareness of a problem only arises when the person experiences an inability to stop using. Therefore, understanding how the physiological development of dependency occurs is important.

We are all born with an internal regulating system that maintains stability in body temperature, blood pH, and glucose levels, among many other things. The body strives to maintain its systems of functioning within a normal range. This process is the phenomenon of homeostasis and is essential to our survival.

Homeostasis is the physiological process that maintains equilibrium in our bodies and allows us to function normally. Our bodies strive to maintain homeostasis when systems fluctuate. The body accomplishes this through “complaining.” For example, one way our bodies complain is to shiver when itʼs cold. Shivering produces heat and is our bodyʼs attempt to increase temperature. Likewise, when the body overheats, it complains by sweating to decrease temperature.

When alcohol and/or drugs are ingested, the body tries to return to itʼs normal homeostasis by processing them through the liver, kidneys, and lungs. If substances are consumed to a point of intoxication, the body reacts with an upset stomach or possibly vomiting in order to stop the person from consuming more. This is the bodyʼs effort to buy time in order to process and/or purge what it perceives to be poison in itʼs attempt to return to homeostasis.

The problem occurs when a person continues to use despite the bodyʼs complaints. Through continued use, a personʼs homeostasis can become “reset.” The same process still happens, but with a new homeostasis set to the substance levels, the body has become accustomed to it. Now, when the new, reset homeostasis fluctuates, the body again complains. Only instead of complaining when the level of the substance is increased, the body complains when the substance level decreases. These complaints are known as withdrawal symptoms. Common withdrawals from alcohol can be irritability, tremors, clamminess, headache, and nausea. These symptoms are the bodyʼs attempt to return to the new homeostasis. One way to reduce withdrawal symptoms is to re-use the substance, like having a mimosa during Sunday brunch after a Saturday night of drinking in order to alleviate hangover symptoms. The substance has now become the medicine for the symptoms it actually created.

A particularly dangerous withdrawal symptom from alcohol abuse is the possibility of a seizure. Anyone experiencing high levels of continued alcohol consumption should consult a professional for a safe, medically monitored detoxification process.

Nicotine withdrawal symptoms can typically be headache, nausea, anxiety, insomnia, and fatigue. Withdrawal symptoms from marijuana can be headache, nausea, anxiety, insomnia, disturbance of appetite, paranoia, and irritability. Cocaine withdrawal is experienced by tiredness, depression, anxiety, and moodiness. Opiate withdrawal can be all the above, but also include muscle aches, high blood pressure, increased heart rate, and intense craving. Sometimes withdrawal symptoms are confused with chronic pain. This list is not exhaustive or definitive.

Understanding how the process of substance dependence develops is important, but itʼs also crucial to listen to our bodies. Our bodies constantly send us information on what is working and what isnʼt working for us. Itʼs an individual experience. We need to ask ourselves if the substances we are using have become the medicine for symptoms they have caused.

Submitted by Marty J. Rein, Ph.D., LPC, CAC III