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Physical vs. Psychological Addiction

by Noble Wellness Group on

An interesting phenomenon that we often do not think about when it comes to addiction is the differences between psychological and physical addiction.  Granted both are treated in the addiction world and both are frequently talked about almost interchangeably and in some certain situations they can be.  That being said when it comes to treatment it is very important to understand how they are different and how each of the most common addictive drugs can relate to this concept.

Physical addiction: In its most simplest terms is the body’s need to have a drug in its system to function “normally.”  This is most readily identified by withdrawal symptoms when the drug is not present.  Alcohol and Benzos, such as Xanax or Ativan, will produce tremors, shakes, flue like symptoms, and possibly even seizures that potentially could be fatal.  Heroin and other opiates will produce similar flu like symptoms along with severe (or perceived severe) body aches, low energy, loose bowels, and other digestive issues.  Stimulants such as cocaine will produce increased tiredness or lethargy.  All of thee will also be accompanied by a general sense of dread or depression.  

Psychological Addiction: This is the measure to which the brain is convinced that the drug in question is need to “survive.”  Psychological addiction is marked by a proclivity to use the drug in most if not all stimulus type situations.  In other words the person my say things such as “I can’t even start my day without a drink first,” or “How am I expected to do my job without something in my system.”  Regardless of the stimulus or situation at hand the midbrain informs the frontal lobe that it must involve the drug of choice.  This is most frequently accompanied by a ritual of use plus an increase in dopamine and serotonin in the brain.  

Physical addiction is actually quite easy to treat at least in terms of the process.  Most often it involves medicine to stave off the withdrawal symptoms (Suboxone for Opiates, Librium for Alcohol and Benzos, etc.) and if necessary a short stay in a detox ward.  In most cases the drugs leave the system in a matter of days with alcohol being the shortest and marijuana taking the longest.  This is largely dictated by what dissolves the drug itself fat or water.  That being said, once the drug is completely out of the system the person is said to be “detoxed.” This means no traces of the drug remain and the argument can be made that the physical addiction has been addressed at least in the immediate.  


Psychological addiction is the part that is difficult to treat.  This is due to two things: 1. in the Mid-brain (a second of the brain responsible for survival and the production of dopamine) often times the addiction has resulted in that drug being the number one thing the mid-brain believes it needs to survive and 2. Due to reduced blood flow to the frontal lobe the brain at this point has difficulty learning new ways of thinking.  This is where the real work of drug rehabilitation comes in (ie therapy, group support, shifting in values, etc.).  No one can do this alone it simply does not happen.  The person attempting to get sober is not just changing one thing they are changing the way they see the world, their habits, behaviors, and most importantly the way they see themselves.  

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