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What Psychological Dependence Is for Drugs and Alcohol

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There’s a big difference between psychological dependence and physical dependence when it comes to drugs and alcohol.

Psychological dependence is when you can’t stop thinking about whatever drug you’re doing. You’re obsessed with it. Obsession means a thought that you can’t get out of your head, no matter what you do.

Many people think that there’s no such thing as psychological dependence, that all drugs (including alcohol) make you physically dependent.

That’s bullshit.

There are for sure drugs out there that don’t make you physically dependent — cocaine is a perfect example of this.

With cocaine, you can’t get physically addicted. You can put it in your body as much as you want, but when you stop, you’re not going to go through withdrawal — you’re just going to sleep a lot if you’ve been up for a long time.

Sure, you’re going to have a comedown from the high, just like with any drug, but you’re not going to feel the physical symptoms of withdrawal like you would with opioids (nausea, sweats, insomnia, etc.).

How Psychological Dependence Works

Here’s the difference between psychological dependence and physical dependence.

With physical dependence, you go through withdrawal when you stop putting the substance in your body. Depending on the drug, that can look very different.

For example, if you’re physically addicted to alcohol, you get something called the DTs, which is usually characterized by shaking, confusion, and hallucinations, among other really shitty symptoms.

Your body has become dependent on the drug. Your brain can’t function properly without it. Your body becomes sick without the drug, forcing you to take more — that’s physical dependence.

Psychological dependence is only in your head. When you stop taking the drug, nothing happens to your body.

This can happen with any drug, and contrary to popular belief, you can be only psychologically dependent on a drug that often causes physical dependence.

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You Can Be Psychologically Dependent Without Being Physically Dependent (and Vice Versa)

The first three weeks that I abused OxyContin, I was not physically dependent. I wasn’t using it every day (only on weekends), and when I stopped, I didn’t get dopesick.

But whenever we ran out of OxyContin, I started to obsess over it. I got intense cravings. It was all I could think about. I couldn’t wait to get more oxy.

So in this case, I wasn’t physically dependent, but I was definitely psychologically dependent.

The same thing happened to me with alcohol. I never once became physically dependent on alcohol. I drank a lot. I blacked out all the time. I drank huge amounts of alcohol (think 15+ beers or 10+ shots) regularly.

I thought about drinking all the time though. I had psychological dependence. I would fantasize about going to the bar and how this time I could control it, this time it would be different.

I was psychologically dependent on the stuff. When I ran out, I would start to feel totally crazy, like nothing would be okay until I got alcohol into my body.

The opposite is possible too, and I’ve seen it many times — people who are physically dependent but who are not psychologically dependent.

This basically means they don’t think about the drug or obsess about it all the time, but if they stop taking the drug, they will absolutely go through withdrawal.

A perfect example of this is my ex-girlfriend. When I first met her, I was dealing OxyContin, and she was an addict. But something strange struck me about her right away.

She only did a very small amount of OxyContin at a time despite the fact that she’d been using for years — I’m talking about 5mg at a time.

It wasn’t even enough for her to get high — she told me she wasn’t getting high at all.

Yet she didn’t think about it all the time. Basically what had happened was that her boyfriend was an oxy addict and had spiked her drinks with oxy over a period of months until she got physically addicted so that she would be an addict like him.

I know — fucked up, right?

But she didn’t enjoy the feeling of getting high. She didn’t like how oxy made her feel. But after using it for those months, she became terrified that she would run out and become dopesick.

So she kept taking it.

She took those little doses like you might take medicine. To her, it was medicine.

So she was physically addicted, but she didn’t display psychological dependence.

Psychological Dependence and Physical Dependence Often Overlap

Now just because you can have one or the other doesn’t mean you can’t have both at the same time — and frankly, this is usually the case. 

In my experience, I often started with psychological dependence. I wanted to do the drug to excess, whatever it happened to be, because I was chasing the high.

But, after I kept using for days and weeks and months on end, I often became physically addicted. This, of course, would depend on the drug.

In fact, I can safely say that I’ve experienced psychological dependence on just about every drug I’ve ever done without getting physically dependent on the majority of them.

The only ones I can say for sure that I’ve had overlap on are weed and opioids.

For weed, when I would come off of it, I would experience all the symptoms of marijuana withdrawal. When I was off it, I would obsess and obsess about it. I also obsessed about it even when I was smoking all the time. Basically, every 30 minutes or so, I wanted to smoke again — from morning to night.

For opioids, I became profoundly physically addicted. I had to put them in my body or go through significant physical withdrawals — think the worst flu you’ve ever had.

But I was also experiencing psychological dependence. Just like with weed, I would think about opiates all the time, even though I was already putting them in my body.

Basically, even though the high could last for 8 hours or more, I wanted to get high every 20 minutes. That’s some pretty severe psychological dependence.

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What Is Your Experience?

Have you experienced psychological dependence? I want to hear your story. Leave a comment.

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Adam Fout

I'm an addiction / recovery / mental health blogger and a speculative fiction / nonfiction writer. I have a B.A. in English and an M.A. in Professional and Technical Communication. I'm a graduate of the 2020 Odyssey Writing Workshop. I'm a regular contributor to Recovery Today Magazine, and I've been featured on numerous recovery podcasts. I have personal experience with addiction and mental health. I have Substance Use Disorder (SUB), Obsessive-Compulsive Disorder (OCD), Major Depressive Disorder, Generalized Anxiety Disorder (GAD), Intermittent Explosive Disorder (IED), and Binge Eating Disorder (BED), among others. I have been in numerous drug rehabs, detoxes, and mental institutions, so I understand from personal experience how the mental health system works. I have been published in numerous literary magazines, including December, J Journal, and Flash Fiction Online, among others. I LOVE when readers reach out to me! Always feel free to send me an email at awfout at gmail dot com. I can't wait to hear from you!