The Etiology of Opioid Dependence

  • Abraham Wikler


The World Health Organization Expert Committee on Addiction-Producing Drugs (1964) defined drug dependence as

... a state of psychic or physical dependence, or both, on a drug, arising in a person following administration of that drug on a periodic or continuous basis. The characteristics of such a state will vary with the agent involved, and these characteristics must always be made clear by designating the particular type of drug dependence in each specific case; for example, drug dependence of the morphine type, of cocaine type, of cannabis type, of barbiturate type, of amphetamine type, etc.

Common to all of these types of drug dependence is the concept of “psychic” or “psychological” dependence, which is defined as a drive that requires administration of the drug to produce pleasure or to avoid discomfort (Eddy et al., 1970). Psychic dependence is usually distinguished from “physical” dependence, which is inferred from the appearance of drug-specific, transient abstinence phenomena (autonomic and behavioral) when the drug is withdrawn abruptly. However, as Eddy et al. (1970) pointed out, physical dependence is a powerful factor in reinforcing the influence of psychic dependence. It would seem that the main distinction between psychic and physical dependence is that the former is a vaguely defined cluster of inferences derived from subjective reports of the subject, while the latter is inferred from objective changes in his autonomic nervous system and his behavior.


Drug Dependence Physical Dependence Opioid Dependence Minnesota Multiphasic Personality Inventory Heroin User 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Ball, J. C., and Snarr, R. W., 1969, A test of the maturation hypothesis with respect to opiate addiction, LI. N. Bull. Narcotics 21: 9–13.Google Scholar
  2. Bejerot, N., 1972, Addiction: An Artifically Induced Drive. Charles C Thomas, Springfield, Ill.Google Scholar
  3. Brown, B. S., Gauvey, S. K., Meyers, M. B., and Stark, S. D., 1971, In their own words: Addicts’ reasons for initiating and withdrawing from heroin, Int. J. Addictions, 6: 635–645.Google Scholar
  4. Chein,I. Gerard, D. L., Lee, R. S., and Rosenfeld, E., 1964, The Road to H. Narcotics, Deliquency and Social Policy. Basic Books, Inc., New York.Google Scholar
  5. Cicero, T. J., Bell, R. D., Wiest, W. G., Allison, J. H., Polakoski, K., and Robins, E., 1975, Function of the male sex organs in heroin and methadone users, New Engl. J. Med. 292: 882–887.PubMedCrossRefGoogle Scholar
  6. Clausen, J. A., 1957a, Social and psychological factors in narcotic addiction, Law and Contemporary Problems 22 (Winter):34–51.Google Scholar
  7. Clausen, J. A., 1957b, Social patterns, personality and adolescent drug use, in Explorations in Social Psychiatry ( A. H. Leighton, J. A. Clausen, and R. N. Wilson, Eds.), pp. 232–272. Basic Books, Inc., New York.Google Scholar
  8. Eddy, N. B., Halbach, H., Isbell, H., and Seevers, M. H., 1970, Drug dependence: Its significance and characteristics in Drug Abuse: Data and Debate (P. H. Blachly, Ed.), Appendix A, pp. 259–282. Charles C Thomas, Springfield, Ill.Google Scholar
  9. Esposito, K., and Kornetsky, C., 1977, Morphine lowering of self-stimulation thresholds: Lack of tolerance with chronic administration, Science 195: 189–191.PubMedCrossRefGoogle Scholar
  10. Gerard, D. L., and Kornetsky, C., 1955, Adolescent opiate addiction: A study of control and addict subjects, Psychiat. Quart. 29: 457–489.PubMedCrossRefGoogle Scholar
  11. Haertzen, C. A., and Hooks N. T., 1969, Changes in personality and subjective experience associated with the chronic administration and withdrawal of opiates, J. Nerv. Ment. Dis. 148:606–614.Google Scholar
  12. Hill, H. E., Haertzen, C. A., and Glaser, R., 1960, Personality characteristics of narcotic addicts as indicated by the MMPI, 1960, J. Gen. Psychol. 62: 127–139.PubMedCrossRefGoogle Scholar
  13. Hill, H. E., Haertzen, C. A., and Davis, H., 1962, An MMPI factor analytic study of alcoholics, narcotic addicts and criminals, Quart. J. Stud. Alcohol 23: 411–431.PubMedGoogle Scholar
  14. Hill, H. E., Haertzen, C. A., and Yamahiro, R. S., 1968, The addict physician: A Minnesota Multiphasic Personality Inventory of the interaction of personality characteristics and availability of narcotics, in The Addictive States, Res. Publ. Ass. Nerv. Ment. Dis. Vol. 46 (A. Wikler, ed.), pp. 321–332. Williams 0026 Wilkins, Baltimore.Google Scholar
  15. Jones, B. E., and Prada, J. A., 1973, Relapse to morphine use in dog, Psychopharmacologia 30: 1–12.PubMedCrossRefGoogle Scholar
  16. Kelleher, R. T., and Morse, W. H., 1968, Schedules using noxious stimuli. III. Responding maintained with response-produced electric shocks, J. Exp. Anal. Behay. 11: 819–838.CrossRefGoogle Scholar
  17. Kornetsky, C., 1979, Intracranial self-stimulation thresholds: A model for the hedonic effects of drugs of abuse, Arch. Gen. Psychiat. 36: 289–292.PubMedCrossRefGoogle Scholar
  18. Krueger, H., Eddy, N. B., and Sumwalt, M., 1941, The Pharmacology of the Opium Alkalokds, Part 1, Supplement No 165 to the Public Health Reports. Superintendent of Documents, U.S. Government Printing Office, Washington, D.C.Google Scholar
  19. Krueger, H., Eddy, N. B., and Sumwalt, M., 1943, The Pharmacology of the Opium Alkaloids, Part 2, Supplement No. 165 to the Public Health Reports. Superintendent of Documents, U.S. Government Printing Office, Washington, D.C.Google Scholar
  20. Lindesmith, A. R., 1947, Opiate Addiction. Principia Press, Bloomington, Ind.Google Scholar
  21. Martin, W. R., Jasinski, D. R., Haertzen, C. A., Kay, D. C., Jones, B. E., Mansky, P. A., and Carpenter, R. W., 1973, Methadone—A reevaluation, Arch. Gen. Psychiat. 28: 286–295.PubMedCrossRefGoogle Scholar
  22. Martin, W. R., Hewett, B. B., Baker, A. J., and Haertzen, C. A., 1977, Aspects of the psychopathology and pathophysiology of addiction, Drug and Alcohol Dependence 2:185–202.Google Scholar
  23. McAuliffe, W. E., and Gordon, R. W., 1974, A test of Lindesmith’s theory of addiction: The frequency of euphoria among long-term addicts, Amer. J. Sociol. 79: 795–840.CrossRefGoogle Scholar
  24. McKearney, J. W., 1968, Maintenance of responding under a fixed-interval schedule of electric shock presentation. Science 160: 1249–1251.PubMedCrossRefGoogle Scholar
  25. Mendelson, J. H., and Mello, N. K., 1975, Plasma testosterone levels during chronic heroin use and protracted abstinence: As study of Hong Kong addicts, Clin. Pharmacol. Ther. 17: 529–533.PubMedGoogle Scholar
  26. Monroe, J. J., Ross, W. R., and Berzins, J. I., 1971, The decline of the addict as “psychopath”: Implications for community care, Int. J. Addictions 6: 601–608.Google Scholar
  27. O’Donnell, J. A., Voss, H. L., Clayton, R. R., Slatin, G. T., and Room, R. G., 1976, Young Men and Drugs—A Nationwide Survey, NIDA Research Monogr. Series 5, DHEW Publication No. (ADM) 76–311. National Technical Information Service, Springfield, Virginia 22161.Google Scholar
  28. Rayport, M., 1954, Experience in the management of patients medically addicted to narcotics, J. Amer. Med. Ass. 156: 684–691.CrossRefGoogle Scholar
  29. Robins, L. N., 1979, Addict careers, in Handbook on Drug Abuse (R. I. DuPont, A. Goldstein, and J. O’Donnell, Eds.), pp. 325–336. Superintendent of Documents, U.S. Government Printing Office, Washington, D.C.Google Scholar
  30. Robins, L. N., Heizer, J. E., Hesselbrock, M., and Wish, E., 1977, reported to the Committee on Problems of Drug Dependence at its 39th annual scientific meeting in Cambridge, Massachusetts.Google Scholar
  31. Schuster, C. R., and Thompson, T., 1969, Self-administration of and behavioral dependence on drugs, Annual Rev. Pharmacol. 9: 483–502.CrossRefGoogle Scholar
  32. Schuster, C. R., and Villareal, J. E., 1968, The experimental analysis of opioid dependence, in Psychopharmacology: A Review of Progress 1957–1967 (D. H. Efron, Ed.), pp. 811–828. Public Health Service Publication No 1836, Superintendent of Documents, U.S. Government Printing Office, Washington D.C.Google Scholar
  33. Spragg, S. D. S., 1940, Morphine Addiction in Chimpanzees, Comparative Psychology Mongr. No. 15, pp. 1–238. Johns Hopkins Press, Baltimore, Maryland.Google Scholar
  34. WHO Expert Committee on Addiction-Producing Drugs, 1964, World Health Organiza-tion Technical Report Series, No. 273:1–20, Geneva (p. 9 ).Google Scholar
  35. Wikler, A., 1952, A psychodynamic study of a patient during self-regulated readdiction to morphine, Psychiat. Quart. 26: 270–293.PubMedCrossRefGoogle Scholar
  36. Wikler, A., 1971, Present status of the concept of drug dependence, Psychol. Med. (London) 1: 377–380.CrossRefGoogle Scholar
  37. Wikler, A., 1973a, Conditioning of successive adaptive responses to the initial effects of drugs, Conditional Reflex 8: 193–210.PubMedGoogle Scholar
  38. Wikler, A., 1973b, Dynamics of drug dependence: Implications of a conditioning theory for research and treatment, Arch. Gen. Psychiat. 28: 611–616.PubMedCrossRefGoogle Scholar
  39. Wikler, A., 1975, Opioid antagonists and deconditioning in addiction treatment, in Drug Dependence-Treatment and Treatment Evaluation (H. Boström, T. Larsson, and N. Ljungstedt, Eds.), Symposium October 15–17, 1974, pp. 157–182. Skandia International Symposia, Almqvist and Wiksell International, Stockholm.Google Scholar
  40. Wikler, A., 1977, Footnote No. 2 to presentation of paper, in Common Processes in Habitual Substance Use: A Research Agenda. Appendix C: Proceedings, Conference on Commonalities in Substance Abuse and Habitual Behavior, pp. 395–397. National Academy of Sciences, Washington, D.C.Google Scholar
  41. Winick, C., 1962, Maturing out of narcotic addiction, U.N. Bull. Narcotics 14: 1–7.Google Scholar
  42. Winick, C., 1965, Epdemiology of narcotics use, in Narcotics ( D. M. Wilner and G. G. Kassebaum, Eds.) McGraw-Hill, New York.Google Scholar
  43. Zahn, M. A., and Ball, J. C., 1972, Factors related to cure of opiate addiction among Puerto Rican addicts, Int. J. Addictions 7: 237–245.Google Scholar

Copyright information

© Plenum Press, New York 1980

Authors and Affiliations

  • Abraham Wikler
    • 1
  1. 1.Department of PsychiatryUniversity of Kentucky Medical CenterLexingtonUSA

Personalised recommendations