Table of ContentsView AllTable of ContentsDefinitionsDrugs Affecting ToleranceCausesRiskMinimizing RisksFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Definitions
Drugs Affecting Tolerance
Causes
Risk
Minimizing Risks
Frequently Asked Questions
If you use a drug repeatedly, your body can develop drug tolerance. With this condition, you have to take higher doses of the drug—or change to a different drug—to get the same benefit or effect you had when you first began using it.
You can develop a drug tolerance to any drug, regardless of its purpose. It’s possible to form a drug tolerance to prescription morphine you take for pain relief or recreational drugs likecocaine.
While drug tolerance can be a challenge, solutions are available. Your healthcare provider can conduct regular exams to reevaluate your treatment plan and reduce the incidence of drug tolerance. Your provider also can decide whether you may benefit from a higher dose of the drug or a new medication to offset your drug tolerance.
This article compares drug tolerance, addiction, and dependence and discusses various types of tolerance and associated drug types.
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Drug Tolerance: Not Addiction or Dependence
Drug tolerance can be easily confused withdrug addiction(also referred to as substance use disorder) ordrug dependence. While drug tolerance can occur with either condition, it can also exist as a separate condition.
Key Differences
Here are the key differences among drug tolerance, addiction, and dependence that define these conditions:
Drug tolerance naturally occurs when your body has a reduced response to a drug that is used often. You can develop a high tolerance if you take a substance or drug regularly. It can also occur as a result of genetics.
Characteristics of drug tolerance include:
Characteristics of addiction include:
Drug dependenceis a physical dependence that occurs when your body adjusts to the constant presence of a particular drug in your system and accepts it as a new normal. While there is a difference between addiction and dependence, addiction often follows dependence.
Characteristics of drug dependence include:
Substance Use Disorder & Addiction
Lists of Drugs Known to Change Tolerance Levels
What Is Opioid Use Disorder?
Theories About the Cause of Drug Tolerance
While drug tolerance occurs commonly with the long-term use of certain substances, the causes of this problem aren’t well understood. When used as prescribed, drug tolerance is unknown.
Some people may have a natural tolerance to certain drugs or drug types as a result of genetics. However, it’s unclear why others develop an acquired drug tolerance. There are several theories about the cause of acquired drug tolerance
Psychological
There may be a psychological element to drug tolerance. External factors, such asstress, that impact your psychological condition, can contribute to drug tolerance. Stress interferes with a drug’s ability to bind to plasma and tissue proteins, which is necessary for efficacy.
Behavioral
Behavioral tolerance suggests that you become conditioned to the effect of a psychoactive drug over time. As a result, you develop behaviors to overcome the drug’s effects.
Pharmacodynamic
The pharmacodynamic theory of drug tolerance says that the condition occurs as the body works to adapt to the presence of a foreign substance.
As you take a drug for longer periods of time, the receptors or enzymes in your brain and body become desensitized to the drug. This makes it less effective in the same amounts. As a result, your body needs a higher dose to achieve the desired effect of the drug.
Metabolic
Metabolic tolerance results from a faster-than-normal elimination of a drug from your body. It is linked with a specific group of liver enzymes that metabolize alcohol after chronic drinking.
The effect lowers the concentration of blood alcohol and lessens the time during which alcohol remains active in your body. This reduces the amount of time you are subject to the intoxicating effects of alcohol.
Reverse
Reverse tolerance, also called sensitization, has the opposite effect of other types of tolerance. It occurs with drugs like psychoactive substances. Repeated use of the drug changes the body’s sensitivity to it so that repeated use of the drug enhances, rather than reduces, its effect.
Risks
Drug tolerance interferes with a drug’s ability to deliver the intended benefit or effect. However, it also poses several potential problems that can lead to serious results.
If you continue to take a drug despite having signs of tolerance, you increase your risk of the following dangers:
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How to Minimize the Risks of Drug Tolerance
If you suspect that you have a drug tolerance, your healthcare provider will evaluate your treatment plan to determine changes in dosage or the need for different medications.
Dangers of Drug ToleranceDrug tolerance increases your risk of dependence, addiction, and overdose since your body reacts to normal doses differently. Never change the dose of a prescribed medication without advice from your healthcare provider.
Dangers of Drug Tolerance
Drug tolerance increases your risk of dependence, addiction, and overdose since your body reacts to normal doses differently. Never change the dose of a prescribed medication without advice from your healthcare provider.
Summary
You can have a drug tolerance to a drug that you often take for a long time. This can occur with alcohol and both prescribed and recreational drugs.
The problem develops when your body becomes familiar with the drug and no longer regards it as a foreign substance. Instead, the drug is treated as part of your body’s system. This makes it less useful for the pain or chronic illness it treats.
Your healthcare provider can change your treatment plan to offset the effects of drug tolerance. Methods like raising the drug dose, using a new drug, stopping the drug for a short time, or finding nonmedical treatments, may work for you.
A Word From Verywell
Dealing with a drug tolerance can be frustrating when it occurs with a drug that helped you in the past. But continuing to take a drug you’ve built a tolerance to can worsen symptoms and cause your condition to decline.
Contacting your healthcare provider as soon as you notice changes gives you the best chance of reducing the negative effects of drug tolerance. They can re-evaluate your treatment plan and offer the best options based on your sex, age, medical history, and current condition.
Frequently Asked QuestionsIt’s possible to reverse the effects of drug tolerance through strategies like a drug holiday, in which you stop using the drug and then reintroduce it. However, stopping or changing any medication should only be done based on the advice of your healthcare provider.Learn MoreWhat to Do If Your Allergy Medications Stop WorkingThe decision to prescribe painkillers is based on a patient’s sex, age, medical history, and current condition vs. alternative treatments. Your healthcare provider determines the best treatment for you based on this criteria.Learn MoreHow to Recognize and Treat Opiod Abuse Before It’s Too LateSome of the most common types of drug tolerance are antihistamines, antibiotics, opioids, and antidepressants.The best way to wean off of medication is under the direction of your healthcare provider. To avoid the side effects of withdrawal, you should never stop taking medication suddenly on your own.Learn MoreStudy: There’s No Perfect Way to Wean Yourself off of Antidepressants
It’s possible to reverse the effects of drug tolerance through strategies like a drug holiday, in which you stop using the drug and then reintroduce it. However, stopping or changing any medication should only be done based on the advice of your healthcare provider.Learn MoreWhat to Do If Your Allergy Medications Stop Working
It’s possible to reverse the effects of drug tolerance through strategies like a drug holiday, in which you stop using the drug and then reintroduce it. However, stopping or changing any medication should only be done based on the advice of your healthcare provider.
Learn MoreWhat to Do If Your Allergy Medications Stop Working
The decision to prescribe painkillers is based on a patient’s sex, age, medical history, and current condition vs. alternative treatments. Your healthcare provider determines the best treatment for you based on this criteria.Learn MoreHow to Recognize and Treat Opiod Abuse Before It’s Too Late
The decision to prescribe painkillers is based on a patient’s sex, age, medical history, and current condition vs. alternative treatments. Your healthcare provider determines the best treatment for you based on this criteria.
Learn MoreHow to Recognize and Treat Opiod Abuse Before It’s Too Late
Some of the most common types of drug tolerance are antihistamines, antibiotics, opioids, and antidepressants.
The best way to wean off of medication is under the direction of your healthcare provider. To avoid the side effects of withdrawal, you should never stop taking medication suddenly on your own.Learn MoreStudy: There’s No Perfect Way to Wean Yourself off of Antidepressants
The best way to wean off of medication is under the direction of your healthcare provider. To avoid the side effects of withdrawal, you should never stop taking medication suddenly on your own.
Learn MoreStudy: There’s No Perfect Way to Wean Yourself off of Antidepressants
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.The science of drug abuse and addiction: the basics.Pietrzykowski AZ, Treistman SN.The molecular basis of tolerance.Alcohol Res Health. 2008;31(4):298-309.Tamm M, Richards DH, Beghé B, Fabbri L.Inhaled corticosteroid and long-acting β2-agonist pharmacological profiles: effective asthma therapy in practice.Respir Med.2012;106(1):S9-19. doi:10.1016/S0954-6111(12)70005-7Targum SD.Identification and treatment of antidepressant tachyphylaxis.Innov Clin Neurosci. 2014;11(3-4):24-28.Vadivelu N, Singh-Gill H, Kodumudi G, Kaye AJ, Urman RD, Kaye AD.Practical guide to the management of acute and chronic pain in the presence of drug tolerance for the healthcare practitioner.Ochsner J. 2014;14(3):426-433.Meltzer EO, Blaiss MS, Naclerio RM, et al.Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys.Allergy Asthma Proc. 2012;33(Suppl 1):S113-S141. doi:10.2500/aap.2012.33.3603Engin E.GABAA receptor subtypes and benzodiazepine use, misuse, and abuse.Front Psychiatry. 2023;13:1060949. doi:10.3389/fpsyt.2022.1060949Niveditha D, Sharma H, Sahu A, Majumder S, Chowdhury R, Chowdhury S.Drug tolerant cells: an emerging target with unique transcriptomic features.Cancer Inform. 2019;18:1176935119881633. doi:10.1177/1176935119881633UpToDate.Patient education: medications for angina (beyond the basics).Antonia K, Anastasia A, Tesseromatis C.Stress can affect drug pharmacokinetics via serum/tissues protein binding and blood flow rate alterations.Eur J Drug Metab Pharmacokinet. 2012;37(1):1-7. doi:10.1007/s13318-011-0077-2American Psychological Association.Pharmacodynamic tolerance.Haass-Koffler CL, Perciballi R.Alcohol tolerance in human laboratory studies for development of medications to treat alcohol use disorder.Alcohol Alcohol. 2020;55(2):129-135. doi:10.1093/alcalc/agz103American Psychological Association.Reverse tolerance.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.The science of drug abuse and addiction: the basics.Pietrzykowski AZ, Treistman SN.The molecular basis of tolerance.Alcohol Res Health. 2008;31(4):298-309.Tamm M, Richards DH, Beghé B, Fabbri L.Inhaled corticosteroid and long-acting β2-agonist pharmacological profiles: effective asthma therapy in practice.Respir Med.2012;106(1):S9-19. doi:10.1016/S0954-6111(12)70005-7Targum SD.Identification and treatment of antidepressant tachyphylaxis.Innov Clin Neurosci. 2014;11(3-4):24-28.Vadivelu N, Singh-Gill H, Kodumudi G, Kaye AJ, Urman RD, Kaye AD.Practical guide to the management of acute and chronic pain in the presence of drug tolerance for the healthcare practitioner.Ochsner J. 2014;14(3):426-433.Meltzer EO, Blaiss MS, Naclerio RM, et al.Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys.Allergy Asthma Proc. 2012;33(Suppl 1):S113-S141. doi:10.2500/aap.2012.33.3603Engin E.GABAA receptor subtypes and benzodiazepine use, misuse, and abuse.Front Psychiatry. 2023;13:1060949. doi:10.3389/fpsyt.2022.1060949Niveditha D, Sharma H, Sahu A, Majumder S, Chowdhury R, Chowdhury S.Drug tolerant cells: an emerging target with unique transcriptomic features.Cancer Inform. 2019;18:1176935119881633. doi:10.1177/1176935119881633UpToDate.Patient education: medications for angina (beyond the basics).Antonia K, Anastasia A, Tesseromatis C.Stress can affect drug pharmacokinetics via serum/tissues protein binding and blood flow rate alterations.Eur J Drug Metab Pharmacokinet. 2012;37(1):1-7. doi:10.1007/s13318-011-0077-2American Psychological Association.Pharmacodynamic tolerance.Haass-Koffler CL, Perciballi R.Alcohol tolerance in human laboratory studies for development of medications to treat alcohol use disorder.Alcohol Alcohol. 2020;55(2):129-135. doi:10.1093/alcalc/agz103American Psychological Association.Reverse tolerance.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute on Drug Abuse.The science of drug abuse and addiction: the basics.Pietrzykowski AZ, Treistman SN.The molecular basis of tolerance.Alcohol Res Health. 2008;31(4):298-309.Tamm M, Richards DH, Beghé B, Fabbri L.Inhaled corticosteroid and long-acting β2-agonist pharmacological profiles: effective asthma therapy in practice.Respir Med.2012;106(1):S9-19. doi:10.1016/S0954-6111(12)70005-7Targum SD.Identification and treatment of antidepressant tachyphylaxis.Innov Clin Neurosci. 2014;11(3-4):24-28.Vadivelu N, Singh-Gill H, Kodumudi G, Kaye AJ, Urman RD, Kaye AD.Practical guide to the management of acute and chronic pain in the presence of drug tolerance for the healthcare practitioner.Ochsner J. 2014;14(3):426-433.Meltzer EO, Blaiss MS, Naclerio RM, et al.Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys.Allergy Asthma Proc. 2012;33(Suppl 1):S113-S141. doi:10.2500/aap.2012.33.3603Engin E.GABAA receptor subtypes and benzodiazepine use, misuse, and abuse.Front Psychiatry. 2023;13:1060949. doi:10.3389/fpsyt.2022.1060949Niveditha D, Sharma H, Sahu A, Majumder S, Chowdhury R, Chowdhury S.Drug tolerant cells: an emerging target with unique transcriptomic features.Cancer Inform. 2019;18:1176935119881633. doi:10.1177/1176935119881633UpToDate.Patient education: medications for angina (beyond the basics).Antonia K, Anastasia A, Tesseromatis C.Stress can affect drug pharmacokinetics via serum/tissues protein binding and blood flow rate alterations.Eur J Drug Metab Pharmacokinet. 2012;37(1):1-7. doi:10.1007/s13318-011-0077-2American Psychological Association.Pharmacodynamic tolerance.Haass-Koffler CL, Perciballi R.Alcohol tolerance in human laboratory studies for development of medications to treat alcohol use disorder.Alcohol Alcohol. 2020;55(2):129-135. doi:10.1093/alcalc/agz103American Psychological Association.Reverse tolerance.
National Institute on Drug Abuse.The science of drug abuse and addiction: the basics.
Pietrzykowski AZ, Treistman SN.The molecular basis of tolerance.Alcohol Res Health. 2008;31(4):298-309.
Tamm M, Richards DH, Beghé B, Fabbri L.Inhaled corticosteroid and long-acting β2-agonist pharmacological profiles: effective asthma therapy in practice.Respir Med.2012;106(1):S9-19. doi:10.1016/S0954-6111(12)70005-7
Targum SD.Identification and treatment of antidepressant tachyphylaxis.Innov Clin Neurosci. 2014;11(3-4):24-28.
Vadivelu N, Singh-Gill H, Kodumudi G, Kaye AJ, Urman RD, Kaye AD.Practical guide to the management of acute and chronic pain in the presence of drug tolerance for the healthcare practitioner.Ochsner J. 2014;14(3):426-433.
Meltzer EO, Blaiss MS, Naclerio RM, et al.Burden of allergic rhinitis: allergies in America, Latin America, and Asia-Pacific adult surveys.Allergy Asthma Proc. 2012;33(Suppl 1):S113-S141. doi:10.2500/aap.2012.33.3603
Engin E.GABAA receptor subtypes and benzodiazepine use, misuse, and abuse.Front Psychiatry. 2023;13:1060949. doi:10.3389/fpsyt.2022.1060949
Niveditha D, Sharma H, Sahu A, Majumder S, Chowdhury R, Chowdhury S.Drug tolerant cells: an emerging target with unique transcriptomic features.Cancer Inform. 2019;18:1176935119881633. doi:10.1177/1176935119881633
UpToDate.Patient education: medications for angina (beyond the basics).
Antonia K, Anastasia A, Tesseromatis C.Stress can affect drug pharmacokinetics via serum/tissues protein binding and blood flow rate alterations.Eur J Drug Metab Pharmacokinet. 2012;37(1):1-7. doi:10.1007/s13318-011-0077-2
American Psychological Association.Pharmacodynamic tolerance.
Haass-Koffler CL, Perciballi R.Alcohol tolerance in human laboratory studies for development of medications to treat alcohol use disorder.Alcohol Alcohol. 2020;55(2):129-135. doi:10.1093/alcalc/agz103
American Psychological Association.Reverse tolerance.
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