How do alcohol and tobacco fit into discussions of drug use and drug dependence?

In discussions of drug use and dependence, alcohol and tobacco are frequently classified as drugs because they possess psychotropic properties and can lead to significant physiological and psychological effects. While they are often socially integrated, both substances are recognized for their potential to cause dependence and serious health consequences.12

Tobacco and Nicotine Dependence

Tobacco use is characterized by addiction to nicotine, which stimulates the release of dopamine in the brain, reinforcing the habit. With continued use, the body develops tolerance, requiring higher doses to achieve the same effect, and physical dependence, which results in withdrawal symptoms—such as irritability, anxiety, and cravings—upon cessation.34

Alcohol and Dependence

Alcohol is considered a drug with a high propensity for danger, as it is capable of producing physical dependence and withdrawal syndromes. Definitions of alcoholism vary, ranging from a pharmacological-physiological model—focusing on tolerance and withdrawal—to a behavioral model that emphasizes a loss of control and the substance's marked salience in an individual's life. Unlike some other substances, alcohol's impact is often viewed through both medical and sociological lenses, given its significant role in public health and its variable social acceptance.562