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Could a chemical compound change a human body in a way that a regular quantity of that compound is needed to stay alive after the first dose?

The short answer would be yes, there are already such chemicals (and they are more common than I thought, for example alcohol), however those chemicals require an extended period of time in which they are abused.

Similarly, there are substances that replace human biological mechanisms and after a long "training" time those substances may cause the body to stop production of important substances (alcohol is one, but also insulin, benzodiazepines, opiates).

To get inspiration I also asked a similar question on Health SE

However all those substances take a long period of time before taking effect, so is there any real drug/medicine from which I could take inspiration that needs a long detox period (with medical assistance) even after the consumption of a relatively small dose?

Such a drug/medicine would be used (for example) to control special agents; instead of poisoning them and holding the antidote against their good behaviour, a secret agency may simply just give a known substance once, after which the agents need that substance to avoid death.

The fictional drug should be based on some mechanism already present in real medicines so that it has a plausible explanation.

The afore-mentioned substance may have lethal withdrawal, however, a medical assisted detox period should enough to avoid death; in my case I want avoiding death to be non-trivial, while the easiest way to avoid it is simply maintaining regular doses.

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    $\begingroup$ Oxygen and water only. Theoretically, benzodiapines or opiate withdrawal can kill without medical assistance, but even then it's highly unlikely. $\endgroup$
    – Ginden
    May 10 '16 at 12:02
  • $\begingroup$ Please keep in mind that WB SE is dedicated to fictional worlds. Questions asking specifically about our real Earth are (almost exclusively) off-topic. However, asking us to develop a substance that meets your criteria would be on-topic. $\endgroup$
    – Frostfyre
    May 10 '16 at 12:14
  • $\begingroup$ ah thanks. I was undecided if to use WB or Healt SE infact, I just selected this one because I've seen other questions about drugs here. Do you suggest to edit this question and cross-post a similiar question on health? $\endgroup$ May 10 '16 at 12:20
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    $\begingroup$ Please don't cross-post. You can, however, flag this question for moderator attention to get it migrated over there. If your interest is in creating a drug for your world that does this, I would suggest leaving it here and editing it to reflect that desire. $\endgroup$
    – Frostfyre
    May 10 '16 at 13:37
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    $\begingroup$ You don't have to look far for such a drug, alcoholics can die from withdrawal (not after just one dose though). $\endgroup$ May 11 '16 at 8:06
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Antibiotics

The effect is probably not as direct as you are looking for, but any substance with strong antibiotic properties (especially if it strongly affects white blood cell creation in the bone marrow) will leave a longtime regular user with a weakened immune system that may well lead to death from an infection.

Hormone replacement drugs

Another option I could see is long term use of specific hormones or regulatory chemicals to push the body to greater performance. Over time, the body itself would produce less and less of the hormones in an attempt to restore the natural balance, until it's all artificial hormones.

If their use is then stopped, the body's own system may not take over in time to prevent a collapse of the metabolic and/or nervous system. The responsible glands may even have atrophied, making death a certainty.

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  • $\begingroup$ thanks and +1, I suspected antibiotics would be a possible answer, though it is sufficient to avoid being in contact with microorganisms to avoid the infection. $\endgroup$ May 10 '16 at 12:21
  • $\begingroup$ Thanks for editing your answer after I edited my question, I was googling around and found an enourmous amount of drugs with lethal withdrawal O_O. $\endgroup$ May 10 '16 at 13:00
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    $\begingroup$ I bet the drug companies put those effects waaayyyyy down in the fine print. "You will die if you stop buying our product". $\endgroup$
    – Cyrus
    May 10 '16 at 13:04
  • $\begingroup$ Infact my intent was (also) to track down those substances :D (for personal curiosity XD I have no intention to make articles on that), I bet also who know nice answers to this question will probably not answer them XD. $\endgroup$ May 10 '16 at 13:07
  • $\begingroup$ @Cyrus No--such things are going to be quite prominent so patients know they must be careful not to run out. $\endgroup$ Apr 16 '21 at 3:26
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It would be simple enough to create a drug (or more likely a compound of drugs) that has two effects.

The first would be to nuke your bodies production of an important hormone or vitamin or similar. For example lets say it makes it impossible for you to take in vitamin C.

The second effect would be a temporary fix to the first that allows vitamin C to be taken in but only while it remains in your system.

Now unless the first problem is somehow fixed you need the second effect to survive, and that's a permanent change.

Fail to take the drug and your body stops working. Keep taking it though and you feel fine.

If this is designed to control people then you don't need any further explanation. If you do need it then you can say that the first step is a side effect that is either rare or unavoidable for something that you do need to take.

For example on an alien planet you might need to take immunoboosters to not die from the local microorganisms but those have the unfortunate side effect of meaning your body can't X any more. So now you need to take Y for life or die - but you died anyway if you didn't take the drugs so it's still worth doing.

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    $\begingroup$ You don't even need to make it permanent. Drug A blocks life-critical process X and has a half life of 120 hours. Drug B blocks the effects of drug A and has a half life of 12 hours. They're given as a combination. Once you no longer need control you give just B until A is flushed out of the system. $\endgroup$ Apr 16 '21 at 3:29

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