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What Makes An Addict?

Posted: 08/28/07 02:08 PM ET

I went from the Ivy League to IV drugs. And I've been obsessed with figuring out what addiction is ever since. Is it a disease? A moral weakness? A learning disorder? I explore this issue and what science can -- and cannot -- tell us about these questions in today's Washington Post.

I believe it is far more complicated than most advocates of particular perspectives admit.

More here. And as always, I'm interested in hearing what others think about this...

 
 
 

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alkamm
Brevity is the soul of lingerie.
05:19 PM on 08/30/2007
A few years back, they were talking about good addictions--hot baths, sports, reading. . . what have you. These addictions have their communities you join if you are affiliative. With other addictions, you get the sense of community without having to go to a lot of meetings, and you can be furtive and enjoy the benefits rather than constantly going to meetings.
I was able to quit cigarettes by simply deciding, as you decided, to quit. I didn't particularly think it was a glamorous or pleasurable thing, so I quit, but I quit several times before finally realizing I couldn't bum a smoke, or have one under any circumstances. I've quit coffee as well, but I slip back now and again because of articles about its benefits.
One of the reasons I smoked the weed as long as I did was a sense of alienation from the dominant culture. That alienation was fed by my success at selling the weed, I'm afraid. As an honest, dedicated buyer, I made friends all over the country and felt I was doing a service for that part of society that enjoyed it.Maybe I was, maybe I wasn't. At any rate, the criminal justice system has ways of dealing with addiction to dealing, and it is, as they say in prison, nothin nice. Many people take drugs for the community drugs has ready made for you. You can meet people, make friends, get laid, and all without the hassle of traditional networking. Plus there's a buck in it, a buck that makes it necessary to do the drug in order to sell it.
Legalizing drugs would take the monetary cachet away from them, and a lot of people would be less likely to do them then. Drug use should be a health issue, not a legal issue.
Once drug use is a health issue, we can treat the problem with effective public relations and programs designed to bring people together more authentically than simply sharing a pipe, a needle, or various measures of fronts.
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alkamm
Brevity is the soul of lingerie.
05:07 PM on 08/30/2007
The idea that you used drugs to relieve social isolation sounds retrospective, but I think you're right. Using drugs is like joining an exclusive country club--admission has it's community building privileges.
I was taught not to drink by a father who often squandered our meager resources on binges. I was taught, in turn, to drink by the rich kids whose parents provided us booze and cigarettes so we'd grow up and learn to use these respectable drugs.
I was taught to quit drinking by tiring of the trouble booze caused--headaches, hangovers, waste of time. Also, drinking lost its cachet for me. When marijuana came along in the 60s, it seemed so delightfully sub rosa, and it had a very subdued set of effects I found preferable to those of booze. Also, the people trying it seemed of a higher order than the frat boys.
I remember all the articles that said cocaine wasn't addictive! I had doctor friends (med school) who showed me and asked me if I could get some, which I didn't. As the high tide of cocaine consumption crested, I resisted it, mostly (as Mark Twain might say of telling the truth). It was junk, so watch out.
I do not know why self-respect allowed me to resist it, or to be an occasional user. Probably the same self-respect that made me realize that opiates could be very addictive and should not be used regularly.
My only severe addiction, and it was brief, was gambling. It seemed okay for a while, but I realized that I was losing more than winning and had to quit while I was behind. I'm glad I could, but who knows why I could.
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Maia Szalavitz
12:14 PM on 08/30/2007
Again, dependence isn't the problem. That's why the leading experts (Volkow, O'Brien, etc.) want to change the term in the DSM to addiction. Physical dependence is neither necessary nor sufficient for addiction and psychological dependence is a meaningless euphemism coined in an attempt to avoid the stigma of the word addiction.

We're all psychologically dependent on numerous things-- love being the big one. That's not a problem. It's a good thing, in fact. It means we're human.

The problem is compulsive use of substances or activities despite negative consequences. The compulsion, not the dependence, is the problem.

Dependence simply means need-- need is fine. Need for something that's hurting you isn't dependence, but addiction. The word dependence just causes confusion, not clarity
03:51 AM on 08/30/2007
Seems that there is neuro research that shows a link to addiction and the anterior cingulate and the right hippocampus of the brain, this is related to memory and some type of psychological need, that also is related to long term progression of addiction because of a deterioration of the hippocampus abilities to produce new cells.

The research shows some links to emotional memory and pleasure in association to hippocampus stimulus, the connection is not well understood.
05:25 AM on 08/30/2007
Hey Brother Pax,

That's interesting, you say:

"this is related to memory and some type of psychological need"

A psychological need, eh? You mean one is being influenced, controlled or determined by something other than ones conscious awareness?
That ones neuro-transmitters are seeking to reproduce good emotional feelings from an external source? Sounds habit-forming, one could form a psychologically dependence on such a thing.
Imagine that! Go figure.
04:37 PM on 08/30/2007
SWJ,

Seems PC is very knowledgeable on this subject and neuro-science is proving it.

If I remember correctly PC has well over 35 years of experience on the subject.

Agape.
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Maia Szalavitz
03:54 PM on 08/29/2007
Knosiswar, I agree: most love is not addiction because addiction is compulsion despite negative consequences. If the consequences are positive as if often the case in love, then it's not addiction.

Similarly, I don't think endorphins and are a "false fix"-- they are literally a key part of the natural chemistry of love. if your brain's reward system doesn't work (if you block these chemicals or have some dysfunction in these systems for some reason), you cannot connect with other people.

And so, one of the things people do instead is take drugs.

This doesn't mean that "love is false" or "love is a drug" in the sense that it's "fake" or "artificial." It just means that we are chemical beings and that drugs can mimic these natural chemicals in ways that can be destructive.
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knosiswar
Major General Smedley Butler - get to know him
02:04 AM on 08/30/2007
What I was trying to say about 'endorphins', is that our systems have receptors that can be stimulated naturally through loving,nurturing relationships or we can substitute with narcotics that produce, I believe, similiar effects to the body's chemistry. We are hardwired to recognize and in turn seek out those situations suggesting our body's have a reward system for finding love. My suggestion is that Narcotics stimulate that same curcuitry, and if you lack a knowledge of stimulating that system through social relationships, primarily mentoring relationships, then you are more likely to fall into addiction if you are exposed to narcotics. Because you are unable to recognize that the narcotic is telling you that this is what your looking for, but it doesn't last. Like diabetes, your body produces insulin naturally, but if it stops, then you have to find it externally. The same for Love, your body is looking for it, and will produce a pleasing chemical experience, or you can take narcotics.

The endorphins are not the false fix. It is the narcotic that falsely stimulates, in the place of love, the body's endorphin system.

What's destructive is the cycle of repeating the process of quick fix narcotic love, which plagues the body with illness and social consequences, seperating further the person from making and maintaining successful and 'naturally' rewarding relationships.

And your ability to push away a temptation towards addiction would rely on previous experience with a true experience in a loving, nurturing relationship.
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knosiswar
Major General Smedley Butler - get to know him
02:56 PM on 08/29/2007
I've read before that being 'In Love' is a chemical high. That eating Chocolate produces seratonin just like being in love. There seems to be a chemical system that recognizes what we all are looking for, either actively or by 'reflex', and that's to love and be loved. I believe that a person's tendency to become addicted to a chemical quick fix endorphine cheat, is relative to what is being naturally produced from the person's involvement in their environment. I say for this discussion, there are two types of people in this world, the ones that struggle and the ones that are challenged. But that it's clearly a matter of perception(except in extreme cases, which there are many, where people are starving and fighting off disease everyday). So if you are fortunate to have been shown love that gives you confidence in yourself to fail and still have value, then you will see life as a challenge, but if you have never known love, and see failure as a reflection upon your self-worth, then you will struggle. Those who are challenged and self-assured, do not have the addiction problems because they recognize the quick fix as a false fix. But those who have never known love, self-love, cannot recognize the false-fix of endorphines. And then clearly have no rational to decipher what is real and what is empty. They can't reasonably fix what they can't change, in their mind, because they are powerless to effect that change, because they lack the tools to be successful, which is basically, the courage to fail, and know that failing is OK, as part of the process to living a successful life. The addiction is to want to feel safe and secure(the benefits of love), even if only temporary.
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knosiswar
Major General Smedley Butler - get to know him
02:56 PM on 08/29/2007
Everybody wants the same thing, it's just having the tools to make it happen. A loving relationship is an ongoing fix, with positive side effects; increased productivity, increased community outreach, increased self-satisfaction, giving and receiving. Everybody deep down is the same, they just want to be loved and love. The challenge is to create an environment that supports people collectively. But the nature of our modern economy is competitive, and fails us socially to be cooperative. If our society could be mutually constructive more so than individually competitive, our language and our personal relationships would benefit greatly. I hope I wasn't to random. In a relationship, 2 people 'struggling'(with themselves personally) will have a difficult time sustaining a relationship when their identity is built into that relationship. You have to love and accept yourself before you can love and accept another.
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Maia Szalavitz
02:14 PM on 08/29/2007
Actually, dependency is completely different from addiction, which you would know, Jack, if you'd actually read the article.

One of the key points it makes is that you can have dependency without addiction (we're all dependent on food, air, water-- diabetics are dependent on insulin, some blood pressure medications cause dependence but no one robs drugstores to get them)and there is also addiction without physical dependence.

Cocaine, for example, causes very little physical dependence (you don't get physically sick when you quit, just have severe craving) but no one argues any more that it's not addictive (though they used to do, as you would have seen if you read the story).

And serotonin and dopamine are involved in virtually every emotional response by the brain so it's hardly surprising they'd be involved with addiction. That doesn't tell us much.

Omega 3's do help with depression and insofar as some people's addictions are driven by depression (which was true in my case), it may help there as well.

But this is far from simple.
11:04 AM on 08/29/2007
Dependency... ever heard of it! It's what makes addiction chronic.
04:00 PM on 08/28/2007
I've said this before and I'll say it again--I'm pretty sure that dopamine and serotonin in the brain have a lot to do with whether a person is susceptible to becoming addicted to drugs. And those neurotransmitters are influenced by how much EPA and DHA are in the diet, the person's omega-3 fatty acid intake.
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ORSunshine
03:01 PM on 08/28/2007
I agree with the compassion angle. Having never been truly addicted to anything, (just obsessed with chocolate), I can't draw on any personal experience. The people I know who are addicted to things (both, ironically to the nonaddictive marijuana) use because they enjoy the relaxed feeling they get. Instead of being able to relax without it, when they think "Hey, I am ready to relax" they automatically think they need to smoke. I guess most alcoholics do the same thing until they get physically addicted. There's a mental thought that the only way to feel good is to be under the influence. The hardest part is that it is dangerous to their health, they do experience behavior modification as a result of their use, and they will take risk and spend a lot of money to get their "fix."

Other people I know though can recreationally use alcohol, pot, or halucinogens and not experience any addictive behavior.... but then again, we have an obesity epidemic in this country -- addictions to video games and potato chips may be the cause.
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Maia Szalavitz
02:17 PM on 08/28/2007
Self-hatred and being obsessive by nature are a bad combination-- and definitely I sought escape from that during my addiction.

But I think what many people don't get is that it's not a choice to have such feelings-- sure, you can work cognitively to distract yourself and to not "buy into" them, and you can do service to others to reassure yourself that actions count more than thoughts and your actions aren't worthy of such self-loathing.

However, if you still feel as though you are worthless and unloved and that you don't deserve to be loved, it is very, very difficult to avoid chemical escape. It is here where addiction and depression meet: and if you don't somehow-- social support, therapy, medication, ideally combine all three-- lift that, you are either going to be miserable, suicidal or using or all three.

Meanwhile, people who have never experienced such things say things like "get over it" and stop being so self-obsessed. That's like telling someone to ignore a toothache. It's very easy to ignore your teeth if they aren't hurting.

This is where I have sympathy for the disease model-- if by disease you mean something you didn't choose that torments you, I agree. But where I don't buy it is where you say there's no choice involved and no free will. Because that perspective leads to seeing addicts as dangerous zombies who need to be locked up to protect themselves and everyone else.

So I think we need to be alert to complexity here, basically-- and choose approaches that are compassionate and effective. Curiously enough, the more compassionate approaches are the most effective anyway.
02:04 PM on 08/28/2007
They were called Cyclopal, little white pills sold openly in Escuela De Readaptacion (School of Redaptation, or prison) in Hermosillo, Sonora back in 1970. They were a path to sweet dreams, but, being codeine based, something that I had no attraction for. (I stuck with the pot which was plentiful, strong, and cheap.)

Crazy Raul, though, I figured that he may have had an addiction going. Since there were folks in there whose only offense was being homeless and he was so dirt poor, I always figured that he just didn't fit in on the outside. But on the visiting days he was a hustling machine.

The visitors came directly into the prison interior and it created a real holiday atmosphere twice a week. Food and crafts for sale, children running the halls, couples arranging places to be discreet. That sort of thing.

Raul hawked whatever someone was willing to give him a commission on, and he bought pills as fast as he cleared enough for one. Before the end of the visit he was falling down high, but, I think, loving it. And then he needed to keep it going so he hocked what few meager things he had. When we saw him down to his underwear that was the signal that this cycle was over, and that he would have to be basically naked and straight for the next couple of days.

And then it would start over. His clothes were given back to him on trust that what he owed on them would be paid from his first sales, and he never failed, because he would have been out of business, and out of drugs, if he did.
01:52 PM on 08/28/2007
Addition is a poor form of copping with life's up's, and downs. when we feel no one is listening, and our situtions move further toward the depth's of darkness; we disasosiate ourselves from our problems. This can be done not only with substance abuse, but other forms of distrations.

We only feel better when our lanscape offers the oppurtunities for change. I think addition is a calling for help. It is enviromental.
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01:43 PM on 08/28/2007
I might write more, but now will say that you did not go from Ivy League to I.V.. (fake fall).

Assure you that "being obsessed" is part of addiction.
01:14 PM on 08/28/2007
Perhaps addictions are derived from a 24/7 need to escape feeling sorry for yourself, or to elevate that sorrow beyond any threshold any lifeform has a right to.