Talk:Drug addiction

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[edit] Comments on Veracity

Avriette writes:

I am concerned this article is fairly subjective, and some of its facts to be if not entirely incorrect, at least tilted towards a particular political direction. I'll be making changes to it in the interest of removing rhetoric from fact as well as to increase the factual integrity of the article. This will be a gradual process. Please leave any specific input here you wish considered -- or counter to my assessment.

I agree that large parts of this page are indeed rhetorical or inaccurate for either grammatical or scientific reasons. A lot of the remainder is a misinterpretaion or biased interpretation of the scientific facts. For example, take the section, "Drug addiction has two components: physical dependency, and psychological dependency. Physical dependency occurs when a drug has been used habitually and the body has become accustomed to its effects. The person must then continue to use the drug in order to feel normal, or its absence will trigger the symptoms of withdrawal. Psychological dependency occurs when a drug has been used habitually and the mind has become emotionally reliant on its effects, either to elicit pleasure or relieve pain, and does not feel capable of functioning without it." The third sentance here ("The person must then...") uses the word "feel". To "feel" something, is show an essentially "psychological" response, and therefore cannot be accurately described as a "physical" response. Such inaccuracy is rife throughout the article.

Kevin881 writes:

I deleted the assertion that anabolic steroids are addictive substances. There is no medical evidence that shows any physiological mechanisms by which these hormones can become physically addictive. I challenge anyone to provide a study that shows otherwise. Between 1988 and 1990, Congressional hearings were held to determine whether the Controlled Substances Act should be amended to include anabolic steroids. During these hearings, and before anabolic steroids were classified as schedule III drugs in 1991, representatives of government regulatory agencies including the FDA, the DEA and the National Institute on Drug Abuse testified against the proposed amendment to the law. Even the American Medical Association vigorously opposed it, maintaining that steroid abuse does not lead to the physical or psychological dependence required for scheduling. See generally, Legislation to Amend the Controlled Substances Act (Anabolic Steroids): Hearings on H.R. 3216 Before the Subcomm. on Crime of the House of Representatives Comm. on the Judiciary, 100th Cong., 2d Sess. 99, July 27, 1988; Steroids in Amateur and Professional Sports ? The Medical and Social Costs of Steroid Abuse: Hearings Before the Senate Comm. on the Judiciary, 101st Cong. 1st Sess 736, April 3 and May 9, 1989; Abuse of Steroids in Amateur and Professional Athletics: Hearings Before the Subcomm. on Crime of the House Comm. on the Judiciary, 101st Cong., 2d Sess. 92, March 22, 1990; Hearings on H.R. 4658 Before the Subcomm. on Crime of the House Comm. on the Judiciary, 101st Cong., 2nd Sess. 90, May 17, 1990.'

Thomas Writes: My main gripe with this article is the repeated assertion in the first section that drug addiction requires daily use. I know that for a person to be addicted to a drug, they must use it regularly, but everyday use is certainly not a requirement. Some people who are addicted to drugs go on binges followed by sustained periods of sobriety. Another gripe I have in general with the article and with the concept of drug addiction is that addiction is a characteristic of a person, not of a drug. Addiction can occur with every mood altering drug, but does not occur in the majority of users of any drug. What I mean is that a person can use an "addictive drug" and not get addicted to it ever. The most common example is alcohol. Many people use alcohol frequently but can control this behavior when they want to. There are others who may use similar quantities of alcohol and become alcoholics. It is a fact that administering alcohol to a non-alcoholic cannot change that person into an alcoholic. My point is that drugs should not be classified as addictive or not addictive, they should be considered mood altering- addiction should be reserved as a psycological condition. As an example, in reference to the above post by Kevin881, I would agree that anabolic steroids are not typically "addictive." Yet I personally know someone who was addicted to anabolic steroids and sought treatment at an in-patient 12-step based rehab for his condition. A third point I would like to argue is that the terms psycological addiction and physical addiction are both obsolete terms. Drugs addiction to any drug combines physical and psycological symptoms. Certain drugs defintiely have more pronounced physical withdrawl symptoms. However, if such drugs were not also psycologically addicting, it would follow that detoxing an addict of that drug would be enough to cure that addiction. This is clearly not the case. Drug addiction has a very high relapse rate for people who receive treatment, even after a full detox. A fourth point of contention is the assertion that drug addiction is different than drug dependence. Surely there is the contrived example of a patient who needs a drug to survive, but typically, this is not what is meant by dependence. Chemical dependence is typically a term that is synonomous with drug addiction.

[edit] Comments on redirection

from vfd

  • Drug addiction - content manually merged with Addiction Denni 23:36, 2004 Feb 15 (UTC)
    • Redirected. Angela. 02:20, Feb 16, 2004 (UTC)
    • Keep as separate article. Anthony DiPierro 02:52, 16 Feb 2004 (UTC)
    • Keep. Preferably separate article, if not then redirect. Saul Taylor 03:53, 16 Feb 2004 (UTC)
    • I'm retracting the request for VfD. Thanks for the redirect, Angela. Denni 06:02, 2004 Feb 16 (UTC)

end of VfD discussion

  • continuing discussion here, (redirect or not)
    • Redirect, should be sufficiently covered in Addiction --Dittaeva 10:45, 16 Feb 2004 (UTC)
    • Keep seperate [with appropriate wlnk to addiction ... Drug addiciton a subset of addiction in general] JDR

Anthony wrote in his edit comment:

This is a large page on a separate topic: much more than just a redirect

How is drug addiction separate from addiction? It appears to me that it is a subset thereof and that it would therefore be entirely appropriate to redirect to the addiction article, where the material in this one is already covered. In any case, for a multitude of reasons, massive redundancy like in the current arrangement is unacceptable.—Eloquence 06:15, Feb 16, 2004 (UTC)

Not all the material from this page is contained in the current addiction page. Anthony DiPierro
Then why don't you move over the material which you think is missing?—Eloquence
Because there's enough here for a separate article. Why don't you delete the material you feel is redundant? Anthony DiPierro 00:51, 18 Feb 2004 (UTC)
If you could help me understand why this is an issue for you, Anthony, I might have some ideas and suggestions as to where to take this from here. As I look at drug addiction right now, it seems to me to be dead in the water under that title. I also see that there are already lengthy articles on prohibition and the War on drugs. In all seriousness, what is there left that would constitute more than a stub? Denni 17:47, 2004 Feb 18 (UTC)
Are you saying it is only a stub now? What are the parts you want to remove? Anthony DiPierro 17:52, 18 Feb 2004 (UTC)
If you reread what I've said, you'll note that I did not say it was currently a stub. I said it would be a stub if the content already addressed in addiction were removed. I'm not suggesting anything be removed. I believe that drug addiction is properly a subset of a discussion of addiction in general, and hence a page related to drug addiction ought to be directed to addiction unless there is good reason not to. From my perspective, the only thing currently in the drug addiction article that is not in the addiction article is a discussion of the neurochemical processes involved in addiction. If you wish to tackle that, feel free. If not, I have information relating to how different classes of addictive substances affect brain chemistry. In either case, I would far rather be working on that than spending my time barking up a tree here. Denni 20:01, 2004 Feb 18 (UTC)
I took the duplicate content out of addiction. Problem solved. Anthony DiPierro 20:18, 18 Feb 2004 (UTC)
Sorry, Anthony - problem =not= solved. First, you did more than remove duplicate content. You also removed content unique to the article on addiction. Second, despite my rather lengthy response to your concerns as stated above, you have refused to engage in anything remotely resembling debate. Third, while the list of contributors to this discussion is admittedly limited, you remain the only party who insists that drug addiction needs to be treated as an article separate from addiction. Fourth, there has been altogether too much bad behavior here as far as revert wars goes, and I will not be a party to it. I had hoped that this could have been discussed over a cup of eCoffee, but that appears to be not the case, so I will take my case elsewhere. Denni 21:56, 2004 Feb 18 (UTC)
You're the one making the changes, so you're the one who has to make the case. If you think I've taken things out of addiction which aren't duplicated in drug addiction, re-add those parts you think are unique to addiction and don't fall under drug addiction. If I did so, it was a mistake. I think this article is fine the way it is. If you think discussion is over, then let's have a vote. BTW, Saul Taylor has also recommended keeping as a separate article. Anthony DiPierro 18:53, 19 Feb 2004 (UTC)

When I merged the two, I attempted to carry over as much of value as possible. I did not include the section on the War on Drugs because it seems to be a peculiarly American obsession, and the Classes of Drugs is maintained both with a link to the DEA site and with a regularly updated (and searchable) list at www.streetdrugs.com. I also have difficulty with both the tentative tone ("appears to", "perceived") of the first two paragraphs, and the characterization of addiction as a 'habit,' which it most emphatically is not. In all, it was simply easier to merge the two articles than to correct drug addiction (and be left with two articles which essentially covered the same ground). Denni 06:41, 2004 Feb 16 (UTC)

[edit] Drug addiction should be kept as a page separate from addiction

  • Drug addiction is a huge topic worthy of its own article.
    • There are 945,000 google hits for the term "drug addiction."
    • There are 35 articles which link directly to drug addiction, and 3 redirects, with 38 additional pages linking through those redirects, for a total of 73 articles linking to this page.
    • The article is several screens long and is much more than just a stub.
    • There is a lot of room for improvement and additions to this article, which is far from dead in the water.
    • The rule of thumb for combining pages is for pages which have remained less than 1K for several months (see Wikipedia:Page size). This page is currently over 5K.
      • Even without the useful list of drugs, the page is still nearly 4K.
      • Surely if this were a candidate for combining with other pages addiction would be the proper page to combine it with, but it is not.
  • Any issues of redundancy with addiction which are specific to drug addiction can be resolved by removing that redudancy from addiction.
    • The remaining redundancies are minor.
  • Drug addiction is addiction. A dalmatian is a dog. Just because something is a subset of something else doesn't mean we shouldn't have an article on that subset.

Please add any counterpoints to a separate section. This list is subject to modification.

[edit] Drug addiction is addiction

  • There are five million Google hits for "addiction"
  • A redirect page never stopped anyone from getting where they wanted to go
  • The article would be much shorter if it didn't have over forty drugs listed, each on its own line, essentially duplicating what is on the external links. Most of the 35 links to this article are from those pages.
  • Of course there is room for improvement in this article. There is room in any article.
  • If the rule of thumb is that small pages be combined, then logic dictates that specific pages be grouped into more general ones. One does not place an article on dogs into a page on Dalmations in order to promote efficient use of space.
    • You're ducking the issue and you know it. Discussion of size refers to point three, as if 'screens' were any legitimate measure of article length.
  • Same - any issue of redundency in articles on 'dogs' and 'Dalmations' can be resolved by removing the redundency from 'dogs'? You think?
  • "The article does not substantially duplicate material in prohibition." This is a good thing, considering that drug addiction and prohibition have a whole lot of not much in common.
  • "The war on drugs section has been reduced to a single sentence." Acceptable. Given that this is an article on addiction, not on regulation or treatment or any other issue not directly related to use, this ought to be added as a "see also," but I can live with it.
  • "Drug addiction is addiction. A dalmation is a dog. Just because something is a subset of something else doesn't mean we shouldn't have an article on that subset. " Agreed. I'm happy with the article as it stands now, and have no problem with removing the request to redirect.

This article is generally good, but the first section blurs the very important distinction between physical dependence and psychological addiction. While the phenomenon of physical dependence can aggravate psychological addiction when it occurs, they are still distinct phenomena. Several psychologically addictive drugs, such as cocaine, induce little if any physical dependence; conversely, the physical dependence that invariably occurs in the use of opioids to treat chronic pain does *NOT* imply psychological addiction (which is relatively rare under those circumstances, Rush Limbaugh's self-serving excuses notwithstanding).

I think it's fair to say that this is now the consensus opinion of both pain and addiction specialists.

User:Karn

[edit] Addiction is Addiction

Addiction is a compulsive disorder. Whether addicted to drugs, alcohol, gambling, spending, smoking, sex, eating or any other behavior, the person who is afflicted often finds the behavior very unfulfilling after s/he exhibits it, and is unable to control it. Twelve step programs have been helpful in assisting countless people in ameliorating their addiction by introducing a support network and a formula (steps) for living. Chemotherapy such as Methadone (an agonist) or Naltrexone (an antagonist) for opiate addiction can also be helpful.

12-steps is a cult. - FrancisTyers · 11:42, 7 June 2006 (UTC)

- The twelve steps have helped many addicts stop drinking/using drugs.. don't see how it's a cult?

The 13th step is re-addiction. And or a liquor stores name. 70.162.43.130 11:10, 12 November 2006 (UTC). Because knowledge is power! Dammit I'm not logged in... oh well.

[edit] Neutrality and inappropriate tone

PTSD is thought to be a common cause as is ADD/ADHD, and bipolar disorder. Some research is being done on the subject, more needs to be done.

I've added these tags for the above, and likely others. - FrancisTyers · 11:42, 7 June 2006 (UTC)

[edit] Generalizations

Under "The basis for addiction" and "The chemicals responsible" sections it says "Addictive substances, through various means and to different degrees, cause the synapses of this system to flood with excessive amounts of dopamine, creating a brief rush of euphoria more commonly called a "high". " and "The CREB protein, a transcription factor activated by cyclic adenosine monophosphate (cAMP) immediately after a high, triggers genes that produce proteins such as dynorphin, which cuts off dopamine release and temporarily inhibits the reward circuit. In chronic drug users, a sustained activation of CREB leaves the user feeling depressed and dissatisfied, and unable to find pleasure in previously enjoyable activities, often leading to a return to the drug for an additional "fix". It also leads to a short term tolerance of the substance, necessitating that a greater amount be taken in order to reach the same high.". These are assuming that all addictions to addictive substances is mediated by dopamine and this is just not correct. There are many factors and not just the dopamine reward system that make people keep taking addictive substances, sometimes having nothing at all to do with dopamine. While this is obviously a main factor it should be mentioned that there are other factors, different receptors in the brain, that cause this behavior. One example of addictive drugs that aren't mediated by dopamine are dissociatives such as ketamine, nitrous. dextromethorphan and pcp. Also I would like to suggest that the list of addictive substances be fixed, it says analgesics but also puts various popular opiates which are analgesics. Also the list is just very incomplete, if you are going to list individual substances there are thousands of addictive ones (think analogs), perhaps it should be like: opioids, benzodiazepines, cannabinoids, monoamine compound such as tryptamines(addiction potential debated) and phenthylamines(or more specific such as phenethylamime stimulants, psychadelics, empathogens, antidepressants) (although phenethylamines and tryptamines may be the objects of addiction in a few idiosyncratic cases, they are not at all addictive to most people) etc. It also could be listed by the receptors that mediate its effect: Opioidergics, serotoninergics, dopaminergics, gabaergeics, adrenalergics etc. Also another thing that should be included somewhere is the fact that food acts like a drug to the bodies neurochemistry and is addictive as well.

[edit] Sources

I've added the unsourced tag, as the article appears to have no sources, and is mixing up its terms e.g. being addicted to and dependent on a drug are not the same thing. SlimVirgin (talk) 13:33, 17 July 2006 (UTC)

To people who are going to be improving this page, please keep in mind that although many of the "facts" are false, there are many that are true but not worded properly or with neutrality. For instance the statement "Experts on addiction say that the use of LSD and psilocybin causes neither psychological nor physical dependency" is untrue, for LSD and psilocybin can cause a psychological dependency of sorts, and not necessarily the same type of psychological dependency experienced by users of other drugs such as cocaine. However, I believe psychedelic drugs by nature do not cause physical addiction, and I also believe most research agrees with me. Don't take my word for it, just do your own research and don't be too quick to remove something.

[edit] Addiction is Distinct from dependence

To be addicted you must 1. find that stopping the drug is unpleasant while at the same time find that 2. continuing the drug is causing more harm than good. Dependence is just the fact that suddenly stopping the drug causes unpleasant symtoms which are to some degree an impediment to stopping. Both addicts and people who take valuable, helpful medicines are dependent on their drug. If the drug causes more good than harm, then you are dependent, but not addicted; if the drug causes more harm than good, then you are addicted. Taking a drug that apparently causes neither more harm than good, nor more good than harm, would tend to be viewed as addiction, because in reality it causes more harm than good: the cost of the drug, and any bodily damage it causes, no matter how slight, may be viewed as harm. Not to mention the waste of time spent on taking a drug that provides no benefit. --Nomenclator 23:25, 8 December 2006 (UTC)

a more correct definition afaik is 1. you have lost control of your drug usage and 2. you are continuing despite adverse consequences. physical dependence is defined as "stopping the drug produces withdrawal symptoms, which isn't the same thing at all and afaik isn't even the most important factor in the definition of addiction. Benwing 04:51, 8 January 2007 (UTC)

Nomenclator's defintion looks pretty good to me. Doesnt tell us, however, who it is that is really qualified to diagnose, the drug user, or some supposed expert. What I experience as benefit may be perceived as harm by another, and vice versa. Laurel Bush 16:45, 8 March 2007 (UTC).

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