Addiction

[syedamuhibzahra]

What do you think, taht drug addiction is a disease or chracter defect?

[Mike Askew]

I would say its both.

The chemical addiction caused in the body I would say is more like a disease.

But the lack of will power to pull the individual off the drug is more the character of the individual.

My view anyhow.

[mike_2000_17]

I would say neither.
The two words you've chosen are really bad to describe what addiction is (drug or otherwise). A disease usually implies either a virus or an infection, i.e., some kind of foreign organism (pathogene) spreading in your body. Addiction is nothing like that at all. And the word "defect" is usually associated with something permanent and genetic, like a birth defect. Again, addiction is a behavior that can be learned from others or develops on its own, and can be unlearned or tamed. I find that the tone of the terms you chose to use are pejorative.

At most, addiction is classified as a disorder (and a rather mild one at that). I think that officially drug addiction, specifically, is classified as a "substance use disorder". Personally, I think it's a stupid classification. Besides chemical dependence that some drugs cause (mostly tobacco, cafeine, cocaine, and opiates (heroine, morphine, oxycontin, etc.)), which isn't nearly as strong as people think, the main component of a drug addiction is just the behavioral addiction, which, generally speaking, could involve anything, not just drugs. You can be addicted to sex to the point that it ruins any relationship you try to have, you can be addicted to shopping to the point that it has you go bankrupt, and you can be addicted to a whole lot of other things (some more harmful than others, or less conspicuous than others). I would classify addiction as a personality disorder, that is, in the same category as things like eating disorders, obsessive-compulsive disorder, chronic anxiety, etc., with varying degrees of severity, of course, from just a personality trait (i.e., a tendency to...) to a full-blown disorder (i.e., a significant impediment to function normally in society).

[Reverend Jim]

@mike - I imagine that you will be getting lots of blowback for your views on addiction (which I happen to share). I think that there are certain substances, such as nicotine, that can produce powerful cravings when intake is stopped. The cigarette companies used that fact for years to increase usage by boosting nicotine content, then dropping it so that the smoker would have to increase his/her intake to get the same "high". However, I feel that the term "addict" has become much overused. I have come to loathe words ending in "-aholic". Too many people use this pseudo-addiction to excuse bad behaviour. "I can't help myself. I'm a shop-aholic". People now use the label "addict" as an excuse not to change their behaviour.

As for the term, "disease", I, too, used to cringe when this word was used to describe just about every condition under the sun. The actual medical definition of disease is any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown. This is more obvious when you parse the word as dis-ease rather than disease. Clearly this does not require a virus or pathogen.

But I still cringe when I hear alcoholism described as a disease. It's not a disease any more than hitting yourself in the head repeatedly with a hammer is a disease. Both cause a state of dis-ease in the body.

As for the original question - the OP has introduced a false dichotomy. Addiction doesn't have to be one or the other. I don't think addiction is a disease or a character defect. I think it's a choice. Over the course of twenty years I saw a good friend, through abuse of alcohol, go from a highly paid technical job (he was a double honours graduate in math and computer science) to homeless. Every drink he took was a choice.

[mike_2000_17]

It's not a disease any more than hitting yourself in the head repeatedly with a hammer is a disease.

Hitting yourself in the head repeatedly with a hammer is a symptom. Probably of a mental illness of somekind. I think that is the core of the issue. Drug addiction is neither a disease or a defect for the simple reason that it is not a cause, it is an effect or symptom, a mere expression of an underlying disorder. I think the underlying cause is more akin to things we generally classify as personality disorders, like eating disorders (e.g., anorexia) and OCD. These kinds of disorders are very complicated and develop for different reasons, and come at varying degrees of intensity (e.g., some people are just a bit obsessed with cleaning, others are terrified of leaving their house, fearing the dust they'll find on the sidewalk).

But I still cringe when I hear alcoholism described as a disease.

I agree. People label alcoholism or drug addiction as a "disease", "character defect", or even "demonic possession". These all make me cringe because these labels 1) act as a scape-goat ("not my fault, I've got a disease"), 2) divert attention from the true cause (just fighting the symptoms), and 3) creates an "us versus them" mentality (or "sane versus insane"). And I especially hate hearing that religion is the miracle cure for it, as does the AA or Narconon, when all they do is make you feel even worse about being an addict just to strap the shackles on while your down.

I think it's a choice.

Watch out, you're starting to sound like Deepak Chopra. "Choice" sounds nice and all, but it doesn't mean much. It is such a complex process to "make a choice". Not to mention denial, a very powerful thing, that essentially robs you of many choices you could make. Then, brain chemistry can come in as a big cloud of fog, and all you can do is put one foot in front of the next, not seeing the precipice ahead. Then there are social pressures, good or bad. And so on so forth. The point I'm getting at is that making good choices is an up-hill battle for many, and requires certain skills and willpower that some people lack, but it is something you can fix and train to get better at. It's easy to say "every drink he took was a choice", it's harder to ask why he couldn't manage to make any other, better choices. That's the job of a psychologist, IMO, 'cause it's certainly way too hard a question for me to answer or investigate.

[stultuske]

the addiction itself ... I agree that isn't really an illnes nor a character flaw ...
however, the fact that you capparently couldn't live your life without "at least having to try", that IMHO is a character flaw.

the downsides of smoking/drug use/... are well documented and known to everyone. unfortunately, a lot of kids seem to be unable to remember all of this when some other kids say "duude, you really gotta try this, it's reaaally kewl. Oh, you don't smoke, what are you, a nerd?"

and, even more unfortunate, those kids actually think that they have to prove themselves to that group, to show they are "cool" enough to hang out with them, with all the consquenses of it. I've been called terms like a "loosah" and such in high school, because I didn't want no cigarettes or joints. ("They're harmless, just have a hit. just because you smoke cigarettes or joints doesn't make you an addict, nor does it force you to use stronger stuff later on.")
well, pointless to say, I'm still alive and kick'n. The kid who told me that, however ...

[Reverend Jim]

Hitting yourself in the head repeatedly with a hammer is a symptom. Probably of a mental illness of somekind.

Possibly Lesch-Nyhan syndrome; something I got to see first hand while I worked at the Rehab Centre for Children. What I had in mind was the old "banging your head against the wall because it feels so good when you stop" scenario which is most definitely a choice. The hammer thing was a bad example.

I think the underlying cause is more akin to things we generally classify as personality disorders, like eating disorders (e.g., anorexia) and OCD.

Things like OCD are not necessarily classified as personality disorders even though the underlying mechanism is not understood. For example, I have Tourette's. Fortunately not severe (the bursts of swearing type is actually quite rare in spite of what you see on TV). There is a specific set of criteria (age of onset, type and variety of tics, etc) that define the syndrome. Tics can be suppressed for a time but not denied - like trying to suppress a sneeze. Whereas the alcoholic gets some (perceived but not actual) benefit to drinking, there is absolutely no upside to expressing Tourettic behaviour (which, by the way, is considered more "unvoluntary" than "involuntary").

some people are just a bit obsessed with cleaning, others are terrified of leaving their house, fearing the dust they'll find on the sidewalk

I believe these are referred to as spectrum disorders

Watch out, you're starting to sound like Deepak Chopra.

Now you're getting nasty ;-P. I still believe that the first drink or two is a choice. The friend I referred to earlier had no trouble staying sober as long as he had no booze. Trouble was he could only do extremes - no booze or too much. But that first drink was always a conscious decision. And he made that decision knowing what that first drink would lead to.

it's harder to ask why he couldn't manage to make any other, better choices

Yeah. He wasn't too good at that either. His finances were a mess and not just because of the drinking.

[nitin1]

how can you all write too much in the posts ? there can be 2 cases: either your typing speed is too fast or you have someone to type for you. i mean don't you feel lazy ? :p

P.S i am just kidding,don't take seriously :-)

[Reverend Jim]

how can you all write too much in the posts ?

Way too much free time.

[nitin1]

hahahaha... but why is it so ? are you kidding or is it true ?
i don't think you have even time to sleep. ;)

[Reverend Jim]

Sleep is highly over-rated. Coffee, on the other hand, is under-rated. Seriously, one of the benefits of retirement is you can pretty much set your own schedule. If I wake up at 3:00 AM then I can browse/answer questions for an hour or so then sleep in the next morning. Some days are busier. On some days the weather is just too nice to spend it inside. Today is crappy outside so I'm just lounging around. Occasionally I might just nod off in the middle of a sentencccccccccccccccccccccccccccccccccccccccccc

[nitin1]

hahahahahahaaaaaaaa.... that's damn funny. i burst out after reading last sentence. :p LOL.. why do you wake up at 3:am . i think that is a time for a deep sleep . :D

[Reverend Jim]

why do you wake up at 3:am

When you get to my age you'll know ;-) Been a while since I pulled an all-nighter (means something totally different to a 20 year old than a 60 year old).

There are very few things in life that are a choice... We as humans are tempered by our desires... Most of the times we can't act on our desires because of social pressures or health issues.

I'm sure we've all passed a few hotties in the supermarket and thought, 'wow would I like to get into that', but of course our girlfriends or wives would have something else to say.

Drugs, I experimented with my fair share... I'd probably carry on smoking tobacco if it wasn't proven to be linked to cancer. Now, addiction is a funny thing because to one person it might be easy to quit to another it's hardest thing on earth.

The exception is heroin addicts. Now their addiction is different from other addictions because that actually happens to be a physical dependancy. The user actually becomes violently sick if they're not high.

When you go into the realm of psychological dependancies it gets real complicated. The brain is such a complicated organ, so many factors can influence a person's choice. Environmental factors and inborn characteristics. The worst part is logic fails to make an impact. We see alcoholics on some reality TV show and immediately think to ourselves,'What a loser, why don't they just quit drinking... They've lost their entire family wife and kids.'

To some this is enough to wake them up, to others it's not. But these addictions don't just happen from no-where. There's a history and a whole heap of environmental factors that a person has experienced which is probably why they're an addict.

Any time I see an addict, I see a person with deep seated issues. Addicts are generally 'using' to mask a painful memory,experience or unhappiness in their lives.

People who see an alcoholic view 'drink' as being the problem. It couldn't be further from the truth. The real problem lies beyond this... this is what shrinks are paid to get to the root of. And they have to do this without actually telling the person what their problem is. That person has to come to a realisation by themselves and this is the hardest part of their jobs.

[Reverend Jim]

There are very few things in life that are a choice... We as humans are tempered by our desires.

I strongly disagree. People who say "I had no choice" when things go bad are really saying "I knew it was wrong and I did it anyway". If I spend five hours a night in front of the TV instead of trying to better myself either mentally or physically then that is my choice. If I drink six bottles of Coke a day and scarf down doughnuts at the office then develop diabetes as a result of my obesity then that was my choice. If I spend $400 a month on booze (as my friend was doing) instead of paying off my credit cards and mortgage then that is my choice. If I buy a status car like a Mercedes or BMW, or a gas guzzling SUV that I can't afford instead of a cheaper car (or a bike or a bus pass) that I can, then that is my choice. I choose whether to spend $40 on a nice restaurant meal or prepare a meal at home for a fifth of the cost. If I have a desire then I choose either to act or not to act on it.

Granted there are some choices that are actually no choice at all. For an poor inner city kid the choice may be get with a gang or get dead. Not a lot of choice involved there.

addiction is a funny thing because to one person it might be easy to quit to another it's hardest thing on earth.

Very true, but each cigarette that led to the addicted state was a choice. Each dollar I spend foolishly that gets me further into debt is a choice. It doesn't matter that each cigarette and each dollar gets me into a deeper hole that gets harder and harder to climb out of. Each step is a choice.

The exception is heroin addicts. Now their addiction is different from other addictions because that actually happens to be a physical dependancy. The user actually becomes violently sick if they're not high.

I have friends in medical research who have told me that heroin withdrawal is not as severe as portrayed on TV and the movies. They say that in most cases the physical symptoms are pretty much the same as a severe bout of flu. It's the psychological craving (such as with alcohol) that draws you back in.

Addicts are generally 'using' to mask a painful memory,experience or unhappiness in their lives.

I agree. The drug of choice fulfills a need. For many it's an escape, at least temporarily. That's why successful rehab programs must address not only the physical addiction but also the conditions that led to the addictive behaviour. It takes time to change addictive behaviour. That's one of the reasons fad diets for the most part are unsuccessful. It takes weeks to train your body into a new way of behaving. A one week crash diet might get you to drop those few pounds but chances are you'll put them right back on when you go back to your old routine.

[Xantipius]

I'm a heavy smoker (30-40 cigarettes per each 24 hours), since my 19.
I like very much dry red wines, but it is too costly for my wallet.
Don't know what to say about the beer; maybe I've never drunk/met a true beer.
I don't like the vodka (our native drink/plonk) and all of this kind.
Of course, except of cognac :) Also I'm a black tea addict.

[Xantipius]

We as humans are tempered by our desires...

As Oscar Wilde once said: I can resist to anything, but temptations...

[mike_2000_17]

@Reverend Jim

Very true, but each cigarette that led to the addicted state was a choice. Each dollar I spend foolishly that gets me further into debt is a choice. It doesn't matter that each cigarette and each dollar gets me into a deeper hole that gets harder and harder to climb out of. Each step is a choice.

As we would say in French, that train of thought leads you to the tip of your nose, but no further. I don't understand your obsession at making that point. If anything, it is a trivial point that means nothing. Except for automated actions like breathing in and out, or making your heart beat, everything anyone does is a choice. A statement like "each step is a choice" is literally saying "each action is an action", a completely worthless point to make, let alone insist on. It is the reasons for making the choices that you make that are worth discussing.

If your point is about owning responsibility for your situation or something like that, then you should make that point with clear language rather than vague and meaningless sound-bites.

I have friends in medical research who have told me that heroin withdrawal is not as severe as portrayed on TV and the movies. They say that in most cases the physical symptoms are pretty much the same as a severe bout of flu.

I've heard that too, just like having a really bad fever for a few days. Nicotine withdrawal is similar but much milder, like having a mild fever for a couple of days. I know from experience. Increased sweating, mild chills, a mild headache, and a slight lack of concentration. Nothing terrible, not even to the point of calling in sick, just a discomfort for a few days.

[nitin1]

@jim hahaha... am just 18 today.. so, it's damn damn long time for realizing this thing :-) isn't it ? :-D

[GrimJack]

Maybe, just maybe, some of you should do just a little research rather than pull ideas out of your nether region. Here is an abstract that is readable for people who have a 2-year degree or above. Addiction is a complex interaction of neurotransmitters built on biological circuits designed to initiate and maintain survival behaviors. Now I understand that you have to accept evolutionary theory to progress past the (stupid) moral idignation. I could wire your brain with a reward circuit you could stimulate with a button and you would die happily within a week (of course, not me personally - I couldn't actually do the surgery).

Better yet, how many of you have coded for days on end, barely stopping to eat or drink? That is the reward circuitry at work - or gamed for that long. The abstract even breaks down the addictions into nicotine, stimulants, alcohol and opiates.

The OP asked the wrong question, created a logical fallacy called False Dilemma - giving us 2 choices that are not even relevant.

[Mike Askew]

@Jim, sorry on the delayed reply completely missed anything being aimed at me lol.

When given the words used by the OP that would be how I would choose to describe addiction, however, I do agree with the majority of the thread that there are better ways to describe it also.

[Reverend Jim]

I am aware of studies that show rats will happily choose a lever that stimulates their pleasure centre over a lever that gives food. The rats will starve to death because the pleasure reward is stronger than the food reward. However, people are not rats. People are able to weigh consequences. I would happily eat all of the foods that are bad for me in the long run - foods that cause obesity, arterial blockage, high blood pressure, etc. Studies have shown that these foods (salt, fat, sugar) are highly addictive. Yet I can choose to either eat these foods in moderation or not at all. Those people who blame McDonalds for making them fat and try to sue are greedy, stupid or both. Or perhaps they are just being taken advantage of by lawyers. It is like someone today suing the tobacco companies because they didn't know smoking caused cancer.

Addiction may be "a complex interaction of neurotransmitters built on biological circuits designed to initiate and maintain survival behaviors", but so is every other function of the human brain. I will grant you that there are some people whose brains are just wired "wrong" and that makes them less able to resist the siren call of their addiction but claiming that we are all powerless because of biology is just nonsense. By and large we all choose our behaviour.

Now I understand that you have to accept evolutionary theory to progress past the (stupid) moral idignation.

This was a pleasant exchange of ideas and opinions. Let's not drag it down to the level of name calling.

The OP asked the wrong question, created a logical fallacy called False Dilemma

It's actually called a false dichotomy (which I already pointed out). Do your research.

[Xantipius]

My BMI (body mass index) <= 18.5 ("underweight"), my height is ~183 cm,
meanwhile I like very much the lard / schmaletz, with rye bread & salt.

[Reverend Jim]

I hope you are as happy with your choices as I am with mine.

[GrimJack]

Jim, since you asked me to do my research

A false dilemma (also called false dichotomy, the either-or fallacy, etc.)

I will change the parenthetical 'stupid' and say that argument from moral idignation does not really have a place in an exchange of ideas for many reasons including it allows for no introduction of contrary evidence. But if this is just chatting about how you feel about stuff, it is acceptable.

Your description of addiction vs choice does seem a little simplistic; studies on smokers who quit seem to imply that there is something a little more complex going on. Studies seem to imply that 40% of smokers who have quit are smoking again 2 years later (but such longitudinal studies are few and far between - other studies show 2-10% depending on age). One of really important lines from the end of the study is

More important, we were unable to identify a duration of abstinence after which former smokers had no risk of relapse. Thus, no definition of successful cessation can be absolute.
Once an addict always an addict, I guess - just like AA says.

I understand that anecdotal evidence is highly suspect but after being a smoker for 20 years, I have been a non-smoker for 22 years (with a short interval about 5 years ago when I realized I was inhaling my Cuban cigars so I had to cut them out). I could easily become a smoker again but I won't because I have promised myself I can start again when I am 104 (only 40 more years and I can have that wonderful, beautiful first puff again - I still enjoy walking past a smoker when he/she lights up - that first puff takes me back to when I was 6 sitting in a combine hopper smoking with my brother).

Another question that may need to be asked is: what is addiction?
Is watching porn an addction? Most people seem to consider smoking and opiate use to be addictions but not everyone agrees that alcohol use is.

Gotta go - we left our kitty with friends while we were in Argentina and have to pick her up.

[Xantipius]

Not all so simple with tobacco smoking as it seems at first glance.
Medical statistics says: those who smoke 1-10 cigs/day ("moderate smokers")
live longer than absolute non-smokers.
Also, smokers never suffer from Altzheimer's, Parkinson's deseases.
Smoking mothers have no babies with Downe's desease.

PS
Many years ago I met a quote from "Thorax" (an american medical monthly) stating that:

To quit tobacco smoking is harder than to stop doing heroin

[Reverend Jim]

But if this is just chatting about how you feel about stuff, it is acceptable.

That's all I'm doing here. Just expressing an opinion. I agree it's a complex issue and no study will be definitive. I've never suffered from an addiction so I can't say first-hand what it is like to be deprived of ones "fix". I do know smokers who have quit and they say it was difficult because of the cravings. Part of the problem was the "routine" part of it. For example, "I always have a cigarette with..." or "I always smoke while...". Closest I've come is with coffee. I'll drink four cups in a morning, every morning. But when my routine is broken (traveling or whatever) I can go days without coffee and not miss it.

Your description of addiction vs choice does seem a little simplistic; studies on smokers who quit seem to imply that there is something a little more complex going on

Perhaps it is simplistic. That doesn't make it wrong. I hate to harp on the "choice" thing but those smokers quit because they chose to. There are smokers who choose not to. Are you saying that the physical addiction is that much stronger in those individuals than in those who successfully quit? If so, how can anyone quantify that?

Another question that may need to be asked is: what is addiction

That's an excellent question and the definition is very fluid. Here's where my irritation sets in. I hate it when people use the "addict" label to avoid having to take responsibility for or change questionable behaviour. I have no problem when someone claims to be addicted to narcotics, etc. I think that is a perfectly legitimate use of the term.

[logo32design]

I think both because when you start drugs its character defect and with the passage of time its becomes a disease and with our proper treatment you never becomes a prefect person.

[Reverend Jim]

As we would say in French, that train of thought leads you to the tip of your nose, but no further. I don't understand your obsession at making that point. If anything, it is a trivial point that means nothing.

When someone makes the comment

There are very few things in life that are a choice

I think it deserves a response other than "No. You're wrong". As for a trivial point, the debate as to whether free will is actual or illusory has been going on for centuries. That hardly makes it trivial.

There are very few things in life that are a choice
I think it deserves a response other than "No. You're wrong". As for a trivial point, the debate as to whether free will is actual or illusory has been going on for centuries. That hardly makes it trivial.

Yes exactly. I was referring to the bigger picture.

Take for example, when you walk into a coffee shop. What makes you order an expresso rather than a hot chocolate? Or when you're walking in a supermarket and you always pick up roughly the same items for your weekly shop.

There are many factors influencing our decisions. Advertising, experience, cost... Sure we call it free will, 'I'm going to choose to order a tea today instead of a hot chocolate but I always order a hot chocolate.' Why?

Which is why I came to the conclusion that very few things in life are a choice. Our actions are tempered by our desires and life experiences.

Take for example, your typical drug addict. Sure I can confidently say if I was offered heroin I would NEVER take it.

But what if my situation was different. What if I was abused as a child. What if I didn't have a job. What if my social circle of friends were all druggies and they just told me about the most amazing high that beats anything in this world. What happens if that particular day I was feeling like I wanted to end it all but someone offered me this amazing rush! Could I then say I would never take heroin?

Honestly, I don't know and thankfully I'll never be in that situation to ever find out.
This is why most people with addictions (alcohol or drug dependancies) are rarely just addicts by choice.

But I do understand that some addicts turn their lives around. Is this their choice? Or again was there a situation or turning point which caused the chain reaction?

It's a long running sociological debate. These questions have no black and white answers.