Category: General

Defining Addiction: What are the necessary attributes?

09/15/12 | by the professor [mail] | Categories: General, Nomenclature

Link: http://AddictionScience.net

We have chosen to define “addiction” as a behavioral syndrome where drug use and procurement seem to dominate the individual’s motivation and where the normal constraints on behavior are largely ineffective. There are other important attributes of addiction that are usually included in various definitions of this term. The question of interest is whether other attributes are necessary components of a formal definition or whether they add needlessly to the number of terms used to define what we mean by “addiction.” Succinct definitions not only ‘save words,’ but they keep the focus on the primary variable(s) of interest and help to prevent confusing effects with causes in our definitions. The definition adopted here is less than 25 words, and there are definite advantages to keeping definitions sufficiently short so as to simply memorization and to facilitate accurate conveyance amongst those discussing the same phenomenon. One of the biggest challenges to any discourse, whether it be lay, academic or professional, involves semantics or making sure that all parties are actually discussing the same thing. Succinct, consensually accepted definitions facilitate conversations at all levels.

The “Pizza and beer” syllogism is perhaps the most famous example illustrating how a statement that seems logically correct leads to an erroneous conclusion.

  • Pizza and beer are better than nothing.
  • Nothing is better than going to heaven.
  • Therefore, pizza and beer are better than going to heaven!

The syntax is logically correct, but there is a breakdown in semantics involving the meaning of the word “nothing” that invalidates the apparent conclusion. In the first context “nothing” refers to “the absence of anything,” while in the second context it refers to “no-thing.” It is critically important to avoid these types of semantic breakdowns in discussions of addiction, and thus the need for a concise definition that identifies the defining attribute(s) of an addiction while relegating the others characteristics often included to descriptive text.

Addiction is often defined as “a chronically relapsing disorder” or “disease” (whether addiction is indeed a “disorder” or a “disease” is a point of considerable debate in itself; see Drug Addiction as a "Disease"). The phrase "chronically relapsing" certainly describes an important characteristic of an addiction, but is it necessary in a concise definition? The intense motivational strength of an addiction not only predicts the high relapse rates, but it also predicts other attributes of addiction such as motivational toxicity which describes the drug’s impact on normal motivated behaviors such as eating and sexuality. The fact that a single attribute (i.e., motivational strength) can predict from simple logical deduction several other characteristics that are commonly seen in addiction makes this single attribute more valuable as the defining characteristic than is compiling an unnecessarily longer list of characteristics for inclusion in the formal definition of addiction. These other commonly observed features are perhaps best considered simply “characteristics” of an addiction because they can all be derived from the single defining attribute (i.e., high motivation for drug administration). This same logic also applies to adding “motivational toxicity” to formal definitions of addiction. While it may appear to be a defining characteristic, the motivational toxicity inherent in an addiction can also be predicted by simply understanding that addictive drugs produce an intense motivational state and thus even if they lacked their ability to blunt the rewarding impact of natural rewards they would still seemingly overtake the normal motivations in the individual’s life. The same might be said for the second characteristic included in our definition, specifically, that “the normal constraints on behavior are largely ineffective,” but this phrase not only underscores the intense motivation to obtain the addictive drug but also reminds the reader that motivational strength is reflected not only in how hard one will work for the goal object but also by the willingness to overcome aversive conditions which might normally inhibit goal-directed behavior.

Other considerations for inclusion in a comprehensive definition of addiction include the addict’s perceived sense of a “loss of control.” Again, this variable might be deduced simply by considering that the normal choice perceived when several, closely competing goals which vie for the individual’s ‘attention’ and behavior are obviated by a single, overwhelmingly strong motivator—the addictive drug. In other words, the cognitions associated with classic approach-approach and approach-avoidance conflicts might give rise to a sense of ‘choice,’ and these conflicts are less prominent in cases where the motivation to ‘approach’ the goal object (in this case, use the drug) is so strong as to dominate unquestionably the other motivations. In such cases the perception of choice might be absent and the individual may feel that they no longer have control over their own behavior, but rather, that they are being driven by some external force. In a sense they are correct—the stimulus properties of the drug and other cues in conjunction with the (largely unconscious) anticipation of reward engage the individual’s behavior in a manner consistent with the notion of “enslavement” to the external agent (i.e., functionally the drug is serving as the ‘master’ and the addict as the 'slave'). As discussed elsewhere, this apparent “enslavement” is consistent with the etymology of the term “addiction” and adds credence to the use of the term in this fashion as opposed to the popular misconception of “addiction” as physical dependence upon a substance.

The last consideration that might be addressed by our definition of addiction is whether we consider it a disease or a disorder. The definition used here avoids this debate by simply defining “addiction” as a “behavioral syndrome.” Whether it is truly best considered a disease or a disorder is moot for our definition which emphasizes the behavior of the individual as being the primary descriptive variable and hence is consistent with the term’s etymology of "addiction" as "enslavement." As discussed elsewhere, the disease-disorder debate resolves down to one largely of who ‘owns’ the territory—the medical establishment or psychologists, counselors, and social workers (see Drug Addiction as a "Disease"). There are of course other important considerations for whether a pathology is considered a disease or disorder, such as locus of control—biological or more “psychological”—along with the ensuing implications of how to best approach treatment and the degree of individual responsibility for their own ‘problem’ (e.g., the use of the term “disease” implies that the individual has relatively little control over the course of the pathology and that some external treatment is necessary to remediate the problem). There would appear to be no advantages to including the term “disorder” in a formal definition of addiction, but additional characteristics conveyed by the use of the term “disease” merit further consideration for future revisions to our ‘working’ definition. On the other hand, the use of the term disorder would imply that addiction is not a disease, while the description as “a behavioral syndrome” avoids pronouncement on this hotly debated topic.

It is always tempting when formulating definitions to be all encompassing or at least to describe enough of the phenomenon under discussion to vividly illustrate its many facets. Indeed, the more one knows the more eagerly one tries to share their knowledge with anyone and everyone who will listen. Understanding the many aspects of addiction, something shared by more than a few researchers and clinicians, seemingly implores one to offer mini-lectures or tutorials at every opportunity. And when it comes to formal definitions, the desire to share all often gets the best of even academic scholars who should understand well the need for concise definitions devoid of superfluous adjectives. Nonetheless, multifaceted phenomena like addiction are often described from the perspective of individual disciplines studying only one or a few of its many features without trying to identify a common underlying variable responsible for the various attributes.

In this way most definitions focus too much on the vicissitudes of addiction which distract from the core phenomenon responsible for these other, secondary characteristics. Indeed, this often overshadows the primary characteristic of an addiction. In other words, the motivational characteristic of an addiction (which is used here as the basis for its definition) produces the other features such as “chronically relapsing disorder,” the addict’s “perceived loss of control,” and even the “motivational toxicity” inherent in an addiction. Inclusion of these other, secondary characteristics tends to obscure the primary characteristic of the addiction and in some respects seemingly confuses its effects with its cause (i.e., the intense motivational strength can be viewed as the cause and these other features as effects of the addiction!) This is an example of why good science strives to simplify things, to render them in their simplest, not most complex, terms; good definitions like good theories retain a vision of “the forest for the trees,” hence not letting the details obscure the bigger picture. In case anyone is still wondering whether a useful definition of addiction can be resolved down to just 25 words or less the answer is yes, indeed it can, and we are better off ‘keeping it simple stupid’ to ensure the semantic integrity of our discussion of this seemingly complex, multifaceted phenomenon.

So what do we have nearly 1400 words later when we’ve finished with this relatively brief examination of the terms frequently used to define addiction? We’re right back where we started: “addiction” can be defined as a behavioral syndrome where drug use and procurement seem to dominate the individual’s behavior and where the normal constraints on behavior are largely ineffective. The difference between the closing and beginning positions of this discourse lies in the certainly with which we succinctly define addiction—acknowledging the phenomenology of these other important attributes, but rendering their incorporation into a formal definition of addiction (albeit a ‘working’ one) unnecessary.

The podcast of this presentation can be downloaded from our ASNet Podcast Directory.

Click here to listen to the podcast without downloading (length: 11min48sec). Click on the ASNet podcast logo (Anpu) to pause the imbedded player.

Other related commentaries:
A Primer on Drug Addiction
Distinguishing Drug Abuse from Drug Addiction
Drug Addiction as a "Disease"

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ASNet Update 12L12

09/12/12 | by the professor [mail] | Categories: General, Announcements, Drug-Regulation Policy

Link: http://AddictionScience.net

A new podcast has been added to the AddictionScience.net website. In upcoming weeks we will be exploring this technology and assessing reader interest in producing additional podcasts. The first podcast simply presents scripted material already available from our web pages entitled "A Primer on Addiction" and "The Nature of Addiction." Click here to visit the ASNet Podcast Directory.

A new commentary is also available on drug regulation policy: New Opiate-Based Medication Prescribing Guidelines?. This is the first of what we expect to become an on-going discussion on the tightened regulations for opioid-based medications and the impact on those needing these drugs. Please see the commentary for our initial position statement and feel free to post your remarks in support or against maintaining widespread access to opioid-based medications.

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Unscheduled Service Disruption to all ASNet Resources

06/16/10 | by the professor [mail] | Categories: General, Announcements

We may experience a temporary shut-down due to server overload. We are trying to plug a 25+ GB hole in our online discussion forums (which includes several others in addition to this one) that is depleting our computer resources and may produce an effect similar to a denial-of-service attack. This is caused by nuisance posts that attempt to increase traffic to offending websites by linking back to our posts. The comments usually have no obvious connection with the initial commentary (e.g., "good post," "love to read more") and must be manually deleted, often one-by-one.

We will now be more vigilant in 'policing' our discussion forms, routinely deleting posts that do not make specific reference to the content of the individual commentaries. We will also preview posts before allowing them to be published. This is perhaps the most effective method of decreasing this type of spam combined with using an updated list of known spammers. If the problem persists, we may require registration for posting comments. If the problem further persists, we will disallow trackbacks to commercial resources including those involved in drug addition treatment and related services.

We apologize for removing any legitimate posts that are inadvertently deleted. (Your legitimate post might be buried amongst thousands of spam postings.) We do not wish to 'moderate' the content of this discussion forum beyond preventing keyword spamming. If your post is deleted by mistake, please make sure that you are registered and logged-on and then post your comments again. Meanwhile, we have been working through the night and much of the day to prevent a service outage from these malicious web-promotion services.

In the unlikely event that we ever become so popular that we actually require an additional 30 GB of bandwidth, we will be happy to pay for the expanded service. But we certainly are unwilling to pay to promote offending websites while they liter our discussion forum. And of course, resources here are very limited and that's the primary reason lead commentaries and replies have been so sparse this past year. Hopefully time will permit further developing the content of this discussion forum later this summer. Meanwhile, we appreciate your viewership, your active participation by posting, and your patience with this project.

Cheers and sorry for any inconvenience,

"The Professor"

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E=mc(2) and the Science of Addiction

04/14/09 | by the professor [mail] | Categories: General

Laymen and professionals alike often ask for a quick synopsis of what causes addiction—a succinct summary resolved down to 25 words or less. The problem is that addiction, like many behaviors, is far too complex for such a simple rendering that is easily understood beyond its most superficial context (see the closing remark for a brief, 25-word summary of the cause of addiction). And ironically, what is perhaps the most complex endeavor of science (i.e., the study of human behavior) is usually considered so simple by most people that anyone without proper training should be able to grasp instantly its most complex principles and corresponding explanations of behavior. So goes the science of addiction.

One of Einstein's most famous formulations in theoretical physics is expressed simply as E=mc(2). This elegantly illustrates how complex theories in science can sometimes be resolved down to very simple expressions. And while most well-educated students may be able to recite the terms in this equation (i.e., "the amount of energy released equals the mass times the speed of light squared"), few really comprehend its meaning beyond the most superficial terms.

Psychology is far more complex than theoretical physics. Not because of the detailed mathematical derivations upon which it is based nor even the I.Q. points necessary to seriously ponder its most advanced principles, but because of the number of variables that must be considered with even a seemingly simple behavior. (In physics, this is analogous to the number of simultaneous equations that must be solved to resolve the problem.) Einstein is reported to have considered physics relatively simple (pun added ;), apologies to Prof. Einstein), but he considered behavior complicated. So if Einstein considered what most of us consider complex as simple and what most people consider simple as complex, how confused is the state of science today?

Understanding drug addiction, like understanding most aspects of psychology, requires years of careful study which builds upon certain elementary principles and extends to theoretical formulations which fill the gaps in present knowledge. Some topics like drug addiction require additional training in behavioral neuroscience and in psychopharmacology to really understand 'how drugs work in the brain' to produce the strong motivational effects that define addiction. One of the most surprising aspects of my course on Drug Addiction for many undergraduate psychology majors is that "drug addiction involves the action of certain drugs on the brain!" And may the gods of knowledge protect the educator who attempts to explain to the average drug addict that THEY are not the ultimate expert on their addiction: people like to retain the misbelief that they somehow understand and control their own behavior even when faced with overwhelming evidence to the contrary. (Considering addicts, or any other individual for that matter, to have a real understanding of the causes of their own behavior derived from an amateurish 'self-examination' is tantamount to returning the pre-20th Century psychology of introspectionism. Regression is one thing, but losing over 100-years of progress in the field of psychology is inexcusable.)

The tele-psychologists pander to this desire for a quick and simple explanation to a rather complex behavior. The attention span of their audiences, and indeed the attention span of many tele-psychologists themselves, does not permit a more detailed, scientific explanation of the behavior, and it profoundly objects to the notion that some basic understanding of fundamental principles of psychology and psychopharmacology are requisites for understanding why people take drugs. By seeming to provide quick and easy explanations for drug addiction, they do a considerable disservice to the science of addiction and to the addicts themselves (See Dr. Phil’s “Addiction”.).

True drug addiction is relatively simple to understand for those with the appropriate training. The many causes of drug abuse and misuse are more varied and are therefore much more complex. (This is one of the reasons distinguishing between drug abuse and drug addiction is important.) Even alcohol addiction is more complex than addiction to other drugs. And experimental drug use (to a limited degree) is too often seemingly a 'normal' part of adolescent behavior. The desire to understand complex behavior often exceeds the empirical database for establishing cause-and-effect by traditional scientific criteria. The extension of 'understanding' into the realm of the unknown requires sound logic based upon careful examination of the available empirical evidence and systematic theory development; such constitutes the science of addiction today. An understanding of this process simply cannot be conveyed meaningfully in a concise 25-word summary to those not adequately trained in the field, much to the frustration of the specialists, laymen and ‘professionals’ alike.

In conclusion, addiction involves differential perturbations in mesolimbic dopamine and other neural systems mediating incentive motivational processes that produce a profound incentive contrast with consequential motivational toxicity. Or stated even more simply, E=mc(2)!

Addendum

For those who are still not getting the point of the commentary let me add one last explanation of what I'm trying to convey: if I do give you the succinct, 25-word or less reply to your question that you demand, you simply won't understand the answer! Now get it? E = MC(2), a nice, succinct explanation that tells a lot in a few words or symbols but which relatively;) few people truly understand.

The above commentary is my response to those who ask for a quick and simple explanation of what causes drug addiction. Really, would anyone expect to actually understand how two little acetyl groups substituted for a couple of hydroxls on a morphine molecule makes heroin which is preferred over morphine in choice tests without having first taken organic chemistry or studied a bit on their own?! But in psychology, everybody thinks they can understand what we've spent years studying summarized in a simple, 25-word or less explanation. So what causes drug addiction?

Brain + (the right) drug x enough exposure = addiction.

Hey, I kind of like that! It's sort of Clark Hullian and I liked that dude (viz., the dominant force in mid-20th Century experimental psychology that you've probably never heard of). If you recall his equation describing motivated behavior, then you likely understand mine too.

Related on the ASNet
Primer on Drug Addiction
Biological Mechanisms of Addiction
Distinguishing Drug Abuse from Drug Addiction
Dr. Phil's "Addiction"

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Why Distinguishing between Drug Dependence and Drug Addiction is Important

03/30/09 | by the professor [mail] | Categories: General, Nomenclature

The terms drug dependence and drug addiction are often used interchangeably, but this practice leads to confusion among professionals regarding the diagnostic implications of these terms and also contributes to misunderstanding the underlying causes of substance use. As described earlier, drug addiction refers to a behavioral syndrome where the procurement and use of a drug seem to dominate the individual's motivation and where the normal constraints on the individual's behavior seem largely ineffective. Inherent in this definition is the overwhelmingly powerful motivation to obtain and self-administer the drug. And as noted earlier, drug abuse simply means that the substance is used in a manner that does not conform to social norms; the motivation to use the substance may or may not be particularly strong compared with other motivators. The causes of drug abuse and drug addiction can be the same, but they are very often much different. Specifically, drug addiction involves the biological action of a drug on brain reward and motivation systems, while drug abuse often involves other psychosocial factors with only modest direct effects on brain reward systems.

Drug dependence, in contrast to the two terms described above, refers to a state where the individual is dependent upon the drug for normal physiological functioning. Abstinence from the drug produces withdrawal reactions which constitute the only evidence for dependence. Drug dependence can involve disturbances in general bodily (i.e., somatic) function such as vomiting, diarrhea, sweating, and the resulting symptoms indicate a physical dependence syndrome which is usually specific for a given class of drug. Drug dependence can also involve disturbances in psychological functioning, such as inability to concentrate, anxiety, depression, and the resulting symptoms indicate a psychological dependence syndrome which often shares common features with other abused drugs. It is important to note that psychological dependence has a physiological basis and thus it is preferable to use the term physical dependence to refer to disturbances in somatic function to avoid confusion.

A number of substances produce psychological and/or physical dependence without producing an addiction. The therapeutic uses of certain steroids, antidepressant medication of the SSRI class, and even some antihistamines all produce characteristic withdrawal syndromes when their use is abruptly discontinued. However, there is no strong motivation to continue the use of these substances for most patients; some patients even refuse to resume treatment with such drugs because of their adverse experience during unsupervised withdrawal.

Other substances can produce a notable psychological dependence without producing an exceptionally strong motivation to avoid abstinence. Caffeine has desirable stimulating effects that involve general arousal accompanied by a mild mood elevation for many daily coffee drinkers. And while the avid coffee drinker usually chooses not to miss their morning or afternoon ‘brew,’ many voluntarily abstain when the cost is too high ($8 for a cup of coffee in NYC?) or access is difficult. The ensuing abstinence syndrome has both psychological (e.g., lethargy) and physical (e.g., mild headache) withdrawal signs, but the motivation to abate this condition is far below the level produced by highly addictive drugs such as cocaine and heroin.

Physical dependence often occurs without addiction (e.g., therapeutic use of steroids, SSRIs), and addiction can occur without appreciable physical dependence (e.g., cocaine). Similarly, psychological dependence can occur without addiction (e.g., morning coffee for millions of regular users), but it’s not clear whether addiction ever occurs without psychological dependence. And of course drug abuse may or may not be accompanied by drug dependence and addiction.

The fact that notable signs of physical dependence occur with some of the more addictive drugs (e.g., heroin, barbiturates, alcohol) has lead many to mistakenly attribute the motivation for substance use to the avoidance of withdrawal discomfort. Other drugs, such as the psychomotor stimulants, do not produce these characteristic withdrawal reactions and have helped to debunk this common misconception. Of course there are other compelling lines of evidence that physical dependence is not the primary cause of drug addiction (see Bozarth, 1989, 1990, 2009; Bozarth & Wise, 1984; Wise & Bozarth, 1987) although it can contribute to the overall motivation for continued drug use (see Bozarth, 1994).

In summary, drug addiction describes the motivational strength of substance use; drug abuse describes the misuse of a substance without explicit reference to motivational strength; and drug dependence describes the necessity of using a substance to maintain normal psychological and/or somatic functioning without reference to the motivational strength of the substance use or to whether the substance use violates cultural norms. These three terms have distinctively different meanings although there are obvious and numerous cases where all three apply to the same drug-use situation (i.e., the individual may be dependent upon a drug which they abuse because they are addicted).

Click here for the podcast of this commentary via streaming audio which doesn't require downloading.

Click here for our directory of all available podcasts.

Related Topics on the ASNet
A Primer on Drug Addiction
Biological Basis of Addiction
Hard and Soft Drugs
Distinguishing Drug Abuse from Addiction
Medical Marijuana
The Nature of Addiction

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Dr. Phil's "Addiction"

03/23/09 | by the professor [mail] | Categories: General

Dr. Phil and other tele-psychologists promote fundamental misunderstandings about addiction. Playing out in a type of public psychodrama, the inflicted guest is usually told how the problem is easily solved “if you only . . .” as the ‘all-knowing sage’ offers insight (and often resolution) within a single 60-minute episode. This kind of 'pop psychology' is replete with misinformation about addiction—what it is, its nature, and its treatment. Increased sensitivity to the problem of addiction notwithstanding, the misinformation promoted on such popular television programs as Dr. Phil and Oprah does a considerable disservice to addiction science as well as to the addicts themselves. Much of the misinformation may be promoted out of ignorance but some is motivated by commercial interests. The sad fact is that the pain and misery of addiction ‘sells’ and the turmoil of those affected both directly and indirectly is commonly exploited by the popular media: rating points go up as the tissues come out.

Addiction technology transfer attempts to narrow the gap between what is known from the science of addiction and what is commonly practiced in the clinic, promoted on talks shows, and believed by laymen in general. A primary mission of the ASNet is to help narrow this gap through its addiction technology transfer initiative. Indeed, this ‘thread’ is part of that effort. Other efforts include the Addiction Science Network website, university courses, and public lectures. And although this work may seem to have a small impact against the rising tide of tele-psychologists exploiting addiction for rating points, “it’s better to light a single candle than to curse the darkness.” So here’s a flicker of a flame which hopefully contributes to the work of others slowly narrowing the gap between knowledge and ignorance.

Some of the common fallacies promoted by 'talk show' psychologists and other popular media include the following.

  1. Addiction describes any obsession with something that is stronger than the desire most people experience. This type of fixation can occur to almost anything because it is an attribute of the individual and not related to the actual object being desired.

    This is one of the most fundamental misunderstandings about addiction and the proper use of this term. There is a wide range of motivational levels individual people express for normal rewards. Being on the upper tail of a normal distribution remains part of that NORMAL distribution. For example, a particularly strong desire to improve ones life by attending college despite personal hardships may be atypical but it is not pathological!Addiction describes a behavioral syndrome where the use of a substance seems to dominate the individual’s motivation and where the normal constraints on the individual’s behavior seem largely ineffective. This is caused by disturbances in normal brain chemistry that can be produced by the use of certain types of drugs (i.e., addictive drugs) and may also occur with the use of some other substances and even with non-chemical rewards in some people predisposed to developing an addiction. It does not involve any kind of psychological fixation caused by arrested psychosexual development in the Freudian sense nor does it involve the same process as that found with obsessive-compulsive disorders. Addiction is distinctively different from normal motivation and from other mental illnesses and therefore merits its own unique classification as a behavioral disorder. The single most prominent feature of addiction is the intense motivation to take the drug, motivation that exceeds the motivational level seen for most natural rewards. Consequential to this is a disruption of the individual’s normal motivational priorities (i.e., motivational toxicity) which is subjectively experienced typically as a sense of “loss of control” over ones own behavior.

  2. Common gateway drugs propel the individual to seeking stronger and stronger psychoactive substances to escape reality or to self-medicate some underlying psychological disorder. Use of marijuana or even tobacco products is a necessary step in developing an addiction and suppressing the use of these substances would prevent most cases of addiction.

    A corollary of this premise is that the distinction between hard and soft drugs becomes blurred because soft drugs are actually just one step below the use of hard drugs in the genesis of an addiction. And it also follows that the medicinal use of marijuana is unacceptable (despite its demonstrated effectiveness in certain disorders) because it will lead not only to marijuana addiction but addiction to hard drugs such as cocaine and heroin as well. Of course most people who experiment with hard drugs have first experimented with soft drugs, but this is no reason to assume that soft-drug use was a necessary first step or that it somehow goaded the individual into using hard drugs. (For another example of falsely attributing cause-and-effect from similar data, see The Power of the Blog: We did It—Medical Marijuana is Almost Here!) People who experiment with drugs tend to ‘experiment with drugs!' This leads to an increased likelihood of trying a highly addictive drug and developing an addiction. However, people can easily side-step experimentation with soft drugs and begin experimentation with heroin or cocaine if those are the only drugs available. The use of soft drugs such as marijuana in no way ‘propels’ most individuals into hard drug use. It’s even possible many that people who experiment with soft drugs somehow satisfy some adolescent need to try drugs as an expression of independence and social defiance, and if only hard drugs were available the incidence of drug addiction would be even higher.

  3. Drug addiction is caused by a lack of respect for oneself and other psychodynamic factors like those involved in some other cases of abnormal behavior not involving drugs. If the individual develops "self respect," their drug use will simply fade away.

    This and the following false premise are related to the "denial of brain disorder" problem addressed by ASNet's addiction treatment-facility rating project. Part of the problem may be one of semantics and failing to distinguish drug abuse from drug addiction. But this distinction is often deliberately blurred to incorporate the severe emotional and behavioral turmoil of addiction with simple cases of drug abuse which are more easily remediated.

  4. Once the addict obtains insight into their own addiction, the addiction rapidly abates as they rebuild their lives unimpaired by their drug abuse.

    The notion of the curative power of 'insight' is used to justify the seemingly endless 'psycho-rumination' which discusses over-and-over the addiction in telling emotional terms until the 'flash of light' illuminates the true source of the problem and the desire for drug use stops. There are cases where this type of 'psychotherapy' may be useful, but it has little impact on true drug addiction which has a biological basis.

  5. Addicts are whisked away to treatment centers that magically cure their addiction at least for most people. Relapse to drug use is uncommon once 'propper' treatment is provided.

    Most addicts relapse to using drugs. If this were the sole criterion for treatment effectiveness, drug addiction treatment would be deemed ineffective. But effective treatment does increase the time before relapse, and drug addicts often re-enter treatment making progress each time towards eventually remaining drug abstinent for a sufficiently long period to consider the treatment overall effective if not 'perfect.' So treatment does work even though addicts typically relapse, but there's no 28- or 90-day program that magically saves the addict from their addiction. Too many treatment facilities promise unrealistic results and focus on treatment approaches that are known to be ineffective while enhancing the psychodrama aspects of addiction.

On the positive side, the portrayal by tele-psychologists often promotes:

  • an increased awareness and sensitivity to the problem of addiction, and
  • a greater tendency to seek help for addiction and to enter treatment programs.

So the question open for comment is:

Do tele-psychologists like Dr. Phil do more harm than good for understanding and treating drug addiction?

And subtopics include specific examples where the popular portrayals of addiction help and hinder a better understanding of this disorder. Of course general comments on "Dr. Phil's [portrayal of] Addiction" are also welcomed.

Read more »

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ASNet Updates via RSS/Atom Feeds

03/13/09 | by the professor [mail] | Categories: General, Announcements

The Addiction Science Network will discontinue e-mail notification of updates by the end of 2009. Please subscribe to RSS or Atom feeds linked on the bottom right-hand side of the ASNet Discussion Forum to receive notification of updates to the main AddictionScience.net website in addition to new postings to the discussion forum. Please note that RSS/Atom feeds for new postings and for replies to existing postings are separate notifications. You may subscribe to receive only notification of new postings and/or to receive notification of replies to existing postings. If you wish to minimize the number of RSS/Atom broadcasts that you receive, only subscribe to receive new postings which will include announcements about updates to the Addiction Science Network website.

RSS and Atom feeds have set the standards for timely notification of updated web information and for publication of new material online. Those not familiar with these services are advised to learn about them and to use them for keeping up-to-date in their areas of interest. Microsoft Outlook provides automatic downloading of subscribed RSS feeds seamlessly integrated with normal e-mail. More information will be provided later on how to use RSS/Atom feeds to keep up-to-date on the ASNet activities. Meanwhile, "try it, you'll like it!"

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