Addictions?

[Psyclops]

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Anyone on here good with addictions? If so here is a question that I have. At what point does an addiction become non-physically dependant, and start being purely psychological. So, for example, if a person is a smoker, and they get down to two cigarettes a day from a pack, do you really think that is physical? I would doubt it. But the same goes for other drugs, Etoh, cocaine, caffeine, etc.

And this isn't meant to turn into a dualsm debate.

 

[JatPenn]

I would argue that addictions are never "purely" psychological, there is always a physiological component.

However, it may be the case that the physiological aspects of the addiction are brought about and maintained by a psychological state (as opposed to the other way around). Is this what you are referring to?

 

[Psyclops]

Not really, my question was spurned on by observing someone who had previously smoked habitually, meaning ~15 cigarettes a day, who then tried to quit, but only was able to get down to 2-3 a day. Now having been a smoker myself, I understand that it is a difficult addiction to get over. But, I don't think those last 2 cigarettes a day are doing much in terms of the physiological addictions. Naturally they are giving her a boost of nicotine, and she would derive pleasure from that. But if you can get down to 2 a day, cutting nicotine out all together shouldn't be any more physically aversive. And I would assume the same goes for cafeine and habitual coffee drinkers. I'm not sure that the same would hold for heroin and alcohol, but just for the sake of arguemtn we could use them as well.

 

[Psyclops]

I would argue that addictions are never "purely" psychological, there is always a physiological component.

The flip side is that they are never purely physiological either, unless someone has been given the substance without being aware of it.

 

[50960]

I would argue that addictions are never purely physiological... I have seen many who can get off Xanax 3-4 mg qd, or morphine IR 30 IR, tid etc... without problems if they are tapered correctly, and have seen folks hooked on soma (yes I know it metabolizes to mebrobamate), who would fight to death to stay on it. I feel that there are many reasons why people become addicted, and a big one is the meds work! Another is escape, another is habit, and there are many more. I think every pt on a controlled substance should have a contract with their prescriber, and that should be the measure of whether or not they are experiencing a problem with addiction or just getting properly treated 😉

 

[Psyclops]

So contract like how? So if and when the prescriber sees there being a problem, then they would have to follow their recommendation to ween off?

 

[50960]

Contract says this is what I agree you can take per day, week, month. If you go over, ask for refills early etc it breaks the contract. Any medical facility will have such a policy.....

 

[codetype4/9]

I would argue that addictions are never purely physiological...

A client at our clinic had been taking sleeping pills and decided she was going to wean herself off of them. She began by breaking the pills in half for a couple weeks and taking the halves, then it was the thirds and quarters and so forth. When she entered therapy she had been taking a portion of the pill about the size of a grain of sand, and kept on taking it.

At that point the med isn't doing anything, you really have to consider what psychological purpose it was holding for her.

 

[Dr.JT]

One other point relevant to this topic is that physical dependence does not equal addiction.

 

[Psyclops]

One other point relevant to this topic is that physical dependence does not equal addiction.

Would you mind elaborating on this point?

 

[Dr.JT]

Addiction is defined by behaviors. You can be physically dependent on a substance, but not addicted. For example this is the case with many pain patients. They take their meds as prescribed and are physically dependent on them. When they are weened of, they have no problems. It is a distinction (dependence vs addiction) that is often overlooked because those who are addicted are often dependent.