Addictions?

[Psyclops]

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.

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[OldPsychDoc]

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.

Don't know if I'm "good with addictions", but I am board-certified.
Addiction is more than physical dependence. If you look at the DSM-IV criteria for substance dependence, only the first 2 address physical dependence. The next 5 are all about behaviors--including thinking about the substance. So yes, they can be 305.10, Nicotine Dependent, even if they are not currently physically dependent on the substance. And not to debate dualism either, all behavior and learning is biological, so it is physical as well--that persons synapses are simply primed to "light up" (pun intended ) when the cues to use are present.

 

[Psyclops]

Interesting answer, I hadn't been thinking in the BSB terms (big siver book). I was thinking more from a theoretical standpoint. Mainly trying to think of when could you say to someone "Alright, enough, you don't 'need' those X cigarettes a day, just cut it out." So, at some point in weening, this may vary for diferent types of drugs, I would imagine that someone would get to a point where their use no longer was to avoid the aversive state of withdrawal but more of a "psycholigical" urge, some last vestige of "being an adict" or "being a smoker/adicted" whatever.

And Poety, this is assuming that just telling them to cut it out from the outset isn't productive or recommended.

 

[Anasazi23]

A large portion of addiction is psychological. It doesn't have to be in the DSM to be true addiction, either. i.e. caffeine (interesting topic since there are some aspects of associated physiological dependency).

You can look up hospital addiction as another interesting example.

In terms of cigarettes, you'll get different responses depending on the doc you talk to. A psychodynamic psychiatrist will give you the oral fixation speech, while purely biopsychiatrist will tell you about dopamine reward pathways. As is usual, the answer is likely in the middle.

 

[50960]

See post in psychology. I agree sazi and OPD.

 

[Poety]

Interesting answer, I hadn't been thinking in the BSB terms (big siver book). I was thinking more from a theoretical standpoint. Mainly trying to think of when could you say to someone "Alright, enough, you don't 'need' those X cigarettes a day, just cut it out." So, at some point in weening, this may vary for diferent types of drugs, I would imagine that someone would get to a point where their use no longer was to avoid the aversive state of withdrawal but more of a "psycholigical" urge, some last vestige of "being an adict" or "being a smoker/adicted" whatever.

And Poety, this is assuming that just telling them to cut it out from the outset isn't productive or recommended.

OH, I forgot to leave the memo stating that I smoke Old nursing habits die hard - shoot me pffffffffft

ETA: also regardint the reward bio or psycho reason why: I happen to like smoking so I have no intention of quitting although I may say I will often I like the taste of a cigarette with french fries ... shoot me.

 

[Triathlon]

OH, I forgot to leave the memo stating that I smoke Old nursing habits die hard - shoot me pffffffffft

ETA: also regardint the reward bio or psycho reason why: I happen to like smoking so I have no intention of quitting although I may say I will often I like the taste of a cigarette with french fries ... shoot me.

Poor little CN.

 

[Poety]

Poor little CN.

She doesn't see it - and 5 a day doesn't really increase your risk for anything

 

[Psyclops]

I love smoking, it is delightful. Personally, I think people look cool when they smoke.

 

[OldPsychDoc]

I love smoking, it is delightful. Personally, I think people look cool when they smoke.

You're both going stright to Hades--but at least you can smoke there.

 

[Poety]

You're both going stright to Hades--but at least you can smoke there.

You gotta die of sumffin right? <puff puff>

just kidding. Emphysema isn't funny, or Lung CA yuck.

 

[Triathlon]

I love smoking, it is delightful. Personally, I think people look cool when they smoke.

I just have to laugh at this one.
What about mullets?

And Poety, 5 a day away from the kid sounds a little better.

 

[Psyclops]

What about mullets?

Above or below the mason/dixon?

 

[Triathlon]

Above or below the mason/dixon?

I would have to say below, I am not too familiar with the above crowd.

 

[PublicHealth]

biopsychiatrist will tell you about dopamine reward pathways. As is usual, the answer is likely in the middle.

Neat basic science article on how the dopamine reward hypothesis may not be entirely accurate: http://www.ncbi.nlm.nih.gov/entrez/..._uids=15661623&query_hl=2&itool=pubmed_docsum

 

[50960]

Of course it is harder to quit something that most people do 10-20 times per day. Dopamine is involved in the placebo effect as well.

 

[Psyclops]

I would have to say below, I am not too familiar with the above crowd.

Then I'd say they look pretty cool too.

PH, I'm not sure what exactly the abstract is getting at, but is it just more of the DA not just being rewarding but operating on wanting? In which case it would make sense here.

 

[Poety]

One in the morning, one after lunch (with french fries) one after dinner and two at night - not too shabby for a former pack a dayer! As long as its outside, out of sight, I see nothign wrong with a little toke on a daily basis

I have no mullet, mullets are NOT cool

 

[pschmom1]

It's funny that this is brought up now as I was just talking about the whole physical and psychological dependence on nicotine the other day. I am a smoker unfortunately . However, I am happy my fiance doesn't smoke b/c I personally find it disgusting. I find that, although I have been smoking for 14yrs, I have a huge psychological dependence on it. That alone has been the hardest part of thinking about quiting. Obviously I am physically addicted, but I wonder if the psychological part isn't the hardest. I associate smoking with so many other aspects of my day to day life, that quiting would not be braking one deadly habit, but several daily habits and routines as well. It would almost be like a loss of myself in a weird sort of way. Everything would change if I quit. I am well aware of what is important and dire for my health, yet, I will admit it is a frightening thing to think about the whole process involved with giving up "one" habit/addiction. The funny thing is, I had no problem what so ever giving it up during both pregnancies. I'm just stupid for starting up again I will keep the faith alive that I will one day be a successful non smoker

 

[Logic Prevails]

I smoked for 10 years and eventually quit on my 3rd attempt. The "patch" worked for me; I think by not reinforcing those neural circuits that associate hand-to-mouth with the nice feeling of nicotine. I would essentially get my 'fix' from the patch. Once I weened myself off, I'd keep a "patch" on me just in-case I had one of 'those days' where I felt like taking it up again. I replaced my 'oral fixation' with a bottle of water that was always nearby. So yeah, I think addiction is equal parts psychological and biological.

 

[jeromenastella]

I guess quitting is a matter of choice. I believe that addiction is just a state of mind and physical dependence follows. Therefore, these two go together. You should first change your mindset and decide to really quit, then slowly manifest it on your act (meaning, slowly eliminating your dependence to it). Then if you are really committed to it, then time will come you can really get rid of your addiction. I was once addicted to drugs and smoking too, but just like you i found it disgusting doing it in front of my family, especially my children. How could I become effective father to them if I myself is messing with my life? That's why I really decided to stop it. It's just really a matter of choice since it's just a state of mind, once you change your mindset, then you can also eliminate your physical dependence to it.

 

[Shikima]

I guess quitting is a matter of choice. I believe that addiction is just a state of mind and physical dependence follows. Therefore, these two go together. You should first change your mindset and decide to really quit, then slowly manifest it on your act (meaning, slowly eliminating your dependence to it). Then if you are really committed to it, then time will come you can really get rid of your addiction. I was once addicted to drugs and smoking too, but just like you i found it disgusting doing it in front of my family, especially my children. How could I become effective father to them if I myself is messing with my life? That's why I really decided to stop it and go to addiction treatment center, luxurybeachrehab.com. It's just really a matter of choice since it's just a state of mind, once you change your mindset, then you can also eliminate your physical dependence to it.

Thanks for the sales pitch.

 

[smalltownpsych]

I guess quitting is a matter of choice. I believe that addiction is just a state of mind and physical dependence follows. Therefore, these two go together. You should first change your mindset and decide to really quit, then slowly manifest it on your act (meaning, slowly eliminating your dependence to it). Then if you are really committed to it, then time will come you can really get rid of your addiction. I was once addicted to drugs and smoking too, but just like you i found it disgusting doing it in front of my family, especially my children. How could I become effective father to them if I myself is messing with my life? That's why I really decided to stop it. It's just really a matter of choice since it's just a state of mind, once you change your mindset, then you can also eliminate your physical dependence to it.

Oh...addiction is just a state of mind...I get it now. My patients just need to change their state of mind. I'll start telling them that now. Seriously though, you are describing some aspects of MI. Basically, people won't change until they are ready and the more effective the medication at providing psychological benefit, then the harder it can be to get to that point of readiness to change.

As I read through some of the older posts, I was struck by the lack of knowledge of addiction in some of the postings. I taught the distinction between physical dependence and psychological dependence in my addictions group because it is extremely important to understand. Each abusable substance has differing degrees of physical and psychological dependence. For example, marijuana has minimal physical dependence, but can have a higher level of psychological dependence; whereas, ETOH can cause a high level of both. Understanding tolerance curves is important as well, especially the point where effective dose intersects with lethal dose. Plug any drug into these three constructs and you get a pretty good idea why some drugs are more dangerous for people than others. Heroin, for example, steep tolerance curve, high psychological dependence, and high physical dependence. Not a surprise that most see it as a more dangerous drug than something like marijuana.