More information about addiction and dependence

[In his book, "Mind Matters" (Houghton-Mifflin, Boston, 1988), Michael S. Gazzaniga, Ph.D., a professor of psychiatry at Dartmouth Medical School, summarizes current scientific thinking in his chapter on "Addiction" (p. 140 ff). Here is an excerpt:]

. . . . Most of what we hear is hyperbole, and it is encouraged by those who profit from a continuance of the drug hysteria. It is hyped by medical researchers who get paid to study drugs. It is hyped by the social service industry that gets paid to help rehabilitate the addict. It is hyped by politicians who get elected by showing they have a social conscience.

This urgency to solve the problem loses some of its force once we realize that addiction, in the sense of physiological need, is very limited and relatively easy to fix. Most so-called addicts are not suffering from physiological needs; their cravings are psychological, and one has to wonder whether all the helping agencies that concentrate on the physiological dependencies are not in fact serving the function of reinforcing various forms of dependent or fatalistic psychologically driven behavior. Consider a study by Professor Stanley Schacter of Columbia University.

Schacter spent years studying why it was so difficult to wean smokers from their cigarettes. He examined all the data from rehab services and observed that no matter what the treatment had been, 60 to 70 percent of the participants returned to smoking. As he puzzled this fact and unearthed relations between nicotine levels and cigarette use, he also wondered why he no longer knew anyone who smoked. Years before, a seminar room would be so filled with smoke that the blackboard was barely visible. Now, not only was the air clear, but a maverick smoker incurred the wrath of all those around him when he lit up. What was going on?

Schacter formally surveyed his highly educated colleagues at Columbia. He also polled residents of Amagansett, a middle- to upper-middle-class community on Long Island where he summered. He first determined who were smokers and who had been smokers. he took into account how long they had smoked, what they had smoked, and all the other variables he could think of for such a study. It wasn't long before the truth began to emerge. Inform a normally intelligent group of people about the tangible hazards of using a particular substance, and the vast majority of them simply stop. That's all, they stop. They don't need treatment programs, support groups, therapeutic drugs - nothing. People who had been smoking for years on a daily basis abruptly quit. This suggested that the rehab centers were attracting only those people who were unable to stop. As a consequence, the rehab patients are not a random sampling of the population with an addiction. They are a subculture that cannot easily give up their addictions. Yet it is the patients from these centers who make up most of the studies about addiction and how hard it is to kick the drug habit. Clearly, the Schacter study strongly suggests that the world is getting a distorted report about the addictive process.

About 10 percent of the population fall into addictive patterns with drugs. . . . Similar conclusions can be made from a large drug study on returning Vietnam vets ordered by Richard Nixon.

Nixon, who rarely relied on the powers of social science research, thought the country should know how many vets returned as addicts. This was in response to an outcry from Americans who seemed to regard all returning veterans as junkies. The director of the study, Dr. Lee Robbins of Washington University, had a large sample to draw on. She chose those soldiers returning to the United States in 1971. Of those 13,760 Army enlisted men who had returned, 1,400 were found to have urine that tested positive for drugs (narcotics, amphetamines, or barbiturates). In short, these 1,400 men were unquestionably drug users. Of that sample, she retested 495 men eight to twelve months after their return home. The results were crystal clear. Only 8 percent of the men who had been drug positive in their first urine test remained so. Therefore, 92 percent of those using drugs upon their return home simply quit, walked away from a dependence on the substance they enjoyed in Vietnam. It was the remaining 8 percent that were making their way to the rehab facilities - the hard-core addicts.

This finding is staggering in its implications. Virtually every study and every statement made about human addiction is based on the image that heavy drug users are victims of their substances. Yet Schacter's work suggests that the vast majority of humans are able to walk away from a drug should they choose to do so. Those who cannot are not so much victims of a ravaging physiological need as they are of a certain psychological character. That psychological profile, no matter how it might be characterized, is what is at issue - not the substance abuse.

[End quote]

Portland NORML adds: Professor Gazzaniga's summary is reflected in the current medical and scientific literature. For example, the Sept. 15, 1994 peer-reviewed New England Journal of Medicine (Vol 331, No. 11) reports that "Treatment, of course, is only part of the picture. The sociologist Charles Winick presents evidence that 'some people can regularly use [illicit] drugs without harming themselves or inflicting losses on others.' Most who try them soon stop, and among those who continue, recent studies suggest, 'controlled use' may be the norm, even for cocaine and heroin.'" (p. 749)


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