cannabisnews.com: Addiction: A Brain Ailment, Not a Moral Lapse Addiction: A Brain Ailment, Not a Moral Lapse Posted by CN Staff on September 29, 2003 at 15:31:41 PT By Jane E. Brody Source: New York Times For all that has been written and spoken about addiction as a medical disease, most people, including most physicians, understand little about what draws people to drugs and keeps them hooked, often despite severe consequences and repeated attempts to quit.A better understanding of the pull and tug of addiction can help those who are hooked and those who want the monkey off their backs for good. The savings in life-years, quality of life and lost income can be huge, not to mention the costs of drug-instigated crime and medical care. According to the National Institute on Drug Abuse, $133 billion a year is spent just on treating the short-term and long-term medical complications of addiction. Among the many health consequences of addictions are sudden cardiac arrest, irreversible kidney and liver damage, AIDS, fetal harm and many cancers, including cancers of the lung, bladder, breast, pancreas, larynx, liver and oral cavity.That it is possible to become free of addictions and remain so is unquestioned. Seeking Definitions The nature of addiction is the same no matter whether the drug is cocaine, heroin, alcohol, marijuana, amphetamines or nicotine. Yes, whether they know it or not, chronic cigarette smokers and users of chewing tobacco are addicts.Every addictive substance, according to a report this month in The New England Journal of Medicine, induces pleasant states or relieves distress. Furthermore, the authors of the report, Dr. Jordi Cami and Dr. Magi Farré of Barcelona wrote, "Continued use induces adaptive changes in the central nervous system that lead to tolerance, physical dependence, sensitization, craving and relapse."In other words, addiction is a brain disease, not a moral failing or behavior problem. People do not deliberately set out to become addicts. Rather, for any number of reasons — like wanting to be part of the crowd or seeking relief from intense emotional or physical pain — people may start using a substance and soon find themselves unable to stop.Of course, not everyone who smokes a cigarette, be it tobacco or marijuana, takes a drink, snorts cocaine or self-injects morphine is destined to become an addict.Most drinkers, for example, know when to stop before they become intoxicated or tolerant to large amounts of alcohol. Many people do not like the sensation of losing control and having their feelings and actions determined by a drug. Others refrain from taking the chance that trying a potentially addictive substance will lead to dependence and, so, never take a drink, a puff or a snort or swallow pills or inject a substance that is not medically indicated. Still others may be protected by their genes. Most Asians, for example, carry a gene that makes them physically ill and flushed before they can consume an addicting amount of alcohol.But genes can work two ways. The risk of addiction can be inherited. The genetics of alcoholism have been well studied, and heredity accounts for about 40 percent of the risk, though it is unclear whether what is inherited is an underlying emotional disorder that drives people to seek relief or a particular physiological reaction to addictive substances that gets them easily hooked. Dr. Nora D. Volkow, director of the drug abuse institute, told a conference on drug dependency in June that she had never met a patient who wanted to be an addict. "Sure," she said, "they start out wanting to take a drug. But the problem is we don't know who will become addicted." According to the Institute of Medicine of the National Academy of Science, 32 percent of people who try tobacco become dependent, as do 23 percent of those who try heroin, 17 percent who try cocaine, 15 percent who try alcohol and 9 percent who try marijuana.Dr. Cami and Dr. Farré observed that personality traits like risk-taking and novelty-seeking tendencies, as well as mental disorders, are "major conditioning factors in drug addiction."An increased risk of drug abuse has been associated with psychiatric disorders like schizophrenia, bipolar disorder, depression and attention deficit hyperactivity disorder, they wrote. Changing the BrainIn a "perspectives" article in The Journal of the American Medical Association this month, Brian Vastag, reporting on the June conference, wrote, "The brain changes during addiction."Mr. Vastag explained that all drugs of abuse activated a pleasure pathway in the brain, the "dopamine reward circuit," which is connected to areas that control memory, emotion and motivation. Any activity that activates those pathways reinforces the pleasurable behavior. "Eventually," he wrote, "the dopamine circuit becomes blunted; with tolerance, a drug simply pushes the circuit back to normal, boosting the user out of depression but no longer propelling him or her toward euphoria." By repeatedly supplying the body with the substance, a new state of "normal" is created, causing the person to continue using the substance to feel normal.The changes in the brain, though not permanent, can be long lasting. Dr. Volkow found that the dopamine system of cocaine users remained impaired for up to three months after their last snort. And despite years of abstinence, former addicts may experience intense cravings when they are exposed to certain cues like watching drug use by a movie character.The Barcelona experts, in discussing the addiction mechanisms, noted, "Long-term administration of addictive drugs produces alterations in the brain that increase vulnerability to relapse and facilitate craving even months or years after successful detoxification." Those changes involve cognitive areas and drug-rewarding circuits.For someone who used drugs to relieve an emotional problem or psychiatric disorder that was not otherwise treated, the temptation to revert to the assuaging drug can be irresistible. Without follow-up treatment for both the addictive disorder and the underlying mental illness, the chances of a lasting recovery from addiction may be slim.Further, there is clearly not one route to recovery. Some addicts manage to kick their habits without any outside help; others require monthlong inpatient programs and continued reinforcement, either professional or lay. Still others may need a year of outpatient treatment plus aftercare. Many former addicts find that support groups of fellow former addicts like Alcoholics Anonymous and Narcotics Anonymous help them maintain their drug-free status. Because prolonged exposure to abused drugs results in long-lasting changes in the brain, "addiction should be considered a chronic medical illness," the Barcelona scientists said. As with other chronic illnesses, including hypertension and diabetes, addiction and its treatment require "long-term strategies based on medication, psychological support and continued monitoring," they concluded. In addition, other experts have suggested, treatment of addiction should be fully insured with no limit on the number of visits covered. Source: New York Times (NY)Author: Jane E. BrodyPublished: September 30, 2003Copyright: 2003 The New York Times Co.Contact: letters nytimes.com Website: http://www.nytimes.com/Related Articles:Revolutionary Thinkerhttp://cannabisnews.com/news/thread17119.shtmlStudy Into the Mysteries of Addictionhttp://cannabisnews.com/news/thread17095.shtmlCannabisNews -- NIDA Archiveshttp://cannabisnews.com/news/list/NIDA.shtml Home Comment Email Register Recent Comments Help Comment #15 posted by John Tyler on September 30, 2003 at 09:59:28 PT out on a limb These guys are talking like risk-taking and novelty-seeking tendencies are a bad thing. If these guys were in charge humans would still be living in the trees. An intelligent mind seeks and needs risk-taking and novelty it is hardwired into our brains. [ Post Comment ] Comment #14 posted by FoM on September 29, 2003 at 22:00:20 PT Thanks puff_tuff I just finished posting it!http://www.cannabisnews.com/news/thread17432.shtml [ Post Comment ] Comment #13 posted by puff_tuff on September 29, 2003 at 21:46:56 PT Dr. Ethan Russo article Students, activists and supporters gather for lecture on legalizing medical marijuana September 30, 2003 Massachusetts Daily Collegian http://www.dailycollegian.com/vnews/display.v/ART/2003/09/30/3f790225066ba [ Post Comment ] Comment #12 posted by greenmed on September 29, 2003 at 21:46:07 PT proposed SAT question "The nature of addiction is the same no matter whether the drug is cocaine, heroin, alcohol, marijuana, amphetamines or nicotine. Yes, whether they know it or not, chronic cigarette smokers and users of chewing tobacco are addicts." (clever misdirection)"Every addictive substance, according to a report this month in The New England Journal of Medicine, induces pleasant states or relieves distress."Q. Which one doesn't belong? A) cocaine B) heroin C) alcohol D) marijuana E) amphetamines F) nicotineAnswer: (D) Cannabis does not act as a direct receptor agonist (stimulant) in the dopamine pleasure center. [ Post Comment ] Comment #11 posted by Dankhank on September 29, 2003 at 19:35:18 PT Moral Lapse O'reilly considers addiction a moral lapse.Don't think he invented the concept, just heard it there first, I think . [ Post Comment ] Comment #10 posted by The GCW on September 29, 2003 at 18:58:08 PT The deluding influence. US CA: LTE: TELL KIDS THE TRUTH ON DRUGS According to several nationally projectable studies -- including Monitoring the Future -- teen drug use has declined nationwide since the launch of the National Youth Anti-Drug Media Campaign. The Pride Survey cited by The Times did not find any statistically significant increase in teen drug use; moreover, Pride's findings came from students in just 24 states nationwide, California not among them. Several independent studies point to the efficacy of anti-drug advertising. A study published in the American Journal of Public Health found exposure to advertising from the Partnership for a Drug-Free America was associated with a reduced probability of marijuana or cocaine use among adolescents. Researchers at the Annenberg Public Policy Center at the University of Pennsylvania concluded that 80% of Partnership ads they tested either strengthened or maintained anti-drug attitudes. Though the Partnership develops and donates many ads for the National Youth Anti-Drug Media Campaign, it has no fiscal interest in the effort. Our only concern remains helping kids and teens reject the use of drugs. Stephen J. Pasierb President, Partnership for a Drug-Free America New York City http://www.mapinc.org/drugnews/v03/n1486/a01.html?397 Pubdate: Sat, 27 Sep 2003 Source: Los Angeles Times (CA) [ Post Comment ] Comment #9 posted by FoM on September 29, 2003 at 18:53:22 PT Robbie I can't answer when it started being referred to as a moral lapse but I remember it happening. The logic was if it's a moral lapse you can straighten up if you find salvation. That's what I remember. [ Post Comment ] Comment #8 posted by Robbie on September 29, 2003 at 18:42:25 PT when did anyone consider addiction a "moral lapse& I would think only the prohibitionists who've been propagandizing against addiction all these years would characterize it as a "moral lapse" [ Post Comment ] Comment #7 posted by FoM on September 29, 2003 at 17:02:24 PT News Article from KRON4.com Prostitutes Lobby for Legalization September 29, 2003 SAN FRANCISCO (BCN) -- Calling herself "a patriotic prostitute," San Francisco sex worker Robyn Few today rallied for the world's oldest profession to be legalized. She spoke from the steps of the San Francisco Federal Building, where she arrived after her hearing in federal court Monday morning. Arrested by FBI agents June 5 at her Sonoma County home, Few, 45, is one of a reported 36 women charged by the federal government with conspiracy to promote prostitution for their alleged involvement in a multi-state prostitution network. Scheduled for sentencing Monday, Few said Judge Marilyn Patel actually continued her hearing to Nov. 10 so she could vote in the Nov. 4 election. "I told the judge that making me a convicted felon today would take away my right to vote in upcoming elections," Few said. "My right to vote is one of the strongest weapons I have to fight back against the federal government. I'm a patriotic prostitute. My vote counts too." Surrounded by a small cadre of fellow prostitutes toting signs emblazoned with "U.S. Out of My Underwear," and "Sex Workers for Medical Marijuana," Few alleges the feds targeted her because of her work as a medical marijuana activist and used her former career as a scapegoat. It was easy to do, she said, because she retains many friends in the sex industry, both locally and nationwide. Complete Article: http://www.kron4.com/Global/story.asp?S=1462408&nav=5D7lIFzD [ Post Comment ] Comment #6 posted by goneposthole on September 29, 2003 at 17:00:21 PT Sigmund Freud Had Sigmund Freud lived in the USSA during these times, I wonder if he would have been able to make the advances in psychiatry that he did, or would he been forced to live a wasted life locked up in some prison cell deep inside the bowels of the American Gulag?Anschluss was the political union between Austria and Germany.What happened to Sigmund Freud? * Nazi sympathizer (is this true?) (didn't the Nazis denounce Freud and psychoanalysis?) "My language is German. My culture, my attainments are German. I considered myself German intellectually, until I noticed the growth of anti-Semitic prejudice in Germany and German Austria. Since that time I prefer to call myself a Jew." * Freud's books were burned in Germany by 1933. * The writing on the wall became more apparent when his daughter, Anna Freud, was interrogated for a full day by the Gestapo. Before Sigmund was allowed to emigrate, he signed a document that stated he had not been mistreated. His postscript, appended to the document, read "I can most highly recommend the Gestapo to everyone." * Freud left Austria after the Anschluss, to avoid the Nazis, to Paris; and then departed Paris for England. This was accomplished with the assistance of Marie Bonaparte (of the Napoleon Bonapartes). While the Bonaparte Papers are in the custody of the Library of Congress, access has never been granted to their scholarship, at the insistence of the Bonaparte heirs, until 2020. * His four sisters, who stayed in Vienna, were murdered in concentration camps. * Committed suicide in 1939, after a long bout with maxillary cancer. * He was cremated, ashes at Golders Green Crematorium in Golders Green. * Anna died in 1982. * Freud's granddaughter Sophie (a doctor in her own right), on Freudian theory: "I think it's such a narcissistic indulgence that I cannot believe in it."timeline 23 Sep 1939 Sigmund Freud commits suicide with the help of his personal physician, Max Schur. The good doctor obligingly administered 21mg of morphine -- a lethal dose.http://www.rotten.com/library/bio/mad-science/sigmund-freud/ [ Post Comment ] Comment #5 posted by E_Johnson on September 29, 2003 at 16:32:56 PT Here is a proposition to debate Proposition:Civilization is created from the tension between the risk-loving and the risk-averse. [ Post Comment ] Comment #4 posted by E_Johnson on September 29, 2003 at 16:29:19 PT What's missing from this article Risk taking is a very necessary part of human personality. This is why we didn't just sit in our caves in the dark at night and eat raw food but took the risk of harnessing fire.Fire is dangerous. Fire is risky. The proto-humans who first started playing with it must have been really scary to the rest of the primate pod.Why do humans have the propensity to get a big kick from risky behavior?Civilization could not exist without the continual tension between the risk-loving and the risk-averse. [ Post Comment ] Comment #3 posted by OverwhelmSam on September 29, 2003 at 16:10:06 PT: Addiction Is A Double Edged Sword. Okay. While you're at it, lets get rid of those people who are addicted to sobriety. Maybe the people who are addicted to fighting marijuana legalization should be put down too. [ Post Comment ] Comment #2 posted by E_Johnson on September 29, 2003 at 16:05:53 PT Addiction is a NECESSARY part of the genome??? "Dr. Cami and Dr. Farré observed that personality traits like risk-taking and novelty-seeking tendencies, as well as mental disorders, are "major conditioning factors in drug addiction." "Risk taking and novelty seeking are cast as disorders by people with the opposite disposition.However, democracy itself is a risk taking enterprise. Democracy is all about taking risks and being open to novelty.No wonder so many of our most forward thinkers in the world have had addictions in addition to their achievements.I think it is better to tolerate addiction than to cure the whole human race of any tolerance for risk. [ Post Comment ] Comment #1 posted by FoM on September 29, 2003 at 15:41:15 PT Mayor Calls for Lethal Injection for Drug Users September 30, 2003Controversial Port Lincoln Mayor Peter Davis has called for drug addicts to be given a lethal injection to cut rising illicit drug use on South Australia's Eyre Peninsula.Police statistics show the rate of amphetamine and marijuana use among teenagers in the region is increasing alarmingly.Cr Davis says the use of intravenous drugs has also risen since the introduction of a local needle exchange program.He says there should be less tolerance to both drug users and traffickers."I don't have a problem with the free needle exchange but the drug addict who wants to exchange a needle should be given a lethal injection," he said."You want the trip of your life, in fact the last trip of your life? Not a problem, come on in and we'll deal with you."http://www.abc.net.au/news/justin/weekly/newsnat-30sep2003-15.htm [ Post Comment ] Post Comment