I think you are quibbling, and that simply obscures the valid points I made. As far as the word "addiction", one can argue forever to no solid conclusion or meaningful point. Almost any literature on benzodiazepines will allude to addictive qualities as well as "rewards".
"Benzodiazepines are potentially addictive drugs: psychological and physical dependence can develop within a few weeks or months of regular or repeated use. There are several overlapping types of benzodiazepine dependence..."
As to my usage of "rewards", there are two ways to misconstrue the points at issue. One way is to unintentionally miss the point.
"These actions, exerted by different benzodiazepines in slightly varying degrees, confer on the drugs some useful medicinal properties. Few drugs can compete with them in efficacy, rapid onset of action and low acute toxicity. In short-term use, benzodiazepines can be valuable, sometimes even life-saving, across a wide range of clinical conditions as shown in Table 2. Nearly all the disadvantages of benzodiazepines result from long-term use (regular use for more than a few weeks). The UK Committee on Safety of Medicines in 1988 recommended that benzodiazepines should in general be reserved for short-term use (2-4 weeks only).
Mechanisms of action. Anyone struggling to get off their benzodiazepines will be aware that the drugs have profound effects on the mind and body apart from the therapeutic actions. Directly or indirectly, benzodiazepines in fact influence almost every aspect of brain function. For those interested to know how and why, a short explanation follows of the mechanisms through which benzodiazepines are able to exert such widespread effects.
All benzodiazepines act by enhancing the actions of a natural brain chemical, GABA (gamma-aminobutyric acid). GABA is a neurotransmitter, an agent which transmits messages from one brain cell (neuron) to another. The message that GABA transmits is an inhibitory one: it tells the neurons that it contacts to slow down or stop firing. Since about 40% of the millions of neurons all over the brain respond to GABA, this means that GABA has a general quietening influence on the brain: it is in some ways the body's natural hypnotic and tranquilliser. This natural action of GABA is augmented by benzodiazepines which thus exert an extra (often excessive) inhibitory influence on neurons (Fig. 1)."
In the post you responded to, I was clearly not offering to quibble over addiction, dependence, and such. I was making the simple observation that people can make habits of virtually anything--from vomiting up their food to masturbating 6 times a day. My overriding point was not to insist (or to care) as to how you wish to use the words "addiction" or "dependency", but rather to emphasize that people choose their behavior as a reward to their organism in some physical, social, or emotional aspect. The compelling or causal influence of such rewards was not my point.
I think that fussing over the words "addictive" and such is a meaningful waste of time for a lot of people who make their living by selling the idea that people are victims who need their particular brand of "help".
The general paradigm is to place physical dependence under the aegis of addiction and to rank order it as a measurement of the addictive nature of various substances. And benzos can certainly induce physical dependence:
"Recreational use of diazepam, alprazolam, lorazepam, temazepam, triazolam, flunitrazepam and others has been reported in various countries. Usually the drugs are taken orally, often in doses much greater than those used therapeutically (e.g.100mg diazepam or equivalent daily) but some users inject benzodiazepines intravenously. These high dose users develop a high degree of tolerance to benzodiazepines and, although they may use the drugs intermittently, some become dependent. Detoxification of these patients may present difficulties since withdrawal reactions can be severe and include convulsions."
benzo.org.uk
Then there are those who entirely dispense with the quibbling over "addictions" and who prefer to view the issue as a matter of people using their free choice to seek or avoid certain sensations or experiences:
The Illusion of the Addictive Substance
Copyright © P. Meehan October 1998. All rights reserved.
"If the word addictive has some actual pharmacological meaning, then it is reasonable to believe that there are experts who can discourse learnedly of that meaning, and that at least some among them are well versed in the methods for determining whether a given substance is in fact addictive. But the literature authored by those who are adepts in the arts and sciences that undergird the Pharmacopeia discloses nothing that goes to the meaning of this word in a direct way, although it is a literature that certainly contains usages of it. Nor does the Oxford English Dictionary (OED) contain a treatment of it; the word goes unmentioned there. Which seems a curious thing, considering the frequency with which this word is used. Among the less prestigious dictionaries, those that do treat addictive, do so in terms of some synonymous expression, illuminating nothing; the Webster's New World Dictionary, for example, reports that it means "relating to or causing addiction."
Shifting the perspective a bit to consider the transitive verb addict, the OED reports that its appearance in the English language took place in the sixteenth century and that--paraphrasing--the word signifies the act of giving oneself over to the habitual practice of some particular type of behavior; a type of behavior to which those who practice it in this habitual way are, by definition, addicted. Plainly, there is nothing of a pharmacological character to be found in any of this, nor, if it comes to that, even of a biological one in the sense in which the term is generally used; the key word here is behavior.
And it is in terms of behavior that the specialized meaning of addiction as it pertains to drug use is defined by the experts: their mainstream factions define drug addiction, in substance, as a pattern of behavior that is marked by an absorption so intense in the getting and the ingesting of a particular type of drug that the ordering of the addict's daily affairs is neglected; and a pattern of behavior that is marked, as well, by a strong tendency, after a period of abstention from the use of the drug, to resume that use. It is a description that is presumably accurate and possibly even useful, although it is totally unclear in what way. But where is there to be found in it anything that points to causality? What is there in all this that addresses the question of the addictive character of a drug? That is to say, that goes to the nature of the power a drug possesses to bring about the condition described? It is stressed at this point, perhaps needlessly, that what is of concern here is not a model of the physico-chemical processes by which drugs alter moods, but a model of the physico-chemical processes through which they addict. A concern, plainly, with the meaning of addictive.
Nor is it idle to pursue that meaning: it is a word that by implication identifies the addict as victim. And the notion of the addict as victim is the hook on which hangs the vast and costly national apparatus that has been devised and elaborated over these many weary years to make an end to the more or less furtive production and distribution of prohibited substances. I acknowledge that there are drugs, such as opium and its derivatives, which with prolonged use bring about a pathological condition called by the medical experts physical dependence, but into this it is without purpose to go here, since it is a condition that derives from addiction, not one that lies at its root; furthermore, there are drugs that produce no physical dependence at all, marijuana and cocaine among them, the very drugs that now stand at the center of the endless public turmoil over prohibited substances. If these drugs are addictive, their addictive characteristics must obviously manifest themselves independently of the physiological states of those whom they addict. Simply put, they must evidently have the power to addict a person in good health and of sound mind.
A search for what is meant by addictive in the literature of the Pharmacopeia is at best a tedious undertaking. But the tedium is broken at times by discoveries of disconcerting texts turned out by folk of uncertain specialties who ape the ponderous idiom and the distant, lofty airs of the psychiatric and sociological communities. Worse, there are in some of these texts splenetic charges of racism against colleagues a century or more dead, and malicious talk against the bourgeoisie; this astounding juvenilia is most pronounced in papers directed to the study of marijuana, but is by no means restricted to them. Despite the sifting of a large store of such dreadful stuff, and of a larger store authored by serious students of drug lore, I found nowhere a direct statement of what these adepts mean by addictive. But in the course of that sifting there crystallized, through the detection of inescapable implications, a paraphrase of what they unquestionably mean by it:
A substance is addictive if: primus, it induces specific moods or affects specific sensations when ingested; secundus, among those who ingest it, there are some who come to do so habitually.
There is no physico-chemical process known to any expert of any sort that causes a human being to become addicted to the ingestion of any substance known to God or man. Which is to say, the word addictive is a nonsensicality shaped to deceive, as anyone of a reflective nature must suspect upon first encountering its use. So shaped either as a deliberate contrivance or as a consequence of the limitations so common to specialists in this or that aspect of natural science who are thoroughly trained, wholly uneducated, essentially incurious, and serene in the belief that the received wisdoms of their specialties have the qualities found by the Pope in holy writ. The notion of deliberate deception is raised here as a matter of form only: there obviously exist vast conspiracies only in the imaginings of minds fevered with hostility and delusions of grandeur and in the labored ratiocinations of minds containing large vacancies. Equally obviously, there exists no supernatural powder that transmogrifies itself, if ingested, into a demonic homunculus with the power to bridle and ride a human mind. Nor are there occult forms of smoke which, if breathed, so transmogrify themselves. Put as bluntly as the topic deserves, a belief in the notion of the addictive substance is a belief in possession. Not possession by goblins from Hell, but by thaumaturgic emanations from inanimate substances. A belief worthy of the primitive who prowls the Amazon rain forest persuaded that there are spirits dwelling in puma dung and stones. And a belief candidly, if hyperborically, expressed by those who speak in the forums of civilization of "slaves" to drugs, or of "victims" of drugs. The ironies in all this for those who are unafflicted with the conceits and crazes of Modernity are, I daresay, among the more charming of the treasures with which they adorn their mansions of the mind.
Those who are given to the use of mood altering drugs are obviously given to doing so because they like the effects the drugs have upon their moods. And those who are given to doing so habitually are, equally obviously, given to doing so because they like these effects entirely too well. Why would any sensible person imagine otherwise? How and where did the unearthly notion arise that behind drug habituation there is anything other than the character and will of the person habituated?
The Prohibitionists were given to the use of the phrase, "The demon rum," but it was understood in prohibition times even by schoolchildren that it was not rum that was the demon, but was, rather, the tippler of rum. We are a people who have always believed that one's character determines one's fate; it is doubtful whether many of us have actually been brought to abandon that belief by the decades of daft psychoprattle directed at us from the left. And we have always believed, as well, that one can alter one's character, for the better or for the worse; that our fates are in our own hands.
Those who use drugs habitually do so wilfully and, with those who use them occasionally, are the knowing and uncaring authors of all the mischief that drugs have brought in their train to the country. Their fates are properly of no public concern; as well fret over the dismal ends that await disbarred lawyers, has-been rock stars, politicians turned out of office, or any other such tiresome public nuisances. The immense social energies that have been wasted on drug users serve as an indicator of the unstinting generosity that is a mark of the American national character. The unwillingness to concede that these drug addled defectives have defeated us is an indicator of another quality of our national character, which is to say, a stubborn refusal to admit defeat.
It is not, of course, the drug manufacturers and distributors who are our enemies in the so called war on drugs, but the drug users.
As for the drug experts, ours is an age that is inclined to believe in experts of every kind, but there was an earlier age, the memories of which still linger in the minds of living, but largely silent, generations, in which it was held that an expert is anyone who says he is, in a locality at least forty miles distant from the one in which he was raised."
Now go take a pill or do some yoga or have a nip of Scotch...
literatus.net |
