Drug Abuse Drug Addiction

Drug Abuse Drug Addiction

b>Drug Abuse Drug Addiction?

Use Doesn’t Mean Addiction

By Ned Wicker

The more I hear the experts, the more I read and the more I try to understand the nature of addiction, I find that I don’t know anything at all. Just trying to understand how to assess whether or not a person is “addicted” to a substance, as opposed to using that substance improperly is enough to get my head spinning. But the science is advancing, the experts are asking good questions and the understanding increases.

The DSM 4 (below) outlines the criteria for substance abuse and substance dependence. Speaking before a large gathering of therapists, counselors and medical professionals at the 45th annual Wisconsin Association on Alcohol and Other Drug Abuse (WAAODA) Dr. Carlton Erickson of the University of Texas explained that dependence means I can’t stop, while abuse means I am making a bad decision.

He referred to abuse being college students drinking too much on a Saturday night. A friend of his asked a super question, “If addiction is a disease, then why should addiction be different from any other disease? Does everyone have what it takes to be addicted?” It’s a good question because we all know that not everybody who drinks becomes and alcoholic, nor does somebody who tries crack cocaine necessarily condemn himself to a life of addiction.

Over the years studies have been done to test this idea, that not everybody becomes and addict. Erickson pointed out that one drug, nicotine, has been tested the most and the results are always the same—over a lifetime of use, one in three (33%) will become dependent. Remember the tobacco industry CEO’s swearing before congress that they did not believe nicotine was addictive? Science has made them out to be liars. Street heroin is next in line with a one in four (25%) prevalence of risk over a lifetime. Cocaine is next with a one in five (20%), with crack being a little higher.

Erickson highlighted cannabis (marijuana) as having a one in ten. “Tell THAT to the teenagers,” he noted with passion. Sedatives, amphetamines and opioid analgesics also come in at one in 10. The opioids are interesting because Erickson stressed that under a doctor’s care, with strict adherence to dosage and frequency, patients should be able to avoid dependence.

However, in the real world we know that people can misuse any drug, so the attention we give to the recreational and addictive use of these drugs may not match the scientific data. Erickson also said that more study and greater data is needed. Psychedelic drugs, such as LSD, come in at one in twenty, as do inhalants.

Alcohol, the most widely misused drug of all, comes in at one in nine. That is interesting to me because alcohol is so socially acceptable.

Erickson stressed that just because a person uses a drug, doesn’t mean they are automatically addicted. He said someone might even “try” to get addicted and can’t, mainly because they just don’t have what it takes to get the disease, the same way another person will never get cancer, heart disease or suffer from diabetes.

For additional information, Dr. Erickson’s web page offers a substantial collection of studies, articles and data covering all aspects of drug abuse and dependence.http://www.utexas.edu/research/asrec/

DSM-IV –TR Criteria for Substance Dependence

Three or more of the following must be present in order for an individual to be diagnosed with a chemical use disorder:
• Tolerance
• Withdrawal
• Substance taken for a longer time and in greater amounts than intended
• Desire or efforts to reduce or control use
• Much time spent trying to obtain substance
• Social, recreational or occupational activities given up or reduced
• Continued use despite knowing problems caused by substance

DSM-IV-TR Criteria for Substance Abuse

Maladaptive use of substance shown by 1 of the following:
• Failure to meet obligations
• Repeated use in situations where it is physically dangerous
• Repeated substance-related legal problems
• Continued use despite problems caused by substance

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