Tuesday, July 21, 2009

Dependence vs. addiction vs. legality.

Yeah, I'm gonna say it. Don't know why since everyone reading is already in the loop on this, but I'll say it anyway. And there are some interesting facts and statistics to drag in that I don't think everyone's aware of.

ETA: A friend of mine who specializes in this stuff has e-mailed me some comments, so I'm gonna throw them in, in a few places. They obviously know more about this than I do.

So. The definitions, just to be tiresome. I've got a slightly different view than the legal and medical worlds, but it all comes out to about the same thing.

Dependence is when some chemical - we'll call them all drugs, though society doesn't always call them that - has some affect on the body that results in unpleasant responses when the chemical is then cut off. Most often these reactions and responses happen in the brain, but not entirely. To use an obvious example, when you take an opioid (one of the many alkaloids from our friend the opium poppy, or related synthetics), your brain chemistry adjusts to having that in your system. Then when you quit taking the opioid, your brain has to adjust again. That's all withdrawal really is - symptoms of your body adjusting to not having a chemical in it. A perfectly normal physical response. And while the degree of dependence and withdrawal will vary by person, the fact of it is proven and everyone gets some form of it.

Addiction is when you steal your grandmother's wedding ring and sell it for drug money. Or rather, it is a BEHAVIOR, a CHOICE, if you will, that is prompted by chemicals. Dependence is inevitable. It is a physical reaction. Addiction is not. It is a choice. I know, I know, some bleeding hearts out there will claim that addicts can't help what they do. I say that's bullshit. They choose to do it. Now, do they need help? Yes. Should they GET help? Absolutely. Do they deserve sympathy? Maybe, sometimes, maybe. But ultimately, all of us behave the way we choose and we all need to take responsibility for it. (Sorry. This is a major hot-button topic with me. I'll get a grip.) Anyway. On a personal level, I define addiction not so much by withdrawal symptoms or heavy use, but by what a person will do to get a hit. Those people who lick toads for a hallucination? I see that as a bit more of a problem than someone who puffs a joint handed to them at a party. Licking a toad seems a bit more extreme to me. A college kid who smokes marijuana and has a 4.0 grade average while doing a master's in organic chemistry? I don't see that as a problem. No matter what they're doing, they're meeting their responsibilities in life, and very well at that.

ETA: According to my friend, addiction is medically defined as "Addiction: A chronic, relapsing disease characterized by compulsive drug-seeking and abuse and by long-lasting chemical changes in the brain." (Their emphasis.) And also pointed out "Yeah, there's a choice component to it, but the compulsive use of drugs jacks up those areas of the brain that control choice. It's a chicken/egg issue. You probably have a susceptibility before you become addicted, and it just makes things worse. " I agree. We're discussing major brain chemistry shifts, and so there is some compulsive behavior involved. That's why I'm saying these people do need and deserve help, and sometimes sympathy. Those people who really fight it, who struggle against it, and slip up, yes, sympathy is needed (Robert Downey Junior is leaping to the front of my mind, here). But so many others seem to revel in it, and I do think in too many cases, there's more choice and less brain chemistry involved. (I would like to add, I've watched this stuff close up, with members of my family. Some I've supported through some really shitty times. Others I've cut out of my life entirely. As with so much else, it's all about degrees.)

Now, with the above, some of you may be thinking "that means people can get addicted to anything, working with that definition". Sure does. Those people out there who go bankrupt because they can't stop buying stuff? I see that as a form of addiction as surely as the people who go bankrupt buying cocaine. And they are just as surely in need of treatment.

ETA: My friend says "I take issue with the addiction to stuff concept, like shopping or fiber or gambling or sex. That's an issue of people who like to do it a lot, and like the rush they get, and have poor impulse control."

So, obviously, in my view, physical dependence isn't that big a deal. It's a damned annoyance, certainly; I'm cutting back on some medication right now and it's making me miserable. (Hence the blog post.) Does this make me an addict? Of course not. I took them for a medical condition and actually have more in the cupboard; I don't need any more right now so I'm not taking them. See where/how the behavior factors in?

Here's the really fucking annoying part. In the United States, and most other countries I'm aware of, drugs - medical drugs AND recreational ones - are allegedly made illegal or controlled due to physical dependence. If a drug causes physical dependence, SO THEY CLAIM, then the drug is a controlled substance if medical, and illegal if recreational. Sounds reasonable, even intelligent, and if those rules were actually FOLLOWED in any real way, I'd say it was a workable system. But really? That little guideline above is used when convenient and ignored otherwise. Let's have some examples, shall we?

-Caffeine. Ever quit caffeine cold turkey? Sucks ass, doesn't it? Blinding headaches, nausea, mood alteration, you name it. Major brain chemistry wonkiness. Yet you can buy the stuff ANYWHERE. Grocery stores, shops, hell, WE SELL IT OUT OF VENDING MACHINES! Caffeine is an absolutely CLASSIC example of physical dependence, and here's the government claiming anything that causes physical dependence should be controlled. Usually with a big pot of coffee in the offices of the idiots making the anti-drug proclamations.

-Booze. Okay, ethyl alcohol. Didn't know it caused physical dependence? Well, it does. Hangovers are partly withdrawal symptoms. (They're also partly your body simply processing the stuff.) But that's not what I'm talking about. I'm talking about the folks who drink a lot of booze, for a prolonged amount of time, suddenly going cold turkey. THE DEATH RATE IS AS HIGH AS THIRTY-FIVE PERCENT. That's right, alcohol withdrawal can KILL YOU. And unlike caffeine, narcotics, and a lot of other chemicals, booze has no (or almost no) medical use when used internally. Meaning it is legal entirely for recreational purposes.

-Chocolate. Yes, I hate to ruin it, but for many researchers, chocolate is fascinating because we act like addicts for it (sometimes - how many of us blow our diets by eating chocolate?), yet no one can find any sign of physical dependency caused by it. Meaning it completely disproves everything the DEA tells us about physical dependency and addiction. I read an entire book about this once, and it actually ruined my desire for chocolate. For about 24 hours. See what I mean?

-Marijuana. No matter how much the DEA would wish otherwise, marijuana doesn't cause physical dependency. Researchers have looked for years and haven't found any sign of it. People quit smoking weed all the time and while they often wish they could have some (mild addiction?), they don't go through any physical reaction from not having it. Additionally, because it is inhaled, it is almost impossible to overdose on; you fall asleep before hitting anything like a physical limit for it. Some researchers, a few years back, searched all the ER records in the US looking for one case of marijuana overdose, and were unable to find one.

So. You read this stuff, and you wonder, what in hell is REALLY going on, with how we decide what's illegal and what's not. The unpopular truth is, it has nothing to do with addiction, dependence, or anything remotely scientific. It's social. Booze and caffeine have been popular in the west and used for time out of mind. They're 'approved' drugs, and therefore legal. Marijuana is 'foreign' (from the Middle East, originally), and - at least in the beginning - misunderstood, and therefore illegal. Fucked up as all get-out, and more and more researchers are beginning to point that out to the lawmakers. I think the next decade or two are going to be really interesting in terms of drug laws.

ETA: Friend adds "Researchers get that most people don't get addicted to many of the drugs - some have higher addiction potential than others. Like heroin. That's bad stuff, and recovery is terrible. For serious addicts, the issue is really the relapse thing. They can quit - just not for very long. It's not a lot of people who have this problem compared to the number of recreational users, but once you're addicted, relapse rates are depressing..." Very true. And I suspect that if researchers and scientists made the laws, things would be WAY different. (And for the record, heroin is on my list of drugs I think should remain illegal, for exactly those reasons.)

If marijuana gets legalized? I will bet you it will be the idea of tax revenue that will motivate it. Not science or reason.

For those of you who haven't seen them, there is an excellent series of documentaries called "Hooked: Illegal Drugs and How They Got That Way", originally made for the History Channel in 2000. The episodes can be found on YouTube. Part one of the episode on marijuana can be found here. The other episodes can be found in the sidebar.

These documentaries will be required watching for the Goober, once she's old enough to understand them. You all may have noticed I'm more about education and good decision-making than rules.


Barbara said...

I agree, Hooked is a great series, very engrossing. Nice post, I am a nicotine addict (2 years clean) and it still nags me every day. Stupid cigarettes. I'm diappointed that there's no scientific proof of chocolate dependency. Yet. I can't wait to see the Goob grow up. Your parenting style is like mine and our kids grew into fabulous adults. (If I do say so myself.) More Goob pictures please.

Anonymous said...

I heard on the news that the RI legislature recently agreed to fund a study to see what the revenue of legalizing marijuana with a sin tax would be. I couldn't find a link the last time I looked. I think it was a $30 sin tax. This is because medical marijuana is approved here, but there is no way to legally buy it, or something like that, so in looking into fixing one they decided to look into the other. If I could get an occasional certified organic joint? And nobody would take my kids away? I'd probably be a better mother. Medical Marijuana for Moms. Shall we start a movement?

--amy, just paranoid enough not to link back

WendyR3 said...

Great post - even if it's not knitting related. But you forgot the biggest legal addiction: nicotine. Meets all the same definitions, but still legal. Stupid, but legal. Which makes me think that most of these laws are because of industry money backers. The alcohol, tobacco and pharmaceutical companies are some of the wealthiest and most powerful politically and have the most influence over our "law makers". JMHO.

Anonymous said...

When it comes to marijuana, I agree with you 100%. I have actually heard that the reason it was made illegal (George Washington and Thomas Jefferson grew the stuff, probably for medicinal use) had to do with the cotton lobby. Hemp, made from the same plant as marijuana, is a better fiber, so the cotton lobby got it made illegal to cut down on competition. I don't have a source, but it's worth looking up.

Take care.

debsnm said...

I'm with you - once the govt figures out how much money they cam make growing, selling & taxing the shit out of marijuana, it'll be legal so fast we won't know what hit us. Dumbasses

Anonymous said...

Great post - thank you for writing it. You've put my thoughts into words better than I ever could.

I would gladly pay a ludicrous tax percentage on pot if it meant I could go to the store, buy it, sit on my balcony and smoke it without fear of repercussion.

Alwen said...

What, no comments on meth yet?

Okay, I'll add a couple. My brother works for a place that collects hazardous waste. Meth labs make a site so toxic that he has to suit up to clean it up.

It takes people who think maybe other people can't quit, but they will be able to, and hooks them so hard they drive down the road making the stuff so the distinctive chemical smells dissipate.

And they must be tossing the toxic waste on the roadside, because if I want to join an Adopt-A-Highway group and pick up trash along the road, I have to watch the safety video and the meth lab debris video first.


Louiz said...

Interesting post, and I'll be looking at those links. My opinion is that when politics don't make sense and laws are not applied evenly, look where the money is.

I work in the legal industry where some of the work we do is called "care work" (this means dealing legally with cases where children have been taken into care for one reason or another)and we see again and again the same parents having children taken away, and although there are always exceptions, for the most part it's like a broken record and leaves a sour taste in the mouth. "Addicts" can be addicted to anything, but the real tragedies happen when the addict won't face reality and has responsibilities to their families that they avoid.

Anonymous said...

Right on!!! on all counts, including Louiz's comment re "following the money."

Donna Lee said...

I'm dependent on my blood pressure meds to keep my bp down low enough to keep me from having a stroke. I'm also dependent on food and oh, yea, air. We've made "dependent" a bad word but it's a reality.

TinkingBell said...

In Britain and Europe heroin is legal, especially for terminal cancer patients. Doctors prescribe it. Pure, unadulterated, government produced and regulated heroin. Lot better than morphine and much better than codeine. You have to be pretty bad to get it, but you do.

There was a woman with 'terminal' cancer who was prescribed heroin in Britain. She got better, but noone told her to stop with the heroin. She kept taking it. some years later someone noticed, so she apologised and stopped. Just like that. No withdrawal. No addiction. No real dependency. Apparently her nose ran for a few days. Makes you wonder which chemicals in the street heroin people actually get 'addicted' to - and how much of the withdrawal is physical and how much psychological.

Anonymous said...

Just feel I have to comment re: legality of heroin in Britain. It is absolutely NOT legal for terminally ill cancer patients, having had a mother who was one I feel I can comment on this. I really don't want anyone going away thinking it's legal or recommended! Hospital grade morphine is given (under strict prescribing conditions - ie if caring for patient at home it is all checked out and you have to give any remainders back after patient has died) for palliative care, but I would assume most modern medical practices do the same. Morphine and heroin are both opiates, sure, but are totally different beasts.

Anonymous said...

Oakland, CA just passed an initiative that adds a city tax to medical marijuana that is legally dispensed in pot clubs. The owners of the clubs fully supported the tax hoping that it would help pave the way to legalize marijuana sales. It passed with 80% approval rate.


Emily said...

Wow. Quite a read.

Once, upon seeing the cannula attached to my face, a woman said, "I see you're dependent on oxygen."

"Well," I answered, "so are you."

hawkeye said...

here is that article about the oakland approved tax. http://kdka.com/national/oakland.pot.tax.2.1096183.html
btw, kim is my ex and she pointed me to your site a while ago and when you post particularly good posts. love the post. very informative and just the right amount of personal opinion to drive the point home. i am dependent on opiates for my arthritis. i would much prefer to use marijuana and i have had a card in oregon for that purpose. i actually take less opiates for pain control when i increase my thc intake. food for thought...

Amy Lane said...

My son and I were discussing this today. My conclusion? People can grow marijuana in their back yards, and there goes profits for the drug companies, the booze companies, and the cigarette companies. It's just like Chris Rock said ten years ago-- only the white man can profit from the people's pain.