Help sort out the meaning of "addiction."

Great Debates
61

That is simply untrue. Wrong. An incorrect inference.

Many things get people drunk - alcohol, ether, nitrous oxide, even ordinary air if it’s breathed at an elevated pressure. Some of these agents are used for clinical anaesthesia - do you believe that they damage the brain?

The nitrogen in air is inert - it doesn’t react chemically with anything in the body, and your body and blood is full of it. And yet it is narcotic when breathed at elevated pressure, pushing extra nitrogen into your tissues. The mechanism is still unclear, but it appears that when extra nitrogen dissolves into the fatty sheaths around our nerves, it makes us drunk. This is called nitrogen narcosis and can affect SCUBA divers. It is also completely reversible when the pressure is reduced and the extra nitrogen is carefully allowed to escape from the body. No hangover, no brain damage, nothing. (You can get “the bends” if you let the nitrogen escape too fast, but that is a side issue. You can do the same trick breathing xenon mixed with air at atmospheric pressure, just as drunk, just as reversible, no problem with the bends.)

Whether alcohol acts by a similar mechanism is not clear, but there are some intriguing indicators. One is that intoxication can be “switched off” by increasing the atmospheric pressure - you can make rats too drunk to run around their maze, up the pressure and suddenly they’re sober. Take the pressure off and they get drunk again. This is called “pressure reversal”, and works for a number of narcotic agents besides alcohol. Does the increased pressure magically halt the “brain damage” caused by the alcohol?

Don’t get me wrong, alcohol can do a body a lot of harm. So can iron, vitamin A, even oxygen, if you have too much of them. But the mechanism of intoxication is NOT “brain damage”, and there is a level of alcohol consumption below which you won’t suffer toxic effects.

(Pressure reversal is briefly mentioned in: http://www.anes.upmc.edu/anesnews/volume/2003winter_spring/articles/focus.html - search for “pressure”. The rest of the article gives a fair bit of detail on the various theories of anaesthesia.)

62

ladies na gentlemen, boys and girls. This is gata ro foflishness, depenting on your pont of view. I ma now frunk. At tjh monmedyyt I am not engaging in any sor to errot correction.

Now I am focusing and correcting errors. I will not preview. The above is supposed to read “this is data or foolishness, depending on your point of view. I am now drunk. At this moment I am not engaging in any sort of error correction.”

It is 1.20 am Saturday. I have been consuming alcohol since 20.30 pm Friday. I cannot estimate the quantity of alcohol I have consumed. I am undoubtably beyond the UK limit for driving. My motor skills are lousy. I seem to be able to recognise and correct mistakes.

I feel middling-good. I have spent the evening in the company of people I like. I am drinking tea and eating toast. I am going to a party on Sunday. I may be going trap shooting before then if the weather holds.

I have a lot of tea. It’s a Scooby Doo mug from the Disney shop, and easily holds a pint. I have fluids to replace. If I remember, I’ll take a vitamin supplement before I go to sleep.

I’ve taken my contact lenses out. I found my glasses first. That is the right order. In the past, I’ve found my contact lenses in their case, filled with saline, left and right correctly placed. I use disposables now - I’ve taken them out, but I can’t remember where I put them. It doesn’t matter.

I’m going to finish my tea, eat more toast and go to bed. Maybe I’m addicted and/or brain damaged. Maybe not. I’ll review and decide in the morning. I think I’m doing quite well at fixing my spelling, but I always was a picky sod.

Submit without preview. Feels like launching a torpedo. Torpedo away!

63

Okay, so I can still proofread while drunk, but my train of thought wanders all over the place. Doesn’t demonstrate a whole lot one way or the other, except perhaps that posting drunk isn’t a good idea.

I’ve just listened to a BBC radio program about alcoholism that mentioned there was a genetic susceptibility - a correlation of alcoholism between twins, and a higher incidence in males with alcoholic fathers. I don’t know how the influence of similar environment was compensated for. There’s some other interesting stuff and first-hand testimony.

The show can be heard online for the next week, but it requires Realplayer, and it streams - you can’t download the whole audio file.

http://www.bbc.co.uk/radio4/progs/listenagain.shtml

Then click on “Brush with the Bottle”.

64

Voltaire drank several cups of black coffee every day. People warned him, “Coffee will harm your health!” Voltaire replied: “Hey, I’m 80 years old. I’ve been drinking coffee every day my whole life. If it was going to hurt me, don’t you think it would have by now?”

Sorry, I call bullshit on this. (Says coffee-addicted Johanna, who at age 45 has had coffee every day for the past 22½ years, half my life. Still kicking.)

Heh, the Germans drank beer with breakfast for centuries. In the 17th century, when coffee was first introduced into Germany, there was a big anti-coffee campaign. This foreign drink (which they got from Muslims, ick!) that people liked at breakfast was cutting into sales of German-made beer.

65

Some notes on the terminology in defense of Tris.

“Addictive” is the word Tris is mostly using in this thread, which is different from “addiction.” Recovering addicts often use this word to cover most any behavior that is associated with their addiction in any way. It can be quite useful allowing them to talk about more than cravings and drugs seeking, but also things like escapism, etc which may contribute to or result from the addiction.

So for **Tris ** to say that drinking to get drunk is “addictive” can be useful - depending on what he’s trying to get at. You might protest that that’s only limited in usefulness to people who are already addicted to something, but maybe not. After all we talk about “addictive personalities” - people who aren’t addicted to anyting but who are prone to it. Addictive personalities presumably have addictive behavior, and the urge to escape reality through psychoactive substances could be considered addictive even if we’re talking about their very first drink.

Obviously, Tris’s defense of his use of the term “addictive” and “addiction” is more extreme. He is intentionally blurring the line between the “addiction” and “substance use.” For most purposes this conflation leaves a lot to be desired. But there is also some validity in doing it. After all a bright line between substance use and addiction is clearly imaginary, and any addict will tell you that if there is a bright line they never saw it until they were well past it. That’s precisely what makes substance use so dangerous.

In the end, my feeling is that it’s dangerous to confuse substance use with addiction because it leads you to underestimate how incredibly powerful an addiction is and how qualitatively different it is from the non-addict’s occasional desire for a drink.

But on the other hand it’s almost equally dangerous to try to pretend the boundaries between addiction and substance use are clear. And not just because drinking risks addiction, but because addictions are very complex disorders that are at root distortions and exaggerations of “normal behaviors” in the brains.

66

That’s just your disease talking. When you’ve hit rock bottom and are ready to recover, Coffee Anonymous will be here for you.

(All kidding aside, apparently there actually are support groups to get people off of coffee! Who knew?)

And lekatt: it’s no secret that heavy, long-term alcohol use can damage your brain. It’s actually caused by a long-term lack of one of the B vitamins due to heavy alcohol use. But this is only a phenomenon that exists in heavy drinkers. It’s not a matter of degree; either you have an alcohol-caused deficiency in that vitamin or you don’t. It’s just not an effect that exists in occasional drinkers.

67

So did I. But, the facts of my blood pressure were hard to deny. At age 45 I drank a pot a day. Now, I cannot drink any. Not every coffee drinker is likely to die from it. Some are.

Tris

68

Hmm, I guess it affects people differently then. It might give my BP a slight nudge up, hard to tell. Are you saying that coffee drives yours up? My BP tends to be a bit on the low side. Now maybe I understand you better.

69

I’ve been reading this thread and it’s possible I understand what Triskadecamus is trying to communicate. Please skewer me swiftly and harshly if not correct:

Instead of saying any drinking is “addictive” behavior, it seems like the point is (possibly) that there is a certain amount of positive feedback going on when drinking, even if it’s a small amount. I know I look forward to the feeling associated with having 1 drink.

So maybe Triskadecamus is trying to say that this positive feedback due to the effects of alcohol influences future decisions about beverage choice (all things being equal, in situation X I decide to have alcohol instead of water because I like the effect), which is pointing me in the general direction of addiction, at least more so than compared to not drinking.

maybe?

70

You could well be right; and if that’s all he’s saying, I can’t disagree that strongly.

However, as I see it, there’s a vital distinction between an alcoholic’s craving of the bottle and (for example) my adoration of well-made creme brulee. When I have a bite of this creamy dessert, my spoon crackling through the brittle caramel crust, I am transported. It is a glorious moment. The first bite spreads an expression of pure bliss across my face. Major positive feedback.

And then I’m done. I may or may not finish my serving of the lovely dessert; if I don’t, I might put it in the fridge for tomorrow’s breakfast. I don’t see it every day. I don’t eat it when I’m alone, eating serving after serving until I make myself sick. I don’t count the hours until I can next eat creme brulee.

The word “addiction” is, I think, a useful word to describe a certain type of self-destructive behavior. I think it’s a good idea not to dilute the word by attributing to it an overbroad definition, one that includes my delight in a fatty treat as well as an alcoholic’s desperate need for the next drink.

Daniel

71

Oh, well, why not.

RaftPeople, you have seen my point quite well. If you look carefully, you will find I never even suggested that every person who drinks becomes hopelessly alcoholic. Everyone seems to think that recognizing the wide spread nature of the adverse affects, and the fact that every person’s body responds to every single drink of alcohol with metabolic changes, will somehow make the word addiction useless. I don’t think so.

Addiction to alcohol is not some irrevocable condition that magically takes place at the confluence of an arcane set of genetic and social circumstances. It is a process, which includes genetic, emotional, social, and environmental factors. But the one factor that is absolutely associated with alcoholism is the use of alcohol as a beverage.

Occasional use can lead to alcoholism, so it is not simply a matter of totaling up our use of alcohol, and comparing it to a standard. There is no standard. Some people plunge into binge drinking, and after even months of it, stop drinking without difficulty. But that doesn’t make it risk free behavior. Noticing that is not a devaluation of the word addiction. Some people become alcoholics and are never observed to be intoxicated by anyone, including those intimate with them. But they are addicted. Noticing that does not dilute the word addiction.

Addiction is a complex phenomenon. But every drink is a part of it, when it occurs. Usually the person to which it is happening does not perceive it as a problem. So, I ask again, if it doesn’t start happening on the first drink, when does it start? If it only happens to someone who is genetically predisposed, is that a yes no dichotomy, or a range? If it is a range, doesn’t that suggest that the process still takes place starting with the very first iteration? If not, when? If it only takes place under social or emotional stress, why does it start with the first drink after the stress occurs, but not before that?

I am not the flaming temperance advocate that everyone seems to think. I am just a person who thinks that chemistry is the same, no matter how much you think it shouldn’t be, or feel it won’t be, or how much you think you aren’t affected by it. Sure people vary. But the chemistry of alcohol metabolysis does change the body. And when does that change start to take place?

Any answer other than “the very first time that alcohol is ingested” seems to me to be an extraordinary claim. Why the 75[sup]th[/sup]? Yes, emotional stress, physical illness, and a hundred other factors can certainly also have effects. But that doesn’t change the fact that any addictive substance begins to have its addictive effects with the first dose.

Forgive me for not respecting the importance of the word addicted, although I don’t think I do, but the dance around the first drink, seems contrived to me. Defensive. I think drinking starts with one drink. I think alcoholism starts with drinking. I find all the arguments I have heard so far against that view unconvincing.

(I do still drink, now and then, although I haven’t been drunk in decades.)

Tris

“It was a woman drove me to drink and I didn’t even have the decency to thank her.” ~ W.C. Fields ~

72

When your body can’t homeostatically return to the same state upon continued absence of substance.

Technically, this never happens, since with every input (substance or otherwise) and passage of time, there is some irreversible change, i.e. with vision, some part of your brain irreversibly changes to perceive, keep in working memory, or store for long-term, the current input.
But within larger scopes of organization or function, things stay in a slowly-changing equilibrium. If an agreeable state can be reverted to, upon abstinence, you’re not addicted.
I’m sure you are aware that every substance can kill you in sufficient quantities i.e. too much water can kill you. So, would you say that drinking a glass of water kills you just a little bit? If I take that to literally mean that at least the death of a single cell, then yes. I’m sure some cell(s)'s death in the body is induced, or otherwise accelerated. by some of the incoming water molecules. But in the sense we find the language to impart useful meaning, the answer’s obviously No. Addiction is a state, not a process. Either you’re, or you’re not.

73

Two factors, actually: alcohol’s use as a beverage, and its consumption by a living human. Do we therefore say that being human is an addictive phenomenon?

A Venn diagram would be helpful. The set of active alcohol addicts lies entirely within the set of alcohol drinkers, it’s true–but the set of alcohol drinkers does not lie entirely within the set of alcohol addicts. As I understand it, you’re claiming that the sets occupy the same space; this is where I disagree.

[quote]
Some people plunge into binge drinking, and after even months of it, stop drinking without difficulty. But that doesn’t make it risk free behavior. Noticing that is not a devaluation of the word addiction. Some people become alcoholics and are never observed to be intoxicated by anyone, including those intimate with them. But they are addicted. Noticing that does not dilute the word addiction.[/qote]
Agreed.

You’ve got a “God of the Gaps” argument here, similar to this one:

A mountain is made of tons of rocks. I ask you: if I pile rocks one on top of the other, at what point do I have a mountain? If it is not at the first rock, when is it?

And yet I’m not convinced that a single pebble is a mountain, even if I cannot point to which pebble’s addition turns a pile into a mountain. My inability to point to the mountainous pebble bespeaks the complexity of the definition, not the need for an oversimplified definition that changes how we speak of geologic features.

Similarly, my inability to point to the drink that turns someone into an alcoholic does nothing to prove that the first drink is the one that turns someone into an alcoholic. It’s a very poor argument to say otherwise.

Yes, alcohol metabolysis changes the body. But it changes different folks’ bodies in different ways. I repeat: it changes different folks’ bodies in different ways. While those changes start at the first drink, in some folks the first drink is part of the process of alcoholism and in others it’s not.

Likewise, your sophisms in this thread seem contrived to me; you keep resorting to these snide little personal attacks when your argument is weak. Knock it off, wouldja?

Daniel

74

Yet, your understanding is in no way based on my statements. My statement implies that the entire set of alcoholics lies within the set of those who have used alcohol more than zero times. Forgive me if I ignore this argument, since it obviously isn’t an argument with me.

Another argument with yourself going on here. My point was that if you start building a mountain by piling up rocks your starting point is the first rock. I pointed out that the definition of this particular type of mountain is vague in the extreme, and person specific in every case.

Agreed. I certainly would argue with anyone who tried to assert that. Of course, again, that isn’t me.

Yet that assertion is based on the belief that there is some difference in the first drink and some subsequent drink. I find that ludicrous. It is true that the process proceeds in widely divergent ways. It is true that for some the risk is far greater, and for some the risk far less. The process still involves each iteration. The difference in subjects does not alter that.

OK.

All alcoholics have used alcohol more than zero times. People who never consume alcohol in their lives are never alcoholics. Never, not even one, despite any amount of emotional stress, social pressure, or genetic propensity. Using alcohol is associated with alcoholism, to a greater extent than any other factor.

Tris

75

Okay, at this point, Tris, you’ve completely changed your argument to the point that I can’t find anything in it with which I disagree (reread your earlier posts in this thread). Excellent!

Daniel

76

In the context of a debate about addiction, this statement is absolutely meaningless.

77

People who would become alcoholics if they were to consume alcohol are more likely to become addicted to other substances or activities. Anyone who has that gene, AIUI, is an addict waiting to happen, and whether they eventually become addicted to alcohol, pot, shopping, or sex is somewhat less important.

78

So, are you claiming that there is a one hundred percent correlation with this gene among alcoholics? (Are there any alcoholics at all who do not have it?)

Tris

79

No, and I don’t know.

However, people without the gene don’t become alcoholics simply by having a few drinks and learning what a buzz feels like. Enough consumption of alcohol can cause physical dependence, but it takes more than that, psychologically, to make an addict.