Addictions concepts

Sanchez-Carbonell X, Sens L Ten-year survival analysis of a cohort of heroin addicts in Catalonia the EMETYST project. Addiction 95 941—948, 2000 Schindler SD, Eder H, Ortner R, et al Neonatal outcome following buprenorphine maintenance during conception and throughout pregnancy. Addiction 98 103-... 

Roffman RA, Barnhart R Assessing need for marijuana dependence treatment through an anonymous telephone interview. Int J Addict 22 639-631, 1987 Russo EB Clinical endocannabinoid deficiency (CECD) can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions Neuro Endocrinol Lett 25(1-2) 31—39, 2004... 

Tolerance, sensitisation, craving, withdrawal and relapse may actually be more complicated than indicated above and may involve separate mechanisms which are too complex to summarise here (See Altman et al., 1996). Recent research on specific drugs of abuse is reviewed by several authors in a special issue of Trends in Pharmacological Sciences 13 169-219 (1992). However, the concept of addiction as "an emotional fixation. .. acquired through learning, which intermittently or continually expresses itself in a purposeful stereotyped behaviour with the character and force of a natural drive, aiming at a specific pleasure or the avoidance of specific discomfort (Bejerot, 1980) still broadly applies. 

Lader M (1993). Historical development of the concept of tranquillizer dependence. In Hall-strom C (ed.) Benzodiazepine Dependence. Oxford Oxford Medical Publications, pp. 46-57 Lader M Morton S (1991). Benzodiazepine problems. British Journal of Addiction, 86, 823-8... 

Subsequently, a committee composed of representatives from the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine have developed a definition that includes typical behavioral changes, as well as the concept of denial ( 387). They characterized alcoholism as the following ... 

Due to a combination of increasing concern about the implications of AIDS/HIV for the treatment of drug takers, and increasing polarisation of attitudes and treatment policies between the Drug Dependence Clinics and private doctors in addiction, the past year has witnessed a renewal of the debate about appropriate prescribing. However, although this debate tends to focus on the currently fashionable concept of flexible prescribing , it has frequently been characterised by the adoption of rather inflexible and extreme positions. 

I have, among other things, been presenting some grounds for dissatisfaction with talk about motivational compulsion, understood on the model of irresistible desire. Although addiction is commonly described (if not always strictly defined) in these terms, we need not be skeptical about the concept itself. For the crucial notion here, 1 suggest, is the idea of an acquired appetite. It is this notion that explains the stereotypical or... 

Since nonhuman animals lack a capacity for critical evaluation, they are not even prima facie candidates for either motivational compulsion or weakness. Addictions may move them contrary to their own good but not contrary to their own conceptions of the good. Nevertheless, when their addictive behavior displaces their natural appetites, they suffer from what might be called an appetitive impairment. 

Nor does the conception of addiction as acquired appetite imply that this condition is necessarily harmful, all things considered. Certain addictions can be regulated without interference with a person s physical or mental health or with productive social relations.27 Opiate dependency can be a reasonable price to pay for control of acute or chronic... 

The conception of addictions as acquired appetites raises difficult questions about both of its constitutive concepts. What should be comprised under the heading of appetite How exactly can we distinguish between appetites that are acquired and those that are original Here, 1 can only touch on these issues. 

By itself, this conception leaves it open whether and to what extent addiction is a bad thing in particular cases. That seems to me desirable. The issues raised by addiction are not sharply distinct from the issues raised by the appetites in general. In part, these concern our notorious troubles in dealing well with the pleasures of life. Addictions dispose us to be ted on and distracted by pleasure, as though it were our master. In extreme cases, they can even corrupt our sense of what evil is, but they can also figure as part of the meaning of a life well enough lived, at least compared to the alternatives. In this respect, too, addictions lie on a continuum with the other appetites. 

The closest relative of this account that I have found in the empirical literature is Loewenstein s (1999) visceral theory. Loewenstein identifies addictions with conditional cravings. Like the proposed account, this view emphasizes the similarities between addictions and appetites and other visceral factors. Loewenstein also emphasizes the importance of cue conditioning for craving. I am not clear enough about the author s conception of craving to venture a more detailed comparison and contrast here. 

Addiction can be thought of as a specific change in some neural pathways. This approach, important as it is, is silent about whether the addictive behavior can be explained as rational behavior or not. Likewise, the explanatory approaches of rational choice theory are silent about whether our wills are unfree when we are addicted but desperately want to quit. Freedom of the will is not a concept placed within rational choice theory that theory explains free action, actions wherein we do what we want. This leaves room for a different sort of theorist, that is, a philosopher. 

---