Cravings concepts

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. 

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. 

The traditional explanation either leans on lack of norms and morals or rests the case on a disease concept. The former has ancient roots and is represented for instance by Plato "From the moment of their birth men have a desire for food and drink. Every living creature has an instinctive love of satisfying this desire whenever it occurs, and the craving to do so can fill a man s whole being, so that he remains quite unmoved by the plea that he should do anything except satisfy his lust for the pleasures of the body, so as to make himself immune to all discomfort." (Plato 1970,782). "Give a man correct education, and these instincts will lead him to virtue, but educate him badly and he ll end up at the other extreme," Plato states. Obviously lack of education is seen to be the core problem. Aristotle used the term akrasia, signifying the weakness of the will that makes man unable to resist temptations. 

The concept of addiction, with the concomitant belief that the craving for the drug is near irresistible, is relatively modem. Before 1800, what we would call alcoholism was often perceived as a form of excessive behav-... 

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