Meaning of Addiction

Peete, Stanton. 1985. The Meaning of Addiction. New York Heath. 

Peek, Stanton. The Meaning of Addiction Compulsive Experience and Its Interpretation. Lexington, MA Lexington Books, 1985. 

Stanton Peek s The Meaning of Addiction Compulsive Experience and Its Interpreiatioii (Lexington, Massachusetts Lexington Books, 1985) is one of the most insightful commentaries on addictive behavior. See also Chapter 7 of Andrew Weil s Natural Health, Natural Medicine A Comprehensive Manual for Wellness and Self-Care (Boston. Houghton Mifflin, 1990). 

The search for opioid analgesics which show reduced addiction liability ha.s centered largely on benzomorphan and morphinan derivatives. Some research has, however, been devoted to derivatives of the structurally simpler meperidine series. The preparation of one such compound, picenadol (59), starts with the reaction of N-methyl-4-piperidone with the lithium derivative from m-methoxybromobenzene. Dehydration of the first formed carbinol 51 gives the intermediate 52. Deprotonation by means of butyl lithium gives an anion which can be depicted in the ambident form 53. In the event, treatment of the anion with propyl bromide gives the product 54 from reaction of the benzylic anion. Treatment of that product, which now contains an eneamine function. 

Findley, J.D. Robinson, W.W. and Peregrino, L. Addiction to secobarbital and chlordiazpoxide in the rhesus monkey by means of a self-infusion preference procedure. Psychopharmacologia 26 93-114, 1972. 

There are not currently any medications that have been approved for treatment of MDMA addiction. In actuality, very few drugs of abuse have possible medical (pharmaceutical) treatments. Heroin addiction is one disease that is treatable by pharmaceutical means. Heroin addiction is often treated with methadone or levo-alpha-acetyl methadol (LAAM) administration. Similarly, alcohol addiction may be treated with pharmacological tools. However, most stimulants, such as cocaine, amphetamine, and MDMA, do not have medications available for treatment of addiction. 

Even therapists who have studied all that there is to study on motivational interviewing, have made several video tapes on the subject, and are invited to do workshops on the topic, are by no means infallible. For our own benefit, and we hope for the benefit of other therapists, we have studied our own shortcomings. The following pitfalls are the most dangerous ravines to stumble into as a therapist working with the motivational problem of addicts. 

Addiction often involves what some writers call existential dependence (Seeburger 1993) that is, the development of an identity to which the addictive practices are crucial. In this way, devotion to the relevant behavior becomes bound up with the meaning of one s life. Pete Hamill (1994) describes his relation to drinking in this way ... 

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. 

Addicts are not people without willpower or people driven to act with out making choices. The clinical picture is of people who too often make choices that, in the long term, reduce their long-term utility and their total well being and, in addition, often burden both their families and society. These choices are suboptimal to long-term utility and, therefore, in the meaning of rational choice theory, irrational. The core problem is one of impeded rationality, of insufficient choice capacity to integrate present and future consideration in a sufficiently consistent pattern. 

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