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Drug addiction: The complex truth

231 points by carey 13y ago

GotAnyMegadeth 13y ago
Kind of on topic: I was surprised to find out that Nicotine is thought to be more addictive that Heroine... http://en.wikipedia.org/wiki/Nicotine#Dependence_and_withdrawal http://en.wikipedia.org/wiki/Nicotine#Dependence_and_withdra...
- Semaphor 13y ago
  Nicotine itself (without the byproducts that happen when burning tobacco) is not even that bad [1] (deadly in relatively low amounts but unless you take it concentrated it's very hard to reach those levels). Unhealthy? Yes, but probably not much worse than caffeine [2]. Besides, Nicotine itself is not that addictive "Technically, nicotine is not significantly addictive, as nicotine administered alone does not produce significant reinforcing properties. However, after coadministration with an MAOI, such as those found in tobacco, nicotine produces significant behavioral sensitization, a measure of addiction potential." [3] [1]: There are a few studies that look at nicotine excluding cigarettes on Google Scholar. [2]: Compare http://en.wikipedia.org/wiki/Nicotine#Pharmacology http://en.wikipedia.org/wiki/Nicotine#Pharmacology and http://www.energyfiend.com/harmful-effects-of-caffeine http://www.energyfiend.com/harmful-effects-of-caffeine [3]: http://en.wikipedia.org/wiki/Nicotine#Psychoactive_effects http://en.wikipedia.org/wiki/Nicotine#Psychoactive_effects
  - berntb 13y ago
    >>[2]: Compare http://en.wikipedia.org/wiki/Nicotine#Pharmacology http://en.wikipedia.org/wiki/Nicotine#Pharmacology and http://www.energyfiend.com/harmful-effects-of-caffeine http://www.energyfiend.com/harmful-effects-of-caffeine Cough, was that completely honest? since you linked to Wikipedia for Nicotine, I suspect you did know you'd get lots of really good effects by linking to Wikipedia for caffeine. :-) http://en.wikipedia.org/wiki/Health_effects_of_coffee#All-cause_mortality http://en.wikipedia.org/wiki/Health_effects_of_coffee#All-ca...
    - Semaphor 13y ago
      Wikipedia had a lack of harmful effects of caffeine (or at least none written in a way I as a layman can understand) and I thought a site with articles about caffeine selling caffeine products would make an okayish substitution. Again for nicotine there is no convenient list on Wikipedia, so: > In one study, a group of Alzheimer's patients were given nicotine patches, while another received a placebo. Those with nicotine patches maintained their cognitive abilities longer and sometimes even recovered lost cognitive function. > Contrary to popular opinion, the study showed that nicotine actually boosts the growth of new blood vessels. > In 2006, Duke scientists found that people with depression who were treated with nicotine patches reported a decrease in their depressive feelings. The results were perhaps not surprising for a drug associated with imparting a "buzz." However, the research also showed a direct link between nicotine and an increase in the release of dopamine and serotonin, two vital neurotransmitters. A lack of dopamine or serotonin is a common cause of depression. -- http://health.howstuffworks.com/wellness/drugs-alcohol/nicotine-health-benefits.htm http://health.howstuffworks.com/wellness/drugs-alcohol/nicot... again, there is much more on Google Scholar.
- mumbi 13y ago
  I find that nicotine's addictiveness is due to legality. That being said, I quit the various opiates much easier than cigarettes.
  - hackula1 13y ago
    As a smoker, I wish it was illegal tomorrow. Then I could buy one or two smokes every now and then, but I would have to go well out of my way.
    - borkabrak 13y ago
      At $10 per cigarette, in a neighborhood where you're likely to get shot. But they're illegal in order to keep us safe. Right.
  - rahoulb 13y ago
    As someone that has smoked [1] I think legality is important - but it's also the relatively mild effects. If you're getting frustrated at work, you can take a break, give yourself a quick "boost" by stopping for a cig, and then go back to work. Something that's not really possible with heroin, or marijuana or any other "drug" apart from caffeine. [1] ten years on and I still don't say "ex-smoker" as one of the mental tricks to help me deal with it EDIT formatting
- madaxe 13y ago
  You can also extract enough pure nicotine from a pack of cigarettes to kill a man, if you know how. It's not hard. Nasty things. Time for a cigarette break.
PGenes 13y ago
What's true of rats is true of people in this case. Economically deprived people are far more likely to abuse alcohol and drugs.
jmngomes 13y ago
"When Alexander’s rats were given something better to do than sit in a bare cage they turned their noses up at morphine because they preferred playing with their friends and exploring their surroundings to getting high." Well, AFAIK, this doesn't happen with most humans struggling with addiction to hard drugs. Addicts will neglect everything, namely social activities, in order to get what they need.
- TelmoMenezes 13y ago
  As far as you know. Firstly, the study is about the onset of addiction from one single experience with the drug. People that take a drug once and decide to not do it again don't attract the same social and media attention as heavy users. Similarly, if functional users of hard drugs exist, you are unlikely to hear about them. This is one of the effects of the drug prohibition: it hides a lot of data. More worryingly, science becomes compromised when researchers cannot attract funding to explore unpopular hypothesis.
  - westicle 13y ago
    This. People assume that all opiate users are crackheads committing armed robbery. Many are highly skilled, highly paid professionals. I must confess a certain amount of cognitive dissonance seeing middle-aged men in tailored suits scoring heroin on the street!
    - redblacktree 13y ago
      These days there is no need for that. They can just visit a "pain clinic" and get a prescription.
      - westicle 13y ago
        Apparently not in St Kilda.
    - girvo 13y ago
      I was :) I even ran a startup while I was using. Heroin is not a drug that discriminates.
rwmj 13y ago
Does anyone really think "one try ... is enough to get us hooked"? They can't know any overt functional drug users if that's the case. Cocaine in particular isn't instantly addictive. If anything on the few occasions I've used it, it actively put me off.
- onion2k 13y ago
  "If anything on the few occasions I've used it, it actively put me off." Cocaine can't have actively put you off that much if you did it again a few times. Reminds me of the joke "Quitting smoking is easy. I've done it lots of times."
  - guruz 13y ago
    Why does this need to be the case? I guess for most people it is more like "there's so many movies about this stuff and famous people take it, it MUST be good, I need to try".
  - rwmj 13y ago
    Considering I've not taken it, or even thought about taking it, for over 15 years, I'd say you are wrong.
  - strickjb9 13y ago
    I enjoyed your comment so I don't want you to think I'm being rude but I think there is a difference between trying a drug (maybe more than once) versus becoming addicted to it and needing to quit. My best (and personal) example is that I would smoke a cigarettes with friends back in college whenever we were out and drinking. It provided a good additional buzz and it was somewhat social. I'd even buy my own pack so I could have one if my other smoking buddies weren't around (also when I was out drinking). I averaged 2-4 cigarettes per week and I'd even go weeks without smoking as well. It was sporadic and I didn't enjoy cigarettes any other time. When I saw people smoking during the daytime I would actually be kind of disgusted at the thought of smoking. So I guess my point is... was I addicted? I don't think I was. Was there ever a line that I would say that I "quit smoking"? Eventually I did stop my "casual" routine. Even now, I think I would still smoke a cigarette if I was put back into similar situations. I think it's completely reasonable to have tried a drug many times and not be considered addicted. On the contrary, many of those same college friends I smoked with I would consider to be addicted. It wasn't a limited activity. It was an anytime and anywhere activity.
Siempre 13y ago
"When naloxone, which blocks the effects of morphine, was added to the morphine-sugar mix, the rats’ consumption didn’t drop. In fact, their consumption increased, suggesting they were actively trying to avoid the effects of morphine, but would put up with it in order to get sugar." Is not completely right.. How about the usage increased because they were actually looking to get more morphine?
mumbi 13y ago
My question is this: if the rats knew that taking the morphine after moving to the park would keep the withdrawals away, would they have still taken the water?
- yebyen 13y ago
  Yeah good question! Reading that story, I understood first that rats like sweet things and hate bitter things. Second that rats are usually willing to take Hobson's choice, and the point of the article being that most scientists don't realize that's what they've actually been testing. I understand that heroin withdrawals are pretty terrible, I've even heard said that "you'd do anything" to make them stop, but they can't kill you in a sort of way that alcohol withdrawals can. It sounded from my reading more like toward the end of the experiments though it was becoming clearer that the rats in Rat Park genuinely did not like the effects of the drug on their normal lives, and when they had the other option of socializing, they were only still taking the drug to get at the delicious sucrose.
  - Ziomislaw 13y ago
    I have 2 rat pets. I can confirm that they LOVE sugar. It probably is the single thing that makes them fight each other for it (if one finishes candy first etc)
robbiep 13y ago
I have previously commented on this topic on HN, but since it's back i'll go again. As a medical student I was taught that addiction is a spectrum. Each drug falls somewhere on that spectrum in terms of addiction potential, (And as GotAnyMegadeth comments, Nicotine is more addictive than Heroin) and every person has some prior probability of becoming addicted, due to the complex interplay of social/biological factors that go into the nature of an addiction). Okay - so Heroin is less addictive than Nicotine. We know this. People understand this if they think about the nature of addiction. Doctors are taught this at medical school. Community mental health, nurses and doctors talk to lots of people who have tried hard drugs and never got into them. But what is the destructive potential of trying heroin and becoming addicted? Obviously much greater than with nicotine (Although nicotine products may well result in your death one day too). This information isn't particularly new, and certainly hasn't been buried by the powers that be in an attempt to strengthen anti-drugs arguments (at least in Australia)
- burgerz 13y ago
  Nicotine is less addictive than heroin only in one measure of addictiveness. There are others, e.g. reinforcement, in terms of which, both heroin and cocaine are more addictive. And with regards to the article, this is nothing new. Who hasn't caught onto the fact that anti-drug materials exaggerate everything and are full of lies (LSD is bad apparently).
- konstruktor 13y ago
  Are you sure you are talking about the destructive potential of heroin itself and not the circumstances in which it is consumed? It is not necessarily an IV drug, but the price, driven by criminalization, makes smoking prohibitively expensive (see the other comment about the Vietnam soldiers). In countries where the distribution of syringes is criminalised (Russia, USA), syringes are reused and shared. The price of the drug encourages the users to resort crime to obtain it and neglect other aspects of their lives (nutrition, hygiene, living conditions). All of those aren't necessarily effects of the drug itself.
  - andyakb 13y ago
AznHisoka 13y ago
We should not look towards drugs to satisfy the void in our lives. We should not look to eating for pleasure, just for health. We should not look to our career as a source of fulfillment - it's just a means to an end. We should not look to our mates as a source of salvation - we should focus on giving. We should not look to our kids as objects to make us whole - we should focus on giving... Ok, so if we're gonna take away all these things as "drugs", what's left?
- dscrd 13y ago
  Nirvana, according to some.
- vdaniuk 13y ago
  Nothing is left and the human life is truly devoid of meaning.
- Ziomislaw 13y ago
  you have a lot of opinions on what we all should do christian I presume?
  - AznHisoka 13y ago
    Ha. I wanted to edit my post and add "(And please don't say God)". So the answer is no :)
    - cgore 13y ago
      That is basically the point of Ecclesiastes. King Solomon had access to everything, being king of one of the most powerful kingdoms of the time, worked his way through that whole list, and then at the end decided it was all pointless. He was a smart Paris Hilton, just with more money and absolute power.
      - darkspaten 13y ago
        And the most oft-repeated phrase in Ecclesiastes is, "Eat, drink, and be merry"
cwarrior 13y ago
Addiction is not just about the substance (alcohol, cocaine, heroine) or the behavior (Sex, gambling, video games). A person is an addict even before that person has that first try. There are many other factors that condition someone to become an addict. There are genetic factors, environmental factors, other underlying mental issues, etc.
- Sami_Lehtinen 13y ago
  True, that's why you should try to recognize your addictions before falling trapped. Like if you're super hooked to boost from caffeine, it might not be good idea to try meth.
- jasallen 13y ago
  This is a misunderstand intentionally propagated by the 'treatment' system. Sure there are plenty of factors that can play into a pre-disposition, but it is the act or the chemicals that begin a physical re-wiring of the brain. It is because of having new additional receptors, or having blocked receptors, or a number of other changes that we have what we call 'physical addiction', and that doesn't happen until "that first try". It is also, in almost all cases, reversible. The receptors adapt, pathways change, hormonal sensitivities reset.
talles 13y ago
"when stories about the effects of drugs on the brain are promoted to the neglect of the discussion of the personal and social contexts of addiction, science is servicing our collective anxieties rather than informing us." This. Also, for who missed the link in the article: http://www.stuartmcmillen.com/comics_en/rat-park/ http://www.stuartmcmillen.com/comics_en/rat-park/
ArbitraryLimits 13y ago
I remember from college my Econ 101 textbook had a sidebar on heroin use by military personnel in Vietnam - apparently (according to my memory of an unattributed source) 90% of personnel stationed in Vietnam tried heroin at least once, and then 89% of them stopped when they left. Why an economics textbook? The authors were trying to illustrate 1) the role of substitutes on consumption of a particular good - there was no TV, no bridge club, no women except prostitutes to go out with, so heroin "cornered the market" on recreational activities, and 2) the fact that people will adjust consumption of almost any good in response to its changing price - heroin was incredibly cheap, so people took more of it. Anyway, I always looked skeptically at claims that trying it once guarantees addiction after that.
- pekk 13y ago
  Heroin has properties attractive to people in a hopeless, brutal war beyond what they can get from bridge club. Self-medication is not exactly recreation. You should also look skeptically at claims that having unprotected sex with possible HIV carriers guarantees that you will get HIV. But you should still put a goddamn condom on.
  - larrys 13y ago
    "to people in a hopeless, brutal war" Exactly. Because it's heroin combined with other shit going on that almost certainly causes brain changes and chemical reactions on it's own. So heroin in combo with war is not the same as heroin while visiting disney world on a nice summer day on your vacation (clearly my hypothesis nothing to back this up). (There is by the way another "addictive" type behavior that starts at a time in ones life that, while not at war, is a time of deep changes in personality as well as hormonal changes. My hypothesis also suggests that this would add to the addictive nature of this activity as well in some people.)
  - Pxtl 13y ago
    Related: http://en.wikipedia.org/wiki/Rat_Park http://en.wikipedia.org/wiki/Rat_Park tl:dr; Rats given access to their choice of clean water and morphine water, and placed in two enclosures: Rat cage and rat park. Rats living in a miserable rat cage will develop a morphine habit. Rats living in a pleasant rat park will avoid the morphine. Rats moved from rat cage to rat park easily kick their morphine habit after a brief period of withdrawal symptoms. tl:dr;tl:dr; Rats self-medicate with morphine IFF life is crap.
bane 13y ago
Like lots of folks I drink a bit, and I smoke the occasional celebratory cigar. I'm fortunate to not have found myself addicted to anything though (that I'm aware of at least). However, I have family members who have deep addiction problems. Life affecting. One thing that I've noticed is that even when they get off of the substance, the addictive personality traits are still there -- years later. One of my relatives, for example, managed to get herself off of drinking and smoking completely and was in counseling. The addictions, and the kinds of behaviors that come with maintaining addictions (all kinds of dissociative, anti-social, manipulative weirdness) were ruining her life. Strange thing was, after removing the substance, the behaviors persisted. Many months later, after quitting drinking and smoking, we found that she was latching onto other activities in an addictive way. For example, she found a puzzle game on her phone that she would play obsessively* -- forgetting to eat, sleep, show up for work, having basic human interaction and even requiring physical therapy at one point for the muscle strain of sitting in the position to play the game for hours on end. Crippling physical pain wasn't even enough to get her to stop -- it was what was providing her "fix". She would sit, literally for days straight and play it. Counseling eventually got her to recognize this addiction, but it was harder for her to stop since she had her phone on her at all times. Then one day she stopped and we all breathed a sigh of relief -- she started sending emails again and generally became more communicative. A few weeks later the behaviors started again, but it wasn't with her phone. Turned out she had just found a computer game she liked more and switched off the phone game. Today she manages a bit better, but she went through a smoking binge for a while. She's "quit" again, but now just habitually chews nicotine gum. Apparently the nicotine helps keep her off of other more destructive behaviors (like playing phone games obsessively). When she feels stressed, she just chews some nicotine gum and that seems to get her through the craving. She's back working a regular job now and doing okay, but the idea that she'll find some other, better, satisfier, scares everybody. * - obsession is outright scary when you see it in another human for real. It makes a mood swing look like a flat affect. A person who's addictively obsessed with something is almost feral, operating on instinct -- except with human level brain power to alter their environment to maintain the obsession.
- JTon 13y ago
  Thanks for sharing. I have never seen the type of addiction you described first hand. Firstly, I wonder how prevalent this "level" of addiction is. Secondly,what type of environmental and genetic factors influence it
netcan 13y ago
Anything that has to be spread to "The Masses" through marketing, propaganda or public education campaigns need a simple message to work. Simple, clear, strong messages with no room for debate. Just say no. Just Do it. The Real Thing. Exaggeration is absolutely essential if you want to get people to react. You cannot rely on reality to provide the necessary frightening statistics. So for example, almost everyone (including smokers) overestimates the risk of lung cancer caused by smoking by an order of magnitude. The danger of second hand smoke by even more. Cigarettes are unhealthy, but people are too irrational to react to that. In order to get a reaction, the dangers must be multiplied. Another good example is HIV transmission. Most people assume the transmission rate is close to 100%. Someone who has had sex with a HIV+ partner and survives dodged a bullet. In reality, transmission rates after a single exposure are very low. It depends on the sex act and viral load but even for high risk activities like anal sex, infection rates are in the low single digits. They are estimated around 0.1% per exposure for vaginal penetrative sex. Campaigns that made you think of how many people are 5 shags removed from you (your ex & her exes & his exes..) implied that infection rates were near 1%. People bought it. They started using condoms. The spread slowed or stopped. A 0.1% risk would not have done that. So yeah. Marketers lie. So do propagandists. The layman public simplify. It's how shoes get sold. it's how public opinions are changes.
- guelo 13y ago
  And yet many times when savvy people notice that they are being lied to they discount the entire message and can end up engaging in more destructive behavior than they would have otherwise. Public health messaging should never contain exagerations or lies even of ommision.
  - z-factor 13y ago
    You have a strange standard for 'savvy' people.
oneofthose 13y ago
One aspect to the "instantly hook a user" theory that I have not seen mentioned here is the following: Taking a potent drug like heroine or cocaine for the first time is described by some users as "pushing open a door to a very enjoyable place you did not know existed". Once this door is open, you will always know that this place exists, you can not "unknow" the experience. While some people might be able to handle the knowledge of this enjoyable place and are able to choose when and if to go back, some might not be able to. Therefore I believe it makes sense to tell people not to open the door at all. I also can imagine that the first time with these potent drugs is a positive experience for many, unlike the first cigarette or the first beer a person ever tries. The second cigarette is not smoked because the first was so good.
blueblob 13y ago
This was very interesting. Thanks!
FollowSteph3 13y ago
Imagine what it must be like in North Korea then?
pcvarmint 13y ago
"Drug, Set and Setting" by Norman Zinberg is another classic. Andrew Weil has talked about it (search YouTube). His thesis was on nutmeg as an addictive drug. Almost anything can be addictive given the right setting. "Addiction is a Choice" by Jeffrey Schaler. Saying it is a choice is not at all meant to cast blame, but to emphasize that to use drugs is a choice given one's life circumstances, and is influenced by many variables. To focus on the drug use itself is to neglect real "problems of living" (as Thomas S. Szasz called them). By viewing it as a choice, one is also empowered to end their addiction, but it must be voluntary and not coerced by family members or the state. I sometimes think of unhealthy addiction as being trapped in a local minimum of pain -- given limited resources, including limited personal strength to change the circumstances or environment one is in (e.g., job, marriage, housing), then addiction to a substance, or even a non-drug activity, can become a local minimum of pain, all avenues out of which produce, short-term, more pain than the status quo. So it can be philosophically argued that addiction is a rational decision given the circumstances and the resources available. The key to successful addiction treatment is not behavior modification or "education", but providing resources so that one may escape local minima, and without punishing them for any behavior which does not harm others (hurt feelings doesn't count). If the drug use is focused on and punished, even criminally, it never addresses the underlying issues which led to drug use being an escape from pain in the first place. In the current system, harsh punishment for drug use, or paternalism over one's life in the name of "protecting one from himself", becomes more important than the principles of improving happiness or avoiding coercion against fellow humans.
marincounty 13y ago
I hope there's more studies done like this. I have always felt there's a lot of false information about drug addiction out there--even among Psychiatrists. I know that there's many addicts out there who are literally afraid of quitting a drug; especially opiates and alcohol. 'I'm not going to get dope sick', 'my doctor wants me to spend my last 30 grand on rehab', 'I was told I will have the DT's.' I have found with most drugs-- tapering off works. This is especially true with alcohol, and opiates. No, it's not simple, but many of you don't need to wipe out your savings on hysteria. Most MD's won't talk about tapering because of liability, but if you don't have the money for a fancy rehab, many of you can taper off alcohol, and opiates, and even benzodiazepines.
gtr32x 13y ago
We acknowledge that the drug addiction is a complex issue and with our current understanding of human psychology it's hard to generalize the rationals behind the addition. With regard to the law system, it basically boiled down to this: if such a behavior or activity does have the potential to threaten recipients in their well-being and the others around them, then it's probably better to ban it to allow a more harmonic society. Such as jay-walking, it is also illegal. However, do people still jay-walk? Of course they do, because it provides convenience, a sense of accomplishment -> dopamine. So is it similar to drug use? Of course. The difference is that jaywalking laws are enforced way less than hard core drug uses. Now laws aren't always black and white, judgment is often involved. Outside of law, mentally should we be more accepting and acknowledge drug use instead simply putting it down? Sure why not. As long as you can safely understand that it won't cause harm to you or your surrounding. But can anyone be absolutely certain of that? Afraid not.
jmcgough 13y ago
I worked in a neuroscience lab for years - our rats were housed in pairs, in extremely small cages. They were required to have "environmental enrichment" by LAR (Lab Animal Resources), which for us meant a small stick for it to chew on. So yes, a lot of research is done on animals that are not exactly what I'd consider healthy or normal.

231 points by carey 13y ago

Kind of on topic: I was surprised to find out that Nicotine is thought to be more addictive that Heroine... http://en.wikipedia.org/wiki/Nicotine#Dependence_and_withdrawal http://en.wikipedia.org/wiki/Nicotine#Dependence_and_withdra...

Semaphor 13y ago
Nicotine itself (without the byproducts that happen when burning tobacco) is not even that bad [1] (deadly in relatively low amounts but unless you take it concentrated it's very hard to reach those levels). Unhealthy? Yes, but probably not much worse than caffeine [2]. Besides, Nicotine itself is not that addictive "Technically, nicotine is not significantly addictive, as nicotine administered alone does not produce significant reinforcing properties. However, after coadministration with an MAOI, such as those found in tobacco, nicotine produces significant behavioral sensitization, a measure of addiction potential." [3] [1]: There are a few studies that look at nicotine excluding cigarettes on Google Scholar. [2]: Compare http://en.wikipedia.org/wiki/Nicotine#Pharmacology http://en.wikipedia.org/wiki/Nicotine#Pharmacology and http://www.energyfiend.com/harmful-effects-of-caffeine http://www.energyfiend.com/harmful-effects-of-caffeine [3]: http://en.wikipedia.org/wiki/Nicotine#Psychoactive_effects http://en.wikipedia.org/wiki/Nicotine#Psychoactive_effects
- berntb 13y ago
  >>[2]: Compare http://en.wikipedia.org/wiki/Nicotine#Pharmacology http://en.wikipedia.org/wiki/Nicotine#Pharmacology and http://www.energyfiend.com/harmful-effects-of-caffeine http://www.energyfiend.com/harmful-effects-of-caffeine Cough, was that completely honest? since you linked to Wikipedia for Nicotine, I suspect you did know you'd get lots of really good effects by linking to Wikipedia for caffeine. :-) http://en.wikipedia.org/wiki/Health_effects_of_coffee#All-cause_mortality http://en.wikipedia.org/wiki/Health_effects_of_coffee#All-ca...
  - Semaphor 13y ago
    Wikipedia had a lack of harmful effects of caffeine (or at least none written in a way I as a layman can understand) and I thought a site with articles about caffeine selling caffeine products would make an okayish substitution. Again for nicotine there is no convenient list on Wikipedia, so: > In one study, a group of Alzheimer's patients were given nicotine patches, while another received a placebo. Those with nicotine patches maintained their cognitive abilities longer and sometimes even recovered lost cognitive function. > Contrary to popular opinion, the study showed that nicotine actually boosts the growth of new blood vessels. > In 2006, Duke scientists found that people with depression who were treated with nicotine patches reported a decrease in their depressive feelings. The results were perhaps not surprising for a drug associated with imparting a "buzz." However, the research also showed a direct link between nicotine and an increase in the release of dopamine and serotonin, two vital neurotransmitters. A lack of dopamine or serotonin is a common cause of depression. -- http://health.howstuffworks.com/wellness/drugs-alcohol/nicotine-health-benefits.htm http://health.howstuffworks.com/wellness/drugs-alcohol/nicot... again, there is much more on Google Scholar.
mumbi 13y ago
I find that nicotine's addictiveness is due to legality. That being said, I quit the various opiates much easier than cigarettes.
- hackula1 13y ago
  As a smoker, I wish it was illegal tomorrow. Then I could buy one or two smokes every now and then, but I would have to go well out of my way.
  - borkabrak 13y ago
    At $10 per cigarette, in a neighborhood where you're likely to get shot. But they're illegal in order to keep us safe. Right.
- rahoulb 13y ago
  As someone that has smoked [1] I think legality is important - but it's also the relatively mild effects. If you're getting frustrated at work, you can take a break, give yourself a quick "boost" by stopping for a cig, and then go back to work. Something that's not really possible with heroin, or marijuana or any other "drug" apart from caffeine. [1] ten years on and I still don't say "ex-smoker" as one of the mental tricks to help me deal with it EDIT formatting
madaxe 13y ago
You can also extract enough pure nicotine from a pack of cigarettes to kill a man, if you know how. It's not hard. Nasty things. Time for a cigarette break.

PGenes 13y ago

What's true of rats is true of people in this case. Economically deprived people are far more likely to abuse alcohol and drugs.

jmngomes 13y ago

"When Alexander’s rats were given something better to do than sit in a bare cage they turned their noses up at morphine because they preferred playing with their friends and exploring their surroundings to getting high." Well, AFAIK, this doesn't happen with most humans struggling with addiction to hard drugs. Addicts will neglect everything, namely social activities, in order to get what they need.

TelmoMenezes 13y ago
As far as you know. Firstly, the study is about the onset of addiction from one single experience with the drug. People that take a drug once and decide to not do it again don't attract the same social and media attention as heavy users. Similarly, if functional users of hard drugs exist, you are unlikely to hear about them. This is one of the effects of the drug prohibition: it hides a lot of data. More worryingly, science becomes compromised when researchers cannot attract funding to explore unpopular hypothesis.
- westicle 13y ago
  This. People assume that all opiate users are crackheads committing armed robbery. Many are highly skilled, highly paid professionals. I must confess a certain amount of cognitive dissonance seeing middle-aged men in tailored suits scoring heroin on the street!
  - redblacktree 13y ago
    These days there is no need for that. They can just visit a "pain clinic" and get a prescription.
    - westicle 13y ago
      Apparently not in St Kilda.
  - girvo 13y ago
    I was :) I even ran a startup while I was using. Heroin is not a drug that discriminates.

rwmj 13y ago

Does anyone really think "one try ... is enough to get us hooked"? They can't know any overt functional drug users if that's the case. Cocaine in particular isn't instantly addictive. If anything on the few occasions I've used it, it actively put me off.

onion2k 13y ago
"If anything on the few occasions I've used it, it actively put me off." Cocaine can't have actively put you off that much if you did it again a few times. Reminds me of the joke "Quitting smoking is easy. I've done it lots of times."
- guruz 13y ago
  Why does this need to be the case? I guess for most people it is more like "there's so many movies about this stuff and famous people take it, it MUST be good, I need to try".
- rwmj 13y ago
  Considering I've not taken it, or even thought about taking it, for over 15 years, I'd say you are wrong.
- strickjb9 13y ago
  I enjoyed your comment so I don't want you to think I'm being rude but I think there is a difference between trying a drug (maybe more than once) versus becoming addicted to it and needing to quit. My best (and personal) example is that I would smoke a cigarettes with friends back in college whenever we were out and drinking. It provided a good additional buzz and it was somewhat social. I'd even buy my own pack so I could have one if my other smoking buddies weren't around (also when I was out drinking). I averaged 2-4 cigarettes per week and I'd even go weeks without smoking as well. It was sporadic and I didn't enjoy cigarettes any other time. When I saw people smoking during the daytime I would actually be kind of disgusted at the thought of smoking. So I guess my point is... was I addicted? I don't think I was. Was there ever a line that I would say that I "quit smoking"? Eventually I did stop my "casual" routine. Even now, I think I would still smoke a cigarette if I was put back into similar situations. I think it's completely reasonable to have tried a drug many times and not be considered addicted. On the contrary, many of those same college friends I smoked with I would consider to be addicted. It wasn't a limited activity. It was an anytime and anywhere activity.

Siempre 13y ago

"When naloxone, which blocks the effects of morphine, was added to the morphine-sugar mix, the rats’ consumption didn’t drop. In fact, their consumption increased, suggesting they were actively trying to avoid the effects of morphine, but would put up with it in order to get sugar." Is not completely right.. How about the usage increased because they were actually looking to get more morphine?

mumbi 13y ago

My question is this: if the rats knew that taking the morphine after moving to the park would keep the withdrawals away, would they have still taken the water?

yebyen 13y ago
Yeah good question! Reading that story, I understood first that rats like sweet things and hate bitter things. Second that rats are usually willing to take Hobson's choice, and the point of the article being that most scientists don't realize that's what they've actually been testing. I understand that heroin withdrawals are pretty terrible, I've even heard said that "you'd do anything" to make them stop, but they can't kill you in a sort of way that alcohol withdrawals can. It sounded from my reading more like toward the end of the experiments though it was becoming clearer that the rats in Rat Park genuinely did not like the effects of the drug on their normal lives, and when they had the other option of socializing, they were only still taking the drug to get at the delicious sucrose.
- Ziomislaw 13y ago
  I have 2 rat pets. I can confirm that they LOVE sugar. It probably is the single thing that makes them fight each other for it (if one finishes candy first etc)

robbiep 13y ago

I have previously commented on this topic on HN, but since it's back i'll go again. As a medical student I was taught that addiction is a spectrum. Each drug falls somewhere on that spectrum in terms of addiction potential, (And as GotAnyMegadeth comments, Nicotine is more addictive than Heroin) and every person has some prior probability of becoming addicted, due to the complex interplay of social/biological factors that go into the nature of an addiction). Okay - so Heroin is less addictive than Nicotine. We know this. People understand this if they think about the nature of addiction. Doctors are taught this at medical school. Community mental health, nurses and doctors talk to lots of people who have tried hard drugs and never got into them. But what is the destructive potential of trying heroin and becoming addicted? Obviously much greater than with nicotine (Although nicotine products may well result in your death one day too). This information isn't particularly new, and certainly hasn't been buried by the powers that be in an attempt to strengthen anti-drugs arguments (at least in Australia)

burgerz 13y ago
Nicotine is less addictive than heroin only in one measure of addictiveness. There are others, e.g. reinforcement, in terms of which, both heroin and cocaine are more addictive. And with regards to the article, this is nothing new. Who hasn't caught onto the fact that anti-drug materials exaggerate everything and are full of lies (LSD is bad apparently).
konstruktor 13y ago
Are you sure you are talking about the destructive potential of heroin itself and not the circumstances in which it is consumed? It is not necessarily an IV drug, but the price, driven by criminalization, makes smoking prohibitively expensive (see the other comment about the Vietnam soldiers). In countries where the distribution of syringes is criminalised (Russia, USA), syringes are reused and shared. The price of the drug encourages the users to resort crime to obtain it and neglect other aspects of their lives (nutrition, hygiene, living conditions). All of those aren't necessarily effects of the drug itself.
- andyakb 13y ago

AznHisoka 13y ago

We should not look towards drugs to satisfy the void in our lives. We should not look to eating for pleasure, just for health. We should not look to our career as a source of fulfillment - it's just a means to an end. We should not look to our mates as a source of salvation - we should focus on giving. We should not look to our kids as objects to make us whole - we should focus on giving... Ok, so if we're gonna take away all these things as "drugs", what's left?

dscrd 13y ago
Nirvana, according to some.
vdaniuk 13y ago
Nothing is left and the human life is truly devoid of meaning.
Ziomislaw 13y ago
you have a lot of opinions on what we all should do christian I presume?
- AznHisoka 13y ago
  Ha. I wanted to edit my post and add "(And please don't say God)". So the answer is no :)
  - cgore 13y ago
    That is basically the point of Ecclesiastes. King Solomon had access to everything, being king of one of the most powerful kingdoms of the time, worked his way through that whole list, and then at the end decided it was all pointless. He was a smart Paris Hilton, just with more money and absolute power.
    - darkspaten 13y ago
      And the most oft-repeated phrase in Ecclesiastes is, "Eat, drink, and be merry"

cwarrior 13y ago

Addiction is not just about the substance (alcohol, cocaine, heroine) or the behavior (Sex, gambling, video games). A person is an addict even before that person has that first try. There are many other factors that condition someone to become an addict. There are genetic factors, environmental factors, other underlying mental issues, etc.

Sami_Lehtinen 13y ago
True, that's why you should try to recognize your addictions before falling trapped. Like if you're super hooked to boost from caffeine, it might not be good idea to try meth.
jasallen 13y ago
This is a misunderstand intentionally propagated by the 'treatment' system. Sure there are plenty of factors that can play into a pre-disposition, but it is the act or the chemicals that begin a physical re-wiring of the brain. It is because of having new additional receptors, or having blocked receptors, or a number of other changes that we have what we call 'physical addiction', and that doesn't happen until "that first try". It is also, in almost all cases, reversible. The receptors adapt, pathways change, hormonal sensitivities reset.

talles 13y ago

"when stories about the effects of drugs on the brain are promoted to the neglect of the discussion of the personal and social contexts of addiction, science is servicing our collective anxieties rather than informing us." This. Also, for who missed the link in the article: http://www.stuartmcmillen.com/comics_en/rat-park/ http://www.stuartmcmillen.com/comics_en/rat-park/

ArbitraryLimits 13y ago

I remember from college my Econ 101 textbook had a sidebar on heroin use by military personnel in Vietnam - apparently (according to my memory of an unattributed source) 90% of personnel stationed in Vietnam tried heroin at least once, and then 89% of them stopped when they left. Why an economics textbook? The authors were trying to illustrate 1) the role of substitutes on consumption of a particular good - there was no TV, no bridge club, no women except prostitutes to go out with, so heroin "cornered the market" on recreational activities, and 2) the fact that people will adjust consumption of almost any good in response to its changing price - heroin was incredibly cheap, so people took more of it. Anyway, I always looked skeptically at claims that trying it once guarantees addiction after that.

pekk 13y ago
Heroin has properties attractive to people in a hopeless, brutal war beyond what they can get from bridge club. Self-medication is not exactly recreation. You should also look skeptically at claims that having unprotected sex with possible HIV carriers guarantees that you will get HIV. But you should still put a goddamn condom on.
- larrys 13y ago
  "to people in a hopeless, brutal war" Exactly. Because it's heroin combined with other shit going on that almost certainly causes brain changes and chemical reactions on it's own. So heroin in combo with war is not the same as heroin while visiting disney world on a nice summer day on your vacation (clearly my hypothesis nothing to back this up). (There is by the way another "addictive" type behavior that starts at a time in ones life that, while not at war, is a time of deep changes in personality as well as hormonal changes. My hypothesis also suggests that this would add to the addictive nature of this activity as well in some people.)
- Pxtl 13y ago
  Related: http://en.wikipedia.org/wiki/Rat_Park http://en.wikipedia.org/wiki/Rat_Park tl:dr; Rats given access to their choice of clean water and morphine water, and placed in two enclosures: Rat cage and rat park. Rats living in a miserable rat cage will develop a morphine habit. Rats living in a pleasant rat park will avoid the morphine. Rats moved from rat cage to rat park easily kick their morphine habit after a brief period of withdrawal symptoms. tl:dr;tl:dr; Rats self-medicate with morphine IFF life is crap.

bane 13y ago

Like lots of folks I drink a bit, and I smoke the occasional celebratory cigar. I'm fortunate to not have found myself addicted to anything though (that I'm aware of at least). However, I have family members who have deep addiction problems. Life affecting. One thing that I've noticed is that even when they get off of the substance, the addictive personality traits are still there -- years later. One of my relatives, for example, managed to get herself off of drinking and smoking completely and was in counseling. The addictions, and the kinds of behaviors that come with maintaining addictions (all kinds of dissociative, anti-social, manipulative weirdness) were ruining her life. Strange thing was, after removing the substance, the behaviors persisted. Many months later, after quitting drinking and smoking, we found that she was latching onto other activities in an addictive way. For example, she found a puzzle game on her phone that she would play obsessively* -- forgetting to eat, sleep, show up for work, having basic human interaction and even requiring physical therapy at one point for the muscle strain of sitting in the position to play the game for hours on end. Crippling physical pain wasn't even enough to get her to stop -- it was what was providing her "fix". She would sit, literally for days straight and play it. Counseling eventually got her to recognize this addiction, but it was harder for her to stop since she had her phone on her at all times. Then one day she stopped and we all breathed a sigh of relief -- she started sending emails again and generally became more communicative. A few weeks later the behaviors started again, but it wasn't with her phone. Turned out she had just found a computer game she liked more and switched off the phone game. Today she manages a bit better, but she went through a smoking binge for a while. She's "quit" again, but now just habitually chews nicotine gum. Apparently the nicotine helps keep her off of other more destructive behaviors (like playing phone games obsessively). When she feels stressed, she just chews some nicotine gum and that seems to get her through the craving. She's back working a regular job now and doing okay, but the idea that she'll find some other, better, satisfier, scares everybody. * - obsession is outright scary when you see it in another human for real. It makes a mood swing look like a flat affect. A person who's addictively obsessed with something is almost feral, operating on instinct -- except with human level brain power to alter their environment to maintain the obsession.

JTon 13y ago
Thanks for sharing. I have never seen the type of addiction you described first hand. Firstly, I wonder how prevalent this "level" of addiction is. Secondly,what type of environmental and genetic factors influence it

netcan 13y ago

Anything that has to be spread to "The Masses" through marketing, propaganda or public education campaigns need a simple message to work. Simple, clear, strong messages with no room for debate. Just say no. Just Do it. The Real Thing. Exaggeration is absolutely essential if you want to get people to react. You cannot rely on reality to provide the necessary frightening statistics. So for example, almost everyone (including smokers) overestimates the risk of lung cancer caused by smoking by an order of magnitude. The danger of second hand smoke by even more. Cigarettes are unhealthy, but people are too irrational to react to that. In order to get a reaction, the dangers must be multiplied. Another good example is HIV transmission. Most people assume the transmission rate is close to 100%. Someone who has had sex with a HIV+ partner and survives dodged a bullet. In reality, transmission rates after a single exposure are very low. It depends on the sex act and viral load but even for high risk activities like anal sex, infection rates are in the low single digits. They are estimated around 0.1% per exposure for vaginal penetrative sex. Campaigns that made you think of how many people are 5 shags removed from you (your ex & her exes & his exes..) implied that infection rates were near 1%. People bought it. They started using condoms. The spread slowed or stopped. A 0.1% risk would not have done that. So yeah. Marketers lie. So do propagandists. The layman public simplify. It's how shoes get sold. it's how public opinions are changes.

guelo 13y ago
And yet many times when savvy people notice that they are being lied to they discount the entire message and can end up engaging in more destructive behavior than they would have otherwise. Public health messaging should never contain exagerations or lies even of ommision.
- z-factor 13y ago
  You have a strange standard for 'savvy' people.

oneofthose 13y ago

One aspect to the "instantly hook a user" theory that I have not seen mentioned here is the following: Taking a potent drug like heroine or cocaine for the first time is described by some users as "pushing open a door to a very enjoyable place you did not know existed". Once this door is open, you will always know that this place exists, you can not "unknow" the experience. While some people might be able to handle the knowledge of this enjoyable place and are able to choose when and if to go back, some might not be able to. Therefore I believe it makes sense to tell people not to open the door at all. I also can imagine that the first time with these potent drugs is a positive experience for many, unlike the first cigarette or the first beer a person ever tries. The second cigarette is not smoked because the first was so good.

blueblob 13y ago

This was very interesting. Thanks!

FollowSteph3 13y ago

Imagine what it must be like in North Korea then?

pcvarmint 13y ago

"Drug, Set and Setting" by Norman Zinberg is another classic. Andrew Weil has talked about it (search YouTube). His thesis was on nutmeg as an addictive drug. Almost anything can be addictive given the right setting. "Addiction is a Choice" by Jeffrey Schaler. Saying it is a choice is not at all meant to cast blame, but to emphasize that to use drugs is a choice given one's life circumstances, and is influenced by many variables. To focus on the drug use itself is to neglect real "problems of living" (as Thomas S. Szasz called them). By viewing it as a choice, one is also empowered to end their addiction, but it must be voluntary and not coerced by family members or the state. I sometimes think of unhealthy addiction as being trapped in a local minimum of pain -- given limited resources, including limited personal strength to change the circumstances or environment one is in (e.g., job, marriage, housing), then addiction to a substance, or even a non-drug activity, can become a local minimum of pain, all avenues out of which produce, short-term, more pain than the status quo. So it can be philosophically argued that addiction is a rational decision given the circumstances and the resources available. The key to successful addiction treatment is not behavior modification or "education", but providing resources so that one may escape local minima, and without punishing them for any behavior which does not harm others (hurt feelings doesn't count). If the drug use is focused on and punished, even criminally, it never addresses the underlying issues which led to drug use being an escape from pain in the first place. In the current system, harsh punishment for drug use, or paternalism over one's life in the name of "protecting one from himself", becomes more important than the principles of improving happiness or avoiding coercion against fellow humans.

marincounty 13y ago

I hope there's more studies done like this. I have always felt there's a lot of false information about drug addiction out there--even among Psychiatrists. I know that there's many addicts out there who are literally afraid of quitting a drug; especially opiates and alcohol. 'I'm not going to get dope sick', 'my doctor wants me to spend my last 30 grand on rehab', 'I was told I will have the DT's.' I have found with most drugs-- tapering off works. This is especially true with alcohol, and opiates. No, it's not simple, but many of you don't need to wipe out your savings on hysteria. Most MD's won't talk about tapering because of liability, but if you don't have the money for a fancy rehab, many of you can taper off alcohol, and opiates, and even benzodiazepines.

gtr32x 13y ago

We acknowledge that the drug addiction is a complex issue and with our current understanding of human psychology it's hard to generalize the rationals behind the addition. With regard to the law system, it basically boiled down to this: if such a behavior or activity does have the potential to threaten recipients in their well-being and the others around them, then it's probably better to ban it to allow a more harmonic society. Such as jay-walking, it is also illegal. However, do people still jay-walk? Of course they do, because it provides convenience, a sense of accomplishment -> dopamine. So is it similar to drug use? Of course. The difference is that jaywalking laws are enforced way less than hard core drug uses. Now laws aren't always black and white, judgment is often involved. Outside of law, mentally should we be more accepting and acknowledge drug use instead simply putting it down? Sure why not. As long as you can safely understand that it won't cause harm to you or your surrounding. But can anyone be absolutely certain of that? Afraid not.

jmcgough 13y ago

I worked in a neuroscience lab for years - our rats were housed in pairs, in extremely small cages. They were required to have "environmental enrichment" by LAR (Lab Animal Resources), which for us meant a small stick for it to chew on. So yes, a lot of research is done on animals that are not exactly what I'd consider healthy or normal.