tag:blogger.com,1999:blog-142743152971096915.post8660747574520643922..comments2023-10-05T04:44:25.174-05:00Comments on Addiction Inbox: Q & A with Nora VolkowDirk Hansonhttp://www.blogger.com/profile/07429793255785560043noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-142743152971096915.post-35491735874299427192010-10-15T01:17:32.123-05:002010-10-15T01:17:32.123-05:00Michelle: "So...every person with an addicti...Michelle: "So...every person with an addiction disorder was initially an abuser and then the abuse became a dependency." <br /><br />Thanks for posting that, Michelle. You are right that you need one or more criteria to be diagnosed with "abuse" and three or more to be diagnosed with "dependence." However, there are two separate lists of criteria which are of a different nature. One is not simply worse than the other. <br /><br />Quoting your linked page, "According to the DSM-IV, a person can be abusing a substance or dependent on a substance but not both at the same time." A person can be dependent, showing tolerance, dependence, repeated attempts to quit, etc., but not meeting the criteria for abuse -- trouble with work, relationships, the law, endangering others, etc. DSM-IV lists nicotine dependence as a separate category but has no separate category for nicotine abuse. This is because nicotine (tobacco) is addictive, but doesn't cause the sorts of social problems associated with abuse.rachelrachelnoreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-66499467108264316912010-06-21T21:32:57.944-05:002010-06-21T21:32:57.944-05:00I think "substance abuse" is accurate te...I think "substance abuse" is accurate terminology. When I look up abuse on the mac dictionary app, this comes up:<br /><br />1. use (something) to bad effect or for a bad purpose; misuse : the judge abused his power by imposing the fines.<br /><br />That's what you're doing by definition, right? You're using substances to bad effect. If you were using them to good effect, then there would be no problem to solve or treat or talk about.Steven Slatehttps://www.blogger.com/profile/15148978892851207090noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-85113424217109502032010-06-17T12:44:17.027-05:002010-06-17T12:44:17.027-05:00I don't think the disease model is a case of &...I don't think the disease model is a case of "one size fits all." Different people require different kinds of treatment, the same as any other neurobiological disorder. <br /><br />I agree that the semantics of addiction are a disaster--how does "dependence" differ from "abuse," for example?<br /><br />Lastly, Peele's book makes as good a case as can be made that addiction has nothing in common with other diseases--and fails to convince. The latest version of the Peele argument (which requires one to discard some 25 years of excellent addiction science),is "Addiction: a Disease of Choice," I think it's called.Dirk Hansonhttps://www.blogger.com/profile/07429793255785560043noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-5813727678325273302010-06-16T20:54:12.694-05:002010-06-16T20:54:12.694-05:00Thanks for this great discussion! After working in...Thanks for this great discussion! After working in this field for nearly 20 years,I am find myself even more confused by terms used by those who have problems in living due to the repetition of harmful behaviors. It is my considered opinion, we have not tackled the hard work of establishing agreed upon terminology between those in recovery and MD/PhD types that research addictive behaviors. For example, is there difference between the term "addiction" and the DSM IV-TR term "dependence?" Our semantics get in the way of effectively helping people change. Also, Stanton Peele in his book, "The Diseasing of America" makes a good arguement against the disease or allergy concept of addiction. Addictive behaviors, whether they be related to drugs or process addictions like gambling are far too complex to be lumped categorized or treated with a one size fits all approach.David Whittinghill, PhDhttp://quittingmyaddiction.comnoreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-52373279674325970932010-01-29T19:18:50.087-06:002010-01-29T19:18:50.087-06:00Maybe something like "substance tolerance&quo...Maybe something like "substance tolerance" or "substance tolerance that has become obsessive and compulsive" would be better? Obsessive-compulsive substance use? Or, I really like the term "allergy" because it helps people understand better that there are some human beings that have a different biological response (a "more!" response) to substances than other people do.Unknownhttps://www.blogger.com/profile/13312814727289016334noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-35508786021566333532010-01-29T18:09:31.581-06:002010-01-29T18:09:31.581-06:00Michelle--that line of thought makes good sense at...Michelle--that line of thought makes good sense at the professional level, and thanks for pointing out the specific definititions. It's still unclear to me what the best informal term would be, in newspapers and popular discourse. They are all loaded terms in their way.Dirk Hansonhttps://www.blogger.com/profile/07429793255785560043noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-54125314132100202062010-01-28T20:26:49.852-06:002010-01-28T20:26:49.852-06:00Let's not forget that the DSM IV (the manual u...Let's not forget that the DSM IV (the manual used for diagnosing mental disorders) has been the source that mental health and medical professionals look to for guidance with regard to the abuse vs dependence criteria/lingo. My guess is that this is why the terms have taken root in the field. My interpretation of abuse is that it is a precursor to dependence. So...every person with an addiction disorder was initially an abuser and then the abuse became a dependency. Makes sense to me. <br /><br />Abuse= 1 or more criteria within a 12-mo period<br />Dependence= 3 or more criteria within a 12-mo period<br /><br />To read the specific diagnostic criteria, here's the link:<br /><br />http://www.sis.indiana.edu/DSM-IV-Criteria.aspxUnknownhttps://www.blogger.com/profile/13312814727289016334noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-49236229869628741472010-01-19T10:55:13.965-06:002010-01-19T10:55:13.965-06:00Rob, since you expressed discontent about the word...Rob, since you expressed discontent about the word 'abuse' and conspire some power-issues behind its use: the prefix "ab-" which is of Latin origin literally means "away from, far from, off" implying compulsion and/or excessive in the context of substance abuse, drug abuse etc. <br /><br />Personally I find the word 'abuse' less problematic than 'addict' or 'junkie'. Look closely to see which of the words are prone to social stigma on comparative terms.<br /><br />T.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-84046124040472589112010-01-06T20:22:51.150-06:002010-01-06T20:22:51.150-06:00How's dependency or better, substance depende...How's dependency or better, substance dependency as an alternative term? Not as harsh and labeling as 'addiction' and clearer than abuse/junkie/misuse.<br /><br />T.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-78577200035645612892009-12-17T14:02:48.517-06:002009-12-17T14:02:48.517-06:00I use it at times as a category--"drugs of ab...I use it at times as a category--"drugs of abuse"-- to indicate psychoactive substances to which addiction-prone people can become addicted. Overall, "addictive drugs" is probably better jargon, although equally prone to misinterpretation, i.e.,if it's so addictive why ain't I addicted?Dirk Hansonhttps://www.blogger.com/profile/07429793255785560043noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-39609267140013315002009-12-17T13:18:12.527-06:002009-12-17T13:18:12.527-06:00Thanks for the post.
Good Q&A.
As a recoverin...Thanks for the post. <br />Good Q&A.<br />As a recovering and classified 'alcoholic' i certainly used pot before getting sober. Did I a 'abuse' it? It's a drug, like alcohol, that alters the brain. So, sure, I guess I did. I didn't get wasted each time I used it alone. I enjoyed it for the most part...but I don't do that any more...just like I don't drink.mikehttp://www.patmoorefoundation.com/drug-detoxnoreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-48852961332020641312009-12-17T11:49:29.273-06:002009-12-17T11:49:29.273-06:00"In what meaningful sense is the use of a sub..."In what meaningful sense is the use of a substance a disease?" <br />------------------------------<br /><br />I wrote an entire book, "The Chemical Carousel," to provide an answer to that question.Dirk Hansonhttps://www.blogger.com/profile/07429793255785560043noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-89940456303695700672009-12-17T10:49:23.212-06:002009-12-17T10:49:23.212-06:00Is the term disease not also worthy of challenge. ...Is the term disease not also worthy of challenge. In what meaningful sense is the use of a substance a disease?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-9479760689376031432009-12-17T10:06:36.086-06:002009-12-17T10:06:36.086-06:00The semantics of drug use is a tricky business. Th...The semantics of drug use is a tricky business. There are plenty of people who would highly resent being called a "junkie" but who could live with being called a drug "abuser." But I agree that "drug abuse" is not a very useful phrase.Dirk Hansonhttps://www.blogger.com/profile/07429793255785560043noreply@blogger.comtag:blogger.com,1999:blog-142743152971096915.post-75558755260998526272009-12-17T09:27:15.343-06:002009-12-17T09:27:15.343-06:00Yet again, reading this piece, I'm struck by t...Yet again, reading this piece, I'm struck by this use of the term 'abuse'. perhaps the Dr could explain what she means by abuse, and why its only used for cannabis and not for nicotine or eating. I never abused drugs, I used drugs. Even as an addict, I only ever used. Crack abuse suggests theres a sensible level of use but no one will tell me the cut off point. The terms 'abuse' and 'misuse' are abused and misused by professionals and do nothing more tha=n elevate them above the people they argue they are helping. If anyone had ever told me I was a substance abuser, I would have told them where to go. I was a junkie but never an abuser.Rob -Anoreply@blogger.com