Showing papers on "Addiction published in 1987"

A psychomotor stimulant theory of addiction

Abstract: The theory is advanced that the common denominator of a wide range of addictive substances is their ability to cause psychomotor activation. This view is related to the theory that all positive reinforcers activate a common biological mechanism associated with approach behaviors and that this mechanism has as one of its components dopaminergic fibers that project up the medial forebrain bundle from the midbrain to limbic and cortical regions. Evidence is reviewed that links both the reinforcing and locomotor-stimulating effects of both the psychomotor stimulants and the opiates to this brain mechanism. It is suggested that nicotine, caffeine, barbiturates, alcohol, benzodiazepines, cannabis, and phencyclidine----each ofwhich also has psychomotor stimulant actions--may activate the docaminergic fibers or their output circuitry. The role of physical dependence in addiction is suggested to vary from drug to drug and to be of secondary importance in the understanding of compulsive drug self-administration. Attempts at a general theory of addiction are attempts to isr late--from a variety of irrelevant actionsmthose drug actions that are responsible for habitual, compulsive, nonmedical drug self-administration. The common assumption of addiction theorists is that general principles of addiction can be learned from the study of one drug and that these principles will have heuristic value for the study of other drugs. Thus far, attempts at a general theory of addiction have failed to isolate common actions that can account for addiction across the range of major drug classes. A major stumbling block has been the psychomotor stimulants--amph etamine and cocainemwhich do not readily fit models traditionally based on depressant drug classes. The present article offers a new attempt at a general theory of addiction. It differs from earlier theories (e.g., Collier, 1968; Himmelsbach, 1943; Jaffe & Sharpless, 1968; Jellinek, 1960; Kalant, 1977; Lindsmith, 1947; Solomon & Corbit, 1974) in that it is based on the common denominator of the psychomotor stimulants---amphetamine, cocaine, and related drugs---rather than on the common denominator of the socalled depressant drugs~opiates, barbiturates, alcohol, and others. We take up two topics before presenting the new theory. First, we briefly discuss the heuristic value of a biological approach and suggest that the biologist's distinction between homology and analogy offers a useful insight. Next we discuss the shortcomings of earlier theories--variants of dependence theory. Then we outline the new theory and review the relevant evidence for its three major assertions: (a) that all addictive drugs have psychomotor stimulant actions, (b) that the stimulant actions of these different drugs have a shared biological mechanism, and (c) that the biological mechanism of these stimulant

Sex differences in addict careers. 2. Becoming addicted.

Abstract: Sex differences are examined for the period during which addiction develops after initial narcotics use. About 25% of the 546 heroin addicts studied became addicted within 1 month after initial use. More women than men fell into this category, and, on the average, women took less time to become addicted. For the majority of those studied (whose addiction occurred 1 month or longer after initial use), patterns of narcotic use during this phase of the addiction career were not significantly different by sex within Anglo or Chicano groups. Differences between female and male addicts in interpersonal relationships, other substance use, drug dealing, legal employment, and criminal behaviors parallel traditional sex role expectations.

Sex differences in addict careers. 3. Addiction.

Abstract: The process and correlates of addiction prior to treatment are examined for a sample of 546 women and men methadone maintenance clients. Narcotic addiction careers for women (defined both a...

Addicted women and crime

Abstract: The relationship between women's narcotics use and crime is examined among Anglo and Chicana methadone maintenance clients. Three types of analyses are employed: (1) the temporal ordering between narcotics involvement and criminal activities: (2) comparisons of crime levels before and after critical events in the addiction career including narcotic initiation, addiction, last daily use, first treatment entry, and first treatment discharge; and (3) crime levels as a function of increasing narcotics use. Women in this study demonstrate extensive criminal involvement and some also engage in dealing and/or prostitution. Property crime activities precede the addiction career for many women but, once addicted, the amount of property crime committed appears to be generally regulated by narcotics use levels. After the addiction career, property crime decreases substantially. Chicanas, in general, display higher baseline pretreatment criminal activity and show fewer changes in crime levels than Anglo women in reaction to events such as treatment or termination of addiction career.

A Moral Vision of Addiction: How People's Values Determine Whether They Become and Remain Addicts

Abstract: Contemporary theories of addiction of all stripes rule out faulty values as a cause of addiction. Yet evidence from cross-cultural, ethnic, and social-class research, laboratory study of addictive behavior, and natural history and field investigations of addiction indicate the importance of value orientations in the development and expression of addictive behaviors, including drug and alcohol addiction, smoking, and compulsive eating. Furthermore, the rejection of moral considerations in addiction deprives us of our most powerful weapons against addiction and contributes to our current addiction binge. The disease myth of addiction in particular attacks the assumption of essential moral responsibility for people's drug use and related behavior, an assumption that we instead ought to be encouraging.

Pathological gambling and associated patterns of crime: Comparisons with alcohol and other drug addictions

Abstract: The pattern of convictions for various categories of crime in the population of the United Kingdom was compared with the corresponding pattern in a sample of addictive gamblers drawn from Gamblers Anonymous in the U.K. A distinctive pattern of income-generating crime was found to be statistically associated with pathological gambling. This pattern was compared with other distinctive patterns associated with the intake of alcohol and with various other drugs and it was found to resemble most closely that of addiction to narcotic drugs. The possible role of gambling as a contributory cause of crime is discussed in the light of what is known of the issues surrounding other addictions as causes of their distinctive patterns of crime.

Bromocriptine-desipramine protocol in treatment of cocaine addiction.

Abstract: Thirty-six male cocaine abusers, in withdrawal, were studied for 99 days in a double-blind design. Treatment with bromocriptine was significantly more effective than placebo in alleviating withdrawal symptoms. Adding desipramine to the bromocriptine regimen was significantly more effective than either placebo or bromocriptine alone. The authors hypothesize that these results support a model of dopamine depletion and receptor supersensitivity in cocaine withdrawal.

The Dependence Syndrome Concept as a Psychological Theory of Relapse Behaviour: an empirical evaluation of alcoholic and opiate addicts

Abstract: Summary This paper examines the drug dependence syndrome (DSS) concept as a psychological theory of relapse to alcohol or opiate use following a period of abstinence from these substances. The results of several empirical studies of relapse in alcoholics and opiate users are described. Measures of the alcohol dependence syndrome provided good prediction of reinstatement in alcoholics, but severity of drug dependence did not predict reinstatement as consistently in opiate users. It is concluded that while the DDS concept may have merit as a psychological explanation of reinstatement, it should be subjected to a more rigorous program of research aimed at better operational measures and more intensive hypothesis testing, especially in samples of drug users.

Classical and Operant Paradigms in the Management of Gambling Addictions

Abstract: Previous (mainly classical) conditioning and current (mainly operant) approaches to the treatment of gambling addictions are reviewed in the light of recent evidence of the central importance of heightened arousal in the experience of normal gambling. Within a general framework which views the central features of addiction as the phenomenology of arousal and the acquisition of altered states of consciousness as goals, the possible contributions of reversal theory are explored. A more detailed examination of operant and classical conditioning analyses of the maintenance and reinstatement of excessive gambling behaviour appears to point towards a return to interventions based upon classical conditioning theory, although to cue exposure and the extinction of “peak experiences” rather than to aversion therapy.

Cocaine abuse and adult attention deficit disorder.

Abstract: Cocaine increases dopaminergic tone in the central nervous system, and hyperprolactinemia has been found in chronic cocaine abusers. Dopamine depletion is believed to result from chronic cocaine abuse. Dopamine deficiency has also been associated with attention deficit disorder (ADD) in adults, and dopamine agonists have been effective in the treatment of ADD. Four case reports of cocaine addiction and ADD are presented. ADD was assumed to play an etiologic role in cocaine abuse, and it was postulated that the patients might in part have been self-medicating a dopamine-deficient state. In addition, cocaine addicts without a premorbid history of ADD may experience a temporary cocaine-induced ADD state. In both cases, the dopamine agonist bromocriptine was highly effective for treating ADD and promoting cocaine abstinence. Restoration of the presumed dopamine deficit may permit an easier course of rehabilitation by improving the patient's ability to participate in therapeutic programs.

A Biobehavioral View of Substance Abuse and Addiction

Abstract: This paper examines addiction from a biobehavioral perspective, defining it as repeated use of a substance and/or a compelling involvement in a behavior that directly or indirectly modifies the internal milieu in such a way as to produce immediate reinforcement, but with harmful long-term effects. Using cigarette smoking as an exemplary addiction, we attempt to develop a comprehensive analysis of substance abuse that incorporates both pharmacological and social learning factors. Such a formulation suggests that research strategies involving multivariate analyses will be required if the complexities of addiction are to be satisfactorily addressed. It also has implications for treatment, in suggesting that interventions with both pharmacological and behavioral components are more likely to produce successful outcomes.

Severity of impairment in dually addicted gamblers

Abstract: While much information about pathological gamblers has been gathered from clinical observations, few data exist from systematic, objective studies. Furthermore, still less is known about that subset of pathological gamblers who are also chemically dependent and/or substance abusers. Previous studies (e.g., McCormick et al., 1984) report that up to 45% pathological gamblers are substance abusers. The present study hypothesizes that inpatient chemically dependent pathological gamblers will exhibit greater impairment on a variety of life-functioning measures than a comparable group of chemically dependent psychiatric inpatient. Twelve chemically dependent pathological gamblers were matched on the basis of age, sex, alcohol/drug history and occupational status with twelve chemically dependent persons with no pathological gambling history. All study members were inpatients in an addictions program at a private psychiatric hospital. Each patient was administered the Addiction Severity Index (ASI) to assess impairment in seven problem areas: medical, employment/support, alcohol, drug, legal, family/social, and psychological/psychiatric functioning. The following findings emerged: 1) Chemically dependent (CD) gamblers report more chronic medical problems than CD psychiatric patients; 2) CD gamblers report more frequent conflicts with relatives and family members than CD psychiatric patients; 3) CD gamblers report more psychiatric symptoms both in amount and duration; Although not reaching statistical significance, 42% of the CD gamblers had made a previous suicide attempt as compared to 8% of the CD psychiatric patients; 4) CD gamblers and CD psychiatric patients appear comparable with regard to employment functioning and amount of legal problems. The clinical and theoretical implications of these findings are discussed further.

Tests Involving Pressing for Intracranial Stimulation as an Early Procedure for Screening Likelihood of Addiction of Opioids and Other Drugs

Abstract: On the basis that the medial forebrain bundle system of the anterior brainstem is a major component of the system whose activity is positive affect, it is submitted that any drug that would increase activity in that system has a high risk of becoming the focus of an addiction. When an increase in activity of that system is a contingency of an act (such as imbibing, inhaling, snorting, or injecting), then that act will occur more and more frequently (i.e., positive reinforcement occurs) and this is a basis for an addiction. The potential for a drug to increase activity in the system is often manifested by measuring the lever pressing of rats for a fixed intensity of electrical stimulation of the system. Drugs, therefore, can be screened for their addiction likelihood by observing their effects on pressing for brain stimulation.

Addictive personality factors.

Abstract: This study was designed to compare mean scores obtained by alcoholics, compulsive gamblers, smokers, chronic joggers, and control subjects on six subfactors of the MacAndrew Alcoholism Scale. Results indicated that some MacAndrew factors may be more sensitive to addictive pathology than others. Alcoholics emerged as the most pathological group, in terms of scores on the Cognitive Impairment, Social Maladjustment, and Risk Taking scales. Gamblers and smokers appeared to be distinctly different, more socially oriented addicts. Frequency of jogging was negatively related to measures of addiction but positively related to measures of compulsiveness.

The limitations of control-of-supply models for explaining and preventing alcoholism and drug addiction.

Abstract: The primary approach to eliminating drug abuse in America for most of the 20th century has been to prohibit the use and sale of certain drugs and to shut down drug supply lines. Yet drug abuse persists at high levels and the use of outlawed substances is a common feature of American life from high school on. The failure of drug policies has not discouraged, but seemingly fuels, renewed efforts of the same kind. Contrasting with this focus on the inherent dangers of the substance itself, the effort to control alcohol abuse has instead focused, since the end of Prohibition, on the characteristics of the individual alcoholic. In recent years, however, the public-health model of alcohol abuse and the psychophysiological formulation of alcohol dependence have emphasized that alcoholism is a consequence of the amount of alcohol available in the society and consumed by the individual drinker. In this way, alcohol and drug dependence (or addiction) formulations have coalesced: both assume that uncontrolled use results from regular or excessive consumption of these substances. This unified model of addiction based on exposure to a substance fails to account for substantial interindividual, intraindividual and cultural variability in patterns of use. The evidence is, moreover, that control-of-supply policies will never reduce substance abuse significantly and that such policies may backfire by propagating images of substances as being inherently overpowering.

Cognitive processes in addiction.

Abstract: Summary In recent years there has been a large increase in the number of theoretical papers and empirical studies which focus upon the cognitive processes involved in addiction. This paper is intended simply to illustrate selected theories and concepts and to highlight some of the avenues of research which are helping to change our models of addiction. The main conceptual framework is that which has come to be known as social learning or cognitive social learning theory but concepts of self awareness, perceptual narrowing and self-handicapping are also described. Implications for the understanding of craving, loss of control, treatment and relapse are also considered.

Addiction time and intellectual impairment in heroin users.

Abstract: -Rorschach test scores for male heroin users and nonusers (ns = 15 each) were compared, to ascertain whether use of heroin influences intellectual Impairment ' (as measured by such indicators of intellectual functioning as P+ 55 and W + % responses). While the results show intellecrual impairment to be greater In heroin users than in nonusers, the parametric and nonparametric indicators do not consistently show more marked impairment in long-term (4 to 5 yr. of addiction) than in short-term users (1 to 2 yr.). While intellectual functioning clearly seems influenced by heroin use, further research is required to ascertain the effect of the length of use either by comparing test and retest scores over a substantial interval or by matching samples including subjects with even longer careers of addiction.

Treating a Sex Addict Through Marital Sex Therapy.

Abstract: The treatment of sexual addiction can be viewed within the context of addiction and family therapy. A case of sexual addiction is presented and an intervention model is explicated. The application of the model emphasizes the importance of family participation in the treatment. This article describes the family treatment of a "sex addict." This term was popularized by Patrick Carnes in his highly-publicized book Out of the Shadows: Understanding Sexual Addiction (Carnes, 1983). Whether or not one can precisely define addictive sex, it is clear some people admit they cannot control their sexual behavior to the point it seriously interferes with their lives in terms of health, occupation, or family (Edwards, 1986). Others prefer to label these behavioral patterns as sexual compulsions (Quadland, 1985) or simply as problems of sexual control (Coleman, 1986). Some authorities are concerned the term is too value-laden, nonspecific, and assumes falsely that there is an accepted definition of normal sexual behavior (Coleman, 1986; Edwards, 1986). Carnes (1986) responds by saying people label themselves: "The fact remains that a significant number of people have identified themselves as sexual addicts: people whose sexual behavior has become 'unstoppable' despite serious consequences" (p. 4). Before describing a particular case, the author will make a few remarks about the interface of family therapy and the addiction field generally and about the etiology of sexual addiction specifically.

Is It Love or Is It Addiction

Abstract: "Love addiction creeps into the best of relationships," writes psychotherapist Brenda Schaeffer in this revised and expanded edition of a book that has sold more than 175,000 copies. "The challenge we face is to acknowledge the addictive elements and build on the best aspects of a relationship. If there is any reason to heal an unhealthy relationship, it is so that we can be more and give more to life."

Criteria of a pharmacologic withdrawal syndrome.

Abstract: To the Editor.— Hughes and Hatsukami 1 add significant findings to our knowledge of the syndrome that ensues when smokers stop smoking. As they suggest, this is very likely a nicotine withdrawal syndrome. Their analysis of alternative hypotheses, however, ignores an important possibility. If it is assumed that a person using a psychotropic drug for a long time was normal without that drug, then a behavioral disorder when the drug is stopped may well be a classic pharmacologic withdrawal syndrome. In reality, however, the assumption cannot be tested because addicts do not come to our attention before their addiction. An alternative hypothesis is that the long-term drug user is self-medicating a behavioral disorder that antedates the drug exposure. In that case, stopping the drug will expose a previously masked set of symptoms. Here we would not be dealing with a classic withdrawal syndrome at all. Either mechanism would produce all