Posted by alan on December 18, 1998, at 11:31:03
In reply to Thank you for getting this started, posted by anon on December 18, 1998, at 9:47:05
> > A few ideas.
> > First 'addiction' is useed to talk about qiute a few rather diverse phenomena; ther may well not be any one feature common to all (and only) the sorts of things we call 'addictions'. We may havw what the philosopher Wittgenstein called a 'family resemblance term' where we lump a whole set of phenomena together because of various chains of similarities in various directions even tho no one thing is common to all of them. Simplistically, a and b may have F in common, b and c have G in common, but a and c have nothing in common; but because of that we call all of a, b, and c by some common name. Of course, that only begins and does not end any explication of the common term applied to a, b, and c: what are the similarities and differences, and why do wee lump thos three things together, seeing them as one kind of thing?
> > Now for 'addiction'. There are several things lumped together by that term: a withdrawal syndrome, tolerance of higher dosages, occasional use of very high dosages, frequency of use, obsessive thoughts of the substance (not caused merely by worries about being 'addicted', getting drugs without prescription, using a drug for 'fun'
> > once or several or many times (moderate alcahol use does not count, the drug has seious adverse effects but has not been prescribed (antihistamines), frequently using the drug even tho you think you sshould not (note here that there is talk of 'food addicts' and 'sex addicts' and 'exercise addict' who overtrain--a frequent problem for athletic coaches), craving. And all I've no doubt left out.
> > Now for a very important point: "addiction' is an evaluative term, like 'disease', in the sense that it is pretty central to the concept that addictions are BAD. Indeed, this has brought on a kind of hysteria that politicians exploit. Thus doctors fear causing anything that may get called an addiction by precribing crtain substances in certain dosages to certain patients even when it may do the patient more good than harm. One doctor once sent a very sick cancer patient to an abuse treatment center for her addiction to pain killers; she soon left for hospital when the cancer flared up. If what I have read is correct, many alcahol abusers benefit from benzos while many docs will never ever prescribe them to suitable such patients. I think there is a tendancy to think 'withdrawal syndrome, ergo addiction, ergo bad. (Of course it may be bad in some cases; but that requires knowing the patient.
> > Well, maybe this can start the sort of discussion you wanted. Needless to say, (something we say only when it is needed) none of this is to imply that there are some devastating addictive phenomena to be avoided, studied, and treated.
> A great way to start this discussion. I will have to think more before I post a response; I just wanted to post this immediately. I suppose these terms are understood differently by different people in different contexts, and therefore should not be thrown around as if they signify a phenomenon exactly and and unambiguously. Thus absolute statements such as "if you have ever in your life taken a prescription drug without a prescription from your doctor, you have a drug problem" are merely opinions, similiar to opionions one one expound when asked to define such notions as "love" or "hate." More from me later.
>1. Does anyone know if I can easily erase a message I'm responding to on webtv without doing it sort of letter by letter?
2. The "absolute statement" you quoted--at least taken out of context--does not deserve serious consideration. We could all think of obvious counterexaamples. Waking in middle of night with terrible toothache or malaria near someone with something that might have something helpful, and taking it does not mean you have a 'drug problem', altho it may be a bad idea in some cases due to sensitivities and interactions.
3. Some opinions are much better than others; in the last analysis, 'opinions' are all we have. And we pay doctor's to get the best opinions we can.
4. It is at least possible that we all mean the same when using a term to refer to a phenomenon we know little about and about whose referent (what the term names) we have different opinions. In some contexts this can be important, so I just mention it now.
5. On some topics, such as drugs (homosexuality, effects of divorce on childen) a doctors opinion may be biased by religious, moral, and political convictions that overide scintific concerns, especially when the science is weak. Moreover, many clinicians are not terribly imbued with any scientific spirit, but hink they are--I think that especially applies to some of the older ones.
6. I thank you for your thank you and thank you for posing a very interesting question.
poster:alan
thread:1619
URL: http://www.dr-bob.org/babble/19990501/msgs/1630.html