keskiviikko 17. helmikuuta 2016

Part 2: Personal thoughts on addiction and dependence

Continuing on my thoughts on the issue of addiction and dependence, I got to thinking about the measures by which dependence and addiction are quantified. Again, going with my personal perspectives as a sort of baseline for my thought experiments to avoid even pretending to be able make generalized statements, though I am trying to perhaps provoke some thoughts.

Considering most of the criteria for nicotine addiction (again, using the substance abuse disorder from DSM 5 as a guideline, since that's what seems to be the conventional wisdom) are more or less predicated on the perception of harm, I can't help but wonder.. are people choosing the behavior, getting addicted instead of choosing the behavior or is the behavior painted as an addiction by manipulating their perception of harm, thus forcing the person to fit the definition of addiction?

So hypothetically, how does one go about creating an addict out of a person?

Take for instance a hypothetical product, which is completely benign but offers a noticeable benefit in the form of pleasure. Now mr A and mr B are essentially identical, both using the same product in exactly the same amounts and ways.

- Somebody manages to convince Mr A that the product is actually very harmful, which leads to him really wanting to quit use. Now, the product offers an actual benefit and no tangible costs, so A does continue the behavior while "knowing" there are harms, still wanting to quit but not being able to and experiencing cravings for those benefits when trying to abstain and using the substance longer than he intended.

- Mr B uses the product in the same amount, but experiences none of the negative aspects.

The only real difference between these two then is that mr A fits the description of moderate addiction after twelve months, while B does not since the criteria do not include benefits.
Thus, A identifies as an addict without any kind of impact from the substance itself.

This ties into vaping quite closely. While it's certainly not completely benign, it's close enough to fit the above example.
If I were suddenly convinced that vaping causes meaningful harm, leading me to suffer the negative consequences of that perception, would I be an addict?
What if I continue to be convinced there is no meaningful harm (that would prompt me to want abstinence) is it even possible for me to be an addict, as my tolerance and withdrawal are both not issues?

This leads me to believe it's almost impossible substance abuse disorder even exists for vaping, snus or other low risk products until one of two things happens: either evidence emerges that they really are substantially harmful or people are manipulated to believe so.

The latter seems to be a goal for some people that like to assert that dependence is something that needs to be avoided at all costs.


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