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Drug addiction can be categorized into two types,
pharmaceutical drug addiction and illicit drug addiction. There
are many types of pharmaceutical medication to which individuals
can become addicted. Some, but obviously not all, include: Hydrocodone
(Vicodin), anti-anxiety agents such as Xanax, sleep aids, mild hypnotics
such as Ambien, and Halcion. The list is extensive, and we are unable
to target the many medications on this web site.
Pharmaceutical medication
The medical professional clearly has to shoulder some of the responsibility
in the abuse and addiction of pharmaceutical medication. This author
has seen irresponsible medicine over the past 20-25 years, where
medication is frequently prescribed to a patient past the point
there is real need, but the flow of medication continues to appease
the patient, as the healthcare provider is either unable, unwilling,
or simply does not know how to confront a patient who may be addicted,
and is afraid of the patient’s response. Poor treatment such
as this is of course a disservice to patients and to the practice
of medicine.
Over the last 5-10 years, the peddling of black market pharmaceuticals
has skyrocketed, and continues to be an ongoing problem.
Illicit drugs
Examples of illicit drugs include cannabis, cocaine, heroin, to
name only a few. Illicit drug usage has existed for as long as drugs
have been labeled illegal. Special mention is made to cannabis usage,
as of all illicit drug usage, it is the most common.
Marijuana Addiction
Cannabis is a frequently used illicit drug. Cannabis abusers are
masters of reframing, rationalizing the use of their drug of choice
by citing research regarding the use of cannabis as an anti-emetic
for those undergoing chemotherapy, and to decrease glaucoma pressure,
in order to validate their smoking.
The legalization of cannabis has been hotly debated, with much lobbying
occurring in hopes of legalizing the drug. It has been hotly debated
that of all illegal drugs, cannabis is the least harmful, with a
strong denial of any addictive component. For the purpose of this
web site, we will not engage in either political or ethical wrangling
regarding the pros and cons of legalization. What we do know is
that inhaling cannabis does increase the severity of respiratory
ailments, partly due to the fact that when inhaled, the smoke is
held inside the lungs for a longer period of time. We also know
that cannabis can cause tachycardia, can induce paranoia, and secondary
depression. Evidence points to a psychological, as opposed to a
physiological addiction to cannabis use. Many long term cannabis
smokers indicate that whatever emotional state one may be experiencing
at the time is exacerbated by the use of cannabis. First time cannabis
smokers universally state that peer pressure was the main reason
for smoking their first marijuana cigarette, as well as their own
curiosity regarding the drug, and desire to experiment.
It is a myth that Native Americans regularly smoke cannabis to
get high or in religious ceremonies. The “peace pipe”
is not filled with cannabis, but with Knickknick, a combination
of tobacco, sweet grass and sage. The pipe ceremony is performed
out of respect to the Four Directions and a prayer to God, as well
as a symbolic gesture of peace toward others.
Nicotine Addiction
Nicotine addiction has been cited as one of the most powerful addictions
known to man. The reason for this is that it is connected to so
many psychological behavior cues, more so than any other addictive
substance. Smoking tobacco is associated with being on the phone,
the morning cup of coffee, after sex, getting in the car and driving
to work. There are many behavior cues that are associated with nicotine,
as opposed to heroine, cocaine and even alcohol, although alcohol
does have some behavioral cues (drinking with your peers or at sporting
events, etc.).
Some facts on nicotine addiction
- It takes approximately 7 attempts to quit before one is successful.
- Tobacco smoke contains more than 200 known poisons. Every time
someone lights up, there is definitely some degree of injury from
these poisons. For example, a 2-pack a day smoker shortens his/her
life expectancy by 8 years.
The following are documented effects of smoking
- Chronic bronchitis
- Emphysema
- Lung cancer
- Bladder cancer
- Gastric ulcer
- Heart disease
- Mouth and throat cancer
- Stroke
Treatment of Nicotine Addiction
There are many different pharmaceuticals available to aid in smoking
cessation. However the best result appears to be a combination of
the patch and Zyban, or Nicorette gum and Zyban. We will only touch
on a few of the aids.
Nicoderm patch
The Nicoderm patch comes in various milligrams to accommodate individuals
who smoke in varying degrees. An individual must stop smoking completely
before using the patch. It is a tapering down system of milligrams
of nicotine over a 6-8 week span. There are warnings associated
with the patch, including elevated blood pressure, increased heart
rate, worsening of angina, dizziness, and whether or not it can
be safely taken while pregnant is not known at this time. Avoid
snuff, chewing tobacco, and avoid smoking.
Nicorette gum
Comes in 2 mg. and 4 mg. square pieces of gum. This also helps with
withdrawal symptoms of nicotine. If an individual smokes less than
25 cigarettes a day, use 2 milligrams of gum. Anything over that,
use the
4 milligrams of gum. There is also a tapering down method over a
6-week span. Warnings are similar to the Nicoderm patch. Individuals
should discontinue if mouth, teeth or jaw problems occur. It does
interact with insulin, anti-depressants and certain asthma agents.
Nicotine inhalers
There are a variety of types of nicotine inhalers, which are used
to reduce nicotine withdrawal symptoms. These are also tapered over
6 weeks. These may cause bronchospasm. You must have stopped smoking
completely. There have been complaints of irritation to the nasal
mucosa.
Zyban
Zyban is not to help reduce nicotine addiction, but is used to “take
the edge” off of the anxiety that occurs with smoking cessation.
It is effective in reducing anxiety during this time. Dosage is
150 mg., once a day for 3 days, then 150-mg. twice daily for at
least 3 months. There should be a target date set. The individual
is at first to continue to smoke, as it takes a couple of weeks
for the Zyban to reach an effective blood level. There are contraindications.
If a person has a seizure disorder, anorexia nervosa, or they are
on an MAOI, which is a certain type of anti-depressant, they should
not use Zyban. IT IS IMPORTANT TO NOTE THAT APPROXIMATELY 35% OF
INDIVIDUALS USING THE ZYBAN TO STOP SMOKING WILL HAVE SOME DEGREE
OF INSOMNIA.
Another technique that this author has found very helpful is reframing.
Reframing is the ability to switch one’s frame of reference
and perception of a behavior. This is fairly easy to do, but very
difficult to maintain over a long period of time. In other words,
the reframing for smoking could be as easy as, “Why am I inhaling
this poison, why am I inhaling a foreign substance into my lungs?”
An analogy would be standing over a campfire and breathing in smoke,
which does not make logical physical or psychological sense. In
the reframing process, instead of saying to oneself, “I need
the cigarette, this is my buddy, this will relax me and calm me
down,” one carefully looks at what one is doing and alters
the thought process about the behavior. It is usually not advisable
to stop smoking for others, for children, grandchildren or spouses.
If failure occurs, guilt ensues, feeling as if you’ve “let
the other person down,” which may lead to a brief depression.
Some individuals pray to God to help them stop smoking. My advice
to them is, “God can save your soul, but he can’t save
your ass.” You need to do this by yourself and for yourself.
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