I did a search for the term “addict” in thread titles here, and found some 14 threads started during the last year with titles containing the words “addicted” or “addiction”. These terms are commonly used, and I would like for you to be as specific as you can about what you mean by such terms.
First, does “addiction” exist in some objective sense, or is that term (and/or the concept of “to be 'addicted' to”) ultimately subjective and/or undefinable?
If you believe that “addiction” or to be “addicted” to a substance is objective in some sense, then how does one determine that one is “addicted” to that substance or has an “addiction” to that substance?
Let's say that a person takes a substance Z every day for at least 2 weeks. Is that person “addicted” to that substance (or, alternatively, does not person have an “addiction”)? Are there some substances that one cannot be “addicted” to or for which a person cannot have an “addiction” under any circumstances? If so, what is distinguishes those substances that one can be “addicted” to and the substances that one cannot?
I broke my big toe earlier this year in a silly accident. It was somewhat painful. I took a substance every day for about 2 weeks, which was longer than I was originally intending to take that substance. Was I “addicted” to it, or, alternatively, did I have an “addiction”? If not, why not?
For many decades in the American Psychiatric Association's DSM provided “diagnostic criteria” for 2 “substance use” mental disorders--Substance Abuse and Substance Dependence. It only required a single symptom for a person to be diagnosed with a Substance Abuse disorders; one of the symptoms that would satisfy the diagnostic criterion for a Substance Abuse disorder was “legal problems”. Many, many people were diagnosed with and “treated” for having a cannabis substance abuse disorder merely on the basis of having been arrested for possession, regardless of how responsibly the person may have used marijuana.
In the most recent iteration of the DSM, the “legal problem” criterion was dropped, and the distinction between substance abuse and substance dependence was eliminated, replaced with a single mental disorder called Substance Use Disorder. “Craving” a substance is added as a possible symptom. The manual contains essentially no discussion of what the concept of pathological “craving” of a substance is supposed to mean.
The DSM-5 says that a Substance Use Disorder entails “clinically significant” impairment or distress as manifested by at least two of the following “symptoms” occurring within a 12-month period. The clinician can specify 3 categories of severity where two or three symptoms indicate a “mild” substance use disorder, “moderate” for four or five symptoms, and “severe” in cases of 6 or more symptoms.
1. Use of a substance leading to failure to fulfill obligations at work, school or home.
2. Use of a substance in situations that may be physically hazardous.
3. Continued use despite it causing or exacerbating social or interpersonal problems.
4. Tolerance (the need for increased amounts of substance to achieve the desired effect or a diminished effect from the same amount).
5. Withdrawal (development of substance specific syndrome due to the cessation of use).
6. The substance is used more or for a longer period than was originally intended.
7. There is persistent desire or unsuccessful efforts to reduce use of a substance.
8. Significant time spent obtaining, using or recovering from the effects of a substance.
9. Decreased social, occupational, or recreational activities due to substance use.
10. Continued use despite subsequent physical/psychological problems.
11. Craving the substance.
So, do you use the term “addiction” as a synonym or colloquialism for a substance use mental disorder? Is to be “addicted” to a substance just to have the behaviors denoted by 2 or more of the above criteria? If so, does it matter which two? You might notice that several of these “symptoms” are difficult to distinguish as denoting distinct behaviors or phenomena. For instance, 1 and 9 seem to me to be just different words to describe something that is essentially the same.
You might also notice the perennial problem with DSM diagnostic criteria, namely the absence of anything that is quantifiable or that can be objectively determined, which is the fundamental requirement for a designation to be used for scientific purposes.
Please also notice that, regardless of the fact that the APA only “recognizes” substance use disorders for certain substances, one can easily satisfy the criteria by use of at least a variety of other substances, especially other psychoactive substances such as those prescribed as treatment for mental disorders. For instance, one of the most common adverse effects of antidepressants is impotence and/or decreased libido. This symptom undoubtedly causes some degree of distress in most people, and/or, in many cases, be the source of “interpersonal problems” with the person's spouse or partner, or cause the person to date less, thus meeting the criteria for numbers 9, 10, and/or 3.
“Irritability” is another quite common effect of antidepressants (and other psychiatric drugs), which alone should satisfy at least 2 of the above criteria for a substance use disorder.
It is also well-documented that after taking antidepressants for 2 weeks or longer, discontinuation causes an increased incidence of "relapse". The neurological correlations of this are fairly well understood and have been demonstrated in animals. Therefore, this syndrome and its effects, or the desire or efforts to avoid such effects, could easily satisfy 2 or more of the above criteria. Many other psychiatric drugs are known to produce withdrawal syndromes upon discontinuation.
Thus, if your concept of “addiction” or to be “addicted” to a substance is synonymous with Substance Use Disorder, then, in order to be consistent, it would seem that one is likewise referring to what happens almost invariably with the taking of psychiatric drugs that are prescribed to millions of people around the world (especially in the US).
Anyway, my questions here are above.
First, does “addiction” exist in some objective sense, or is that term (and/or the concept of “to be 'addicted' to”) ultimately subjective and/or undefinable?
If you believe that “addiction” or to be “addicted” to a substance is objective in some sense, then how does one determine that one is “addicted” to that substance or has an “addiction” to that substance?
Let's say that a person takes a substance Z every day for at least 2 weeks. Is that person “addicted” to that substance (or, alternatively, does not person have an “addiction”)? Are there some substances that one cannot be “addicted” to or for which a person cannot have an “addiction” under any circumstances? If so, what is distinguishes those substances that one can be “addicted” to and the substances that one cannot?
I broke my big toe earlier this year in a silly accident. It was somewhat painful. I took a substance every day for about 2 weeks, which was longer than I was originally intending to take that substance. Was I “addicted” to it, or, alternatively, did I have an “addiction”? If not, why not?
For many decades in the American Psychiatric Association's DSM provided “diagnostic criteria” for 2 “substance use” mental disorders--Substance Abuse and Substance Dependence. It only required a single symptom for a person to be diagnosed with a Substance Abuse disorders; one of the symptoms that would satisfy the diagnostic criterion for a Substance Abuse disorder was “legal problems”. Many, many people were diagnosed with and “treated” for having a cannabis substance abuse disorder merely on the basis of having been arrested for possession, regardless of how responsibly the person may have used marijuana.
In the most recent iteration of the DSM, the “legal problem” criterion was dropped, and the distinction between substance abuse and substance dependence was eliminated, replaced with a single mental disorder called Substance Use Disorder. “Craving” a substance is added as a possible symptom. The manual contains essentially no discussion of what the concept of pathological “craving” of a substance is supposed to mean.
The DSM-5 says that a Substance Use Disorder entails “clinically significant” impairment or distress as manifested by at least two of the following “symptoms” occurring within a 12-month period. The clinician can specify 3 categories of severity where two or three symptoms indicate a “mild” substance use disorder, “moderate” for four or five symptoms, and “severe” in cases of 6 or more symptoms.
1. Use of a substance leading to failure to fulfill obligations at work, school or home.
2. Use of a substance in situations that may be physically hazardous.
3. Continued use despite it causing or exacerbating social or interpersonal problems.
4. Tolerance (the need for increased amounts of substance to achieve the desired effect or a diminished effect from the same amount).
5. Withdrawal (development of substance specific syndrome due to the cessation of use).
6. The substance is used more or for a longer period than was originally intended.
7. There is persistent desire or unsuccessful efforts to reduce use of a substance.
8. Significant time spent obtaining, using or recovering from the effects of a substance.
9. Decreased social, occupational, or recreational activities due to substance use.
10. Continued use despite subsequent physical/psychological problems.
11. Craving the substance.
So, do you use the term “addiction” as a synonym or colloquialism for a substance use mental disorder? Is to be “addicted” to a substance just to have the behaviors denoted by 2 or more of the above criteria? If so, does it matter which two? You might notice that several of these “symptoms” are difficult to distinguish as denoting distinct behaviors or phenomena. For instance, 1 and 9 seem to me to be just different words to describe something that is essentially the same.
You might also notice the perennial problem with DSM diagnostic criteria, namely the absence of anything that is quantifiable or that can be objectively determined, which is the fundamental requirement for a designation to be used for scientific purposes.
Please also notice that, regardless of the fact that the APA only “recognizes” substance use disorders for certain substances, one can easily satisfy the criteria by use of at least a variety of other substances, especially other psychoactive substances such as those prescribed as treatment for mental disorders. For instance, one of the most common adverse effects of antidepressants is impotence and/or decreased libido. This symptom undoubtedly causes some degree of distress in most people, and/or, in many cases, be the source of “interpersonal problems” with the person's spouse or partner, or cause the person to date less, thus meeting the criteria for numbers 9, 10, and/or 3.
“Irritability” is another quite common effect of antidepressants (and other psychiatric drugs), which alone should satisfy at least 2 of the above criteria for a substance use disorder.
It is also well-documented that after taking antidepressants for 2 weeks or longer, discontinuation causes an increased incidence of "relapse". The neurological correlations of this are fairly well understood and have been demonstrated in animals. Therefore, this syndrome and its effects, or the desire or efforts to avoid such effects, could easily satisfy 2 or more of the above criteria. Many other psychiatric drugs are known to produce withdrawal syndromes upon discontinuation.
Thus, if your concept of “addiction” or to be “addicted” to a substance is synonymous with Substance Use Disorder, then, in order to be consistent, it would seem that one is likewise referring to what happens almost invariably with the taking of psychiatric drugs that are prescribed to millions of people around the world (especially in the US).
Anyway, my questions here are above.
