Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP
Posting-Version: version B 2.10.2 9/18/84; site bbnccv.UUCP
Path: utzoo!watmath!clyde!burl!ulysses!allegra!mit-eddie!godot!ima!bbnccv!sdyer
From: sdyer@bbnccv.UUCP
Newsgroups: net.med
Subject: Re: Valium
Message-ID: <204@bbnccv.UUCP>
Date: Mon, 18-Mar-85 19:40:09 EST
Article-I.D.: bbnccv.204
Posted: Mon Mar 18 19:40:09 1985
Date-Received: Wed, 20-Mar-85 04:04:48 EST
References: <271@ttidcc.UUCP> <191@bbnccv.UUCP> <12595@gatech.UUCP>
Organization: Bolt Beranek and Newman, Cambridge, MA
Lines: 52

>> If you look at the number of doses of Valium prescribed versus the number
>> of cases of abuse, not to mention addiction, it is vanishingly low.  This
>> seems to be forgotten in the rather sensational stories one often hears
>> about drugs.  Therapeutic doses of Valium don't cause physical addiction.
> 	
> 	I can't agree with these statements.  Addiction is not a
> 	dose dependant type of behavior, that is the amount one takes at a
> 	given time doesn't appear to influence the level or intensity of a
> 	persons addiction to the particular drug.  Don't confuse the properties
> 	of addiction with that of tolerance.  Many addicts do inevitably move
> 	toward higher doses due to tolerance, but the process of addiction
> 	development is not dose dependant.
> 

I think we need to define our terms better.  Are we speaking about
physical or psychological dependence?  Also, what are you defining
as "addiction"?  And how does that relate to actual "abuse"?
Opioid addiction doesn't seem to be dose-dependent, in that a dose
needed to treat pain will generally lead to some sort of physical
withdrawal syndrome (although the INTERPRETATION and REACTION to
that event varies wildly depending on the context of the administration
of the drug.)  On the other hand, at least in a therapeutic setting,
regular administration of sedatives (15mg of phenobarbital 4 X day,
200mg of a fast-acting barbiturate at bedtime, maybe 30mg of flurazepam
at bedtime) certainly won't have the same kind of withdrawal syndrome
that you see with higher doses of the same or similar drugs.  People
are treated with such doses regularly, and their withdrawal is uneventful.
Now, at the microscopic level, there may be observable changes due to
the removal of the drug, but I think the "synaptic" eye-view of addiction,
taken alone, isn't really too useful in a therapeutic setting.
Even mild observable psychic or behavioral effects upon withdrawal
do not alone constitute "addiction" in a clinical sense.  The situations
which Jerry was describing (reserving a bed with restraints for a week)
are not typical of 20mg of Librium, or 15mg of Valium, a day, and to
infer that they are is simply fear-mongering, in my mind.

I stand by my comment on the number of dosages of Valium dispensed
versus the number of cases of abuse.

My point is not to be excessively cavalier about Librium or Valium
or other drugs, but that comments like "Valium is the most dangerous
and addictive drug..." are simply silly: more political statements
than scientific facts, much like the earlier comments on vitamins
and laetrile.  Whether a drug will be abused depends a lot on who is
taking it, why it's being taken, how much is being taken, and how long
it's been taken.  The typical Valium user taking the drug for muscle
spasm or a brief period of anxiety, under a doctor's care, hasn't got
too much to worry about as far as becoming addicted.
-- 
/Steve Dyer
{decvax,linus,ima,ihnp4}!bbncca!sdyer
sdyer@bbnccv.ARPA