Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.2 9/18/84; site gatech.CSNET Path: utzoo!watmath!clyde!burl!ulysses!gatech!carter From: carter@gatech.CSNET (Carter Bullard) Newsgroups: net.med Subject: Re: Valium Message-ID: <12788@gatech.CSNET> Date: Tue, 9-Apr-85 17:14:50 EST Article-I.D.: gatech.12788 Posted: Tue Apr 9 17:14:50 1985 Date-Received: Wed, 10-Apr-85 06:06:46 EST References: <271@ttidcc.UUCP> <191@bbnccv.UUCP> <12595@gatech.UUCP> <204@bbnccv.UUCP> Reply-To: carter@gatech.UUCP (Carter Bullard) Organization: School of ICS, Georgia Institute of Technology, Atlanta Lines: 101 Summary: Sorry that this is late for a followup, but Gatech has been down for a while. Much of the previous article was included to remind us of what is being replied to. >>> 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"? Neither the word dependence nor abuse has been mentioned in my discussion. It could be safe to say that addiction to a substance generates a "drug-seeking" behavior. This seems general enough for the discussion. Drug withdrawl is not, in my opinoin, a criteria for the development of an addiction. A dependance, maybe, but not an addiction. >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.) This is absolutely wrong. When I say dose-dependant, I mean that the dose of drug is not a contributing factor with regards to the etiology of the addiction. It is not true that any therapeutic dose of codiene, morphine, heroin or demerol will produce a withdrawl syndrome. > 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. I am afraid that you seem to think that severity of withdrawl is some indication of the "severity" of drug addiction. My point has nothing to do with "how bad an addiction you get". The point is that you can become addicted to 15mg of phenobarbital 4 X /day. >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'm afraid that you do not have any practical experience with Valium addicts, or even Valium from a "therapeutic" standpoint. Your statements do not sound like that of an experienced practitioner. > >I stand by my comment on the number of dosages of Valium dispensed >versus the number of cases of abuse. Just remember that Valium is a prescription compound in the U.S. There is a reason for this. > >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. You have completely missed the whole point. HOW MUCH YOU TAKE DOESN'T HAVE THAT MUCH TO DO WITH IT. Carter Bullard School of Information and Computer Science Georgia Institute of Technology Atlanta, Georgia 30332 CSNet:Carter @ Gatech ARPA:Carter.Gatech @ CSNet-relay.arpa uucp:...!{akgua,allegra,amd,ihnp4,hplabs,seismo,ut-ngp}!gatech!carter -- Carter Bullard School of Information and Computer Science Georgia Institute of Technology Atlanta, Georgia 30332 CSNet:Carter @ Gatech ARPA:Carter.Gatech @ CSNet-relay.arpa uucp:...!{akgua,allegra,amd,ihnp4,hplabs,seismo,ut-ngp}!gatech!carter