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!mhuxr!ihnp4!bbnccv!sdyer From: sdyer@bbnccv.UUCP (Steve Dyer) Newsgroups: net.med Subject: Re: Valium Message-ID: <144@bbnccv.UUCP> Date: Wed, 10-Apr-85 19:07:31 EST Article-I.D.: bbnccv.144 Posted: Wed Apr 10 19:07:31 1985 Date-Received: Thu, 11-Apr-85 02:04:26 EST References: <271@ttidcc.UUCP> <191@bbnccv.UUCP> <12595@gatech.UUCP> <204@bbnccv.UUCP> <12788@gatech.CSNET> Organization: Bolt Beranek and Newman, Cambridge, MA Lines: 94 > >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. > I think this clarifies the confusion here. I was identifying "addiction" as physical dependence, whereas Carter, if I understand him finally, is using a much more inclusive term, which could roughly be described as "reinforcing" from an animal behavior point of view. I stand by my previous statements when viewed in this context. The word "addiction" actually is rather frowned upon as jargon these days simply because it can be construed in so many different ways. Physical dependence, psychological dependence (when speaking unscientifically) or, simply, causing "drug-seeking" behavior, are more apt. I still have trouble with his definition in his comments below, which may mean that I am not perceiving his point. > >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 [sic.], morphine, heroin or demerol will produce a > withdrawl [sic.] syndrome. > This is a misstatement made in the heat of typing. I meant to say that prolonged administration of therapeutic doses of opioids will generally lead to physical dependence. Naturally, a single (or a few) therapeutic doses will not produce a physical withdrawal syndrome. > 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. > The key here is what does it mean to be "addicted" to 15mg 4 X day? If you allow that that means that the person taking it WANTS to take it, makes sure s/he always has enough, and gets quite anxious if the supply runs out, well, I can agree that that would agree with your definition of addiction. But I think it's important to get the meaning of your definition across when you make statements about a drug being "addicting", simply because the colloquial use of the word, and even its use in much scientific literature, does not convey this. CAN we expect restraints in people with 15mg of phenobarbital (or Valium)? That would be news to me (all it takes is some evidence for me to change my mind.) Or is your analogy more along the lines of cigarette smoking? > > > >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. Irrelevant. No one is asking for Valium to be sold over the counter. > > > >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. No, I think you aren't seeing MY point. To use your definition of "addiction" here, the great majority of people who are given Valium clinically don't present a "drug-seeking" syndrome during or after therapy. This is not to dismiss that fact that it can occur, but that WHY it occurs and in WHOM, isn't quite clear. Some people seems to be predisposed to this: others can stop taking an "abuse-prone" drug, even in the face of physical withdrawal symptoms, without any problems. -- /Steve Dyer {decvax,linus,ima,ihnp4}!bbncca!sdyer sdyer@bbnccv.ARPA