Click here to get your copy of the latest book by Dr Mark Gillman!
Addiction and dependence and the effects of drugs on the brain – some drugs, if used regularly, and for some time, cause behavioural changes in the user
Some drugs, if used regularly, and for some time, cause behavioural changes in the user. In many cases, they experience so-called ‘loss of control’ and have a compulsive need to use the drug. In other words, the effects of drugs on the brain in this manner means that the drug seems to control them instead of the other way around. In certain cases, their compulsion can cause them to lose control to such an extent that their daily existence is spent thinking about and obtaining supplies of that drug. When a person who has a compulsive urge to use a particular drug somehow manages to abstain, they often begin using it again, despite any negative consequences of resuming their habit.
For hundreds of years, the actual cause for loss of control has been disputed by laypeople, the clergy and doctors. In the 18th Century, where there was little scientific knowledge about addiction, it was put down to ‘weakness’ and absence of ‘moral fibre.’
An English doctor, who practiced then, was the first to describe the ‘withdrawal syndrome’ from repeated opium use and following abrupt abstinence. He believed, wrongly as it turned out, that the withdrawal state was caused by impurities in the opium rather than an intrinsic property of the drug itself. Nonetheless, he was the first physician to describe a withdrawal state or syndrome i.e. the ‘hang-over’ following repeated drug taking. He also pioneered the notion that addiction might be explainable in biological and medical terms as opposed to an account based on moral transgression. Unlike his contemporaries, he seemed to grasp the idea that the withdrawal state had an underlying biological cause, which had produced what he had observed in his opium using patients.
Sadly, the breakthrough did little to produce a consensus on the causes of addiction. Instead, from then onwards, there was a sharp debate between two camps. There were those doctors and others, who still believed that addiction was a sign of moral weakness, and those who favoured a more scientific and rational approach to the problem. As we have seen from the affair with David Nutt and the British government, the camps are still firmly divided along two distinct lines. One group favours science whereas, in contrast, its counterpart prefers to interpose other matters. The non-scientific camp still blames moral societal and political considerations. Thus, the debate continues unabated to our present time.
The subject of addiction causes emotional, heated quarrels that generate more heat than light
Unfortunately, these differences of opinion do little to enable a scientific understanding of addiction. In fact, quite the reverse is true – it has directly contributed to the ambivalent and often unscientific views by governments and lay people alike. As a result, the subject of addiction often causes emotional, heated quarrels that generate more heat than light. The failure to resolve these futile arguments in a rational and scientific manner may well have contributed to the confusion that still exists in the current terminology. These different definitions are used by the various authorities to describe the very same phenomena found in addiction.