Newsgroups: alt.drugs,sci.psychology,talk.politics.drugs
Subject: Re: Partial Legalization
From: pwh@bradley.bradley.edu (Pete Hartman)
Date: Wed, 29 Jul 92 16:10:40 GMT
 <1992Jul27.160010.7599@bradley.bradley.edu> 
 <1992Jul29.004255.7398@pony.Ingres.COM> <1992Jul29.031718.16420@bradley.bradley.edu> <1992Jul29.042409.26527@pony.Ingres.COM>
Distribution: usa
Organization: Bradley University

In <1992Jul29.042409.26527@pony.Ingres.COM> jpk@Ingres.COM (Jon Krueger) writes:
>I wrote:
>> There is a class of substances whose mere exposure leads to addiction.
>David Vessell inquires:
>> so WHAT IS IT
>Pretty much what you'd guess.  For example, cocaine.  Surprise.
>There's also an interesting subclass: substances that the organism
>self administers.  This subclass is also pretty much what you'd guess,
>e.g. cocaine also makes this list.  Anyone surprised?

Not surprised that you'd contend this.

However, I still beg to differ.  To quote extensively from _The Case for
Legalizing Drugs_, the chapter entitled "What Drugs Do to Users":

Horror stories about "instant" crack addiction are unconfirmed by
scientific research.  In the early 1980s, researchers at a California
clinic gave the drug to 200 volunteers.  None became addicts or even turned
into abusers.  A study of 175 illicit crack users in Los Angeles found none
with a compulsive habit; all used the drug in moderation. (74)  Monkeys
allowed to smoke crack will limit their intake. (75)

[...]

Cocaine was studied for a century without anyone detecting resonance of
physical dependance among users of the drug.  Only after politicians
decried cocaine in the 1980s did a handful of scientist claim that
dependence develops.  The claim became widely believed and merits
consideration here.

Proponents of the dependence concept used innovative terminology to change
attitudes toward long-observed effects of cocaine.  For example, not until
1986 was a three-stage "cocaine abstinence syndrome" proclaimed. (94)  The
first stage was called the "crash," likened to an alcohol hangover, (95) in
which a person who stops a cocaine binge feels exhausted and depressed.
Cocaine and other stimulants work by using up energy stored in the body.
At the end of a binge a person will feel like someone who has done hard
physical labor for days without food or sleep.  Those symptoms do not mean
a person has a metabolic need for such punishment [as would be the case if
it were truly "withdrawal" from resonance/physical addiction --pwh].  Nor
are they evidence that physical resonance has been established with
cocaine, any more than a hangover is evidence of physical resonance with
alcohol.  If cocaine resonance existed, a user could quickly resume normal
functioning by taking another dose of cocaine.  But such a dose would
worsen the user's condition, not restore it to normal; a maintenance dose
is impossible because cocaine resonance does not exist.  Although the
second stage in "cocaine abstinence syndrome" was called "withdrawal,"
proponents of the concept admitted that "this does not mean that a classic
drug abstinence syndrome formally occurs"(96) and admitted that the second
stage was "dissimilar [to] 'withdrawal' in alcohol, barbiturate, or opiate
abuse."(97)  Indeed, these promponents declared, "Withdrawal has ...
assumed a clinical meaning, independent of its pharmacological definition,
that derives from the postdrug syndromes for which drug users seek
treatment....  Strict pharmacological use of the term can cause clinical
treatment errors."(98)  In other words, "cocaine withdrawal" has no
pharmacological component.  That is, it is not caused by the drug.

[...]

Proponents [of claims of "cocaine dependence" --pwh], however, achieved a
victory in 1987 when the American Psychiatric Association invented a new
disease called "cocaine dependence" that did not require resonance of
physical dependence for the diagnosis. (100)  An "epidemic" of "cocaine
dependence" appeared overnight because the symptoms had never been
classified as disease until then.  Even the APA admitted this, albeit with
hedgin:  "*Because of the broadened criteria* for Dependence included in
this manual, and because of the definite increase in use in recent years,
the prevalence of Cocaine Dependence is believed to be har higher" than
formerly (emphasis added). (101)  The APA's action gave the term official
medical and governmental recognition even though the APA itself conceded
"Continuing use of cocaine appears to be driven by persistent craving and
urges for the substance rather than attempts to avoid of alleviate
withdrawal symptoms."(102)  Even a prominent "cocaine dependence" proponent
concurred, "This craving...can be understood as a memory of the stimulant
euphoria."(103)

[...]

Criteria that describe "cocaine dependence" are psychological and not
pharmacological.  The clinical condition termed "cocaine dependence" may be
real, even devastating, but it is caused by a psychological process instead
of a pharmacological one.

[...]

If cocaine abuse is inevitable, we might be making an artificial
distinction by saying ailments rarely occur without reckless usage; but
abuse is not inevitable.  Indeed researchers find abuse is the exception
from the norm. (113)  A 1984 study concluded that 10 percent of cocaine
users might become abusers, (114) about the same percentage seen among
drinkers who become alcoholics.  A 1985 investigation found an even lower
percentage of cocaine users becoming abusers, 2.5 percent. (115)  A 1984
study indicated that people can take cocaine for recreation and continue
their moderation. (116)  Researchers found that most cocaine users oin
Canada rarely kept a supply of the drug, normally bought only 1 to 3 grams
in a single purchase, made no more than 4 purchases a year, and took a dose
less than once a month. (117)  A study that tracked specific New York
cocaine users from 1971 to 1984 found the typical use to be intermittent
ranter than compulsive, (118) a finding supported by another study that
tracked specific recreational users from 1975 to 1983. (119)  A survey
asked cocaine users if they had ever tried to give up the drug without
success; 3.8 percent said yes. (120)  That low percentage should be
compared to survey resondents who said they had tried to give up tobacco
cigarettes without success, 18 percent. (121)  Very few cocaine users have
an uncontrollable craving.  An 11-year study concluded that most careers
and lives are not wrecked if people use cocaine. (122)  One researcher
summarized the findings:  "People who have a stake in conventional life
don't throw it all away."(123)  Such findings do not mean that cocaine
abuse should be disregarded.  They do mean the problem is not a fearsome
crisis.


NOTES:

74. Siegel, _Intoxication_, 309-10; Bower, "Drugs," 393.
75. Siegel, _Intoxication, 182-83.

94. Gawin and Kleber, "Abstinence," 107-13.
95. Kleber and Gawin, "In," 298.
96. Kleber, "Cocaine," 1364.
97. Gawin and Kleber, "Abstinence," 112.
98. Kleber and Gawin, "in," 298.

100. Diagnostic, 166-68.
101. Ibid., 179.
102. Ibid.
103. Kleber, "Epidemic," 1364.

113. Nadelmann, "Drug," 944; Graham et al., "Pregnancy," 143; newcomb,
Bentler, and Fahy, "Cocaine," 1167; Grabowski and Dworkin, "Cocaine," 1077.
114. Summarized in Smith, "Cocaine," 117.
115. Summarized in Erickson et al., _Steel_, 136-37.
116. Summarized in ibid., 54.
117. Ibid., 76, 118.  Cocaine might be offered on social occasions, so even
without a personal cache a user could still take a dose.
118. Kandel and Raveis, "Cessation," 109-16.
119. Siegel, "Changing Patterns of Cocaine use: Longitudinal Observations,
Consequences, and Treatment," in Grabowski, _Cocaine_ (National Institute
on Drug Abuse), 106-7.
120. Nadelmann, "Drug," 944.
121. Ibid.  Tobacco smokers are generally considered to be compulsive users
of nicotine, but not all nicotine addicts are compulsive users, and not all
users are addicts.  See Shiffman, "Tobacco," 539-47.
122. Murphy, Reinarman, and Waldorf, "11-year," 427-36.
123. Craig Reinarman, quoted in Raymond, "Researchers," A10.


REFS:

Siegel, Ronald K.  _Intoxication: Life in Pursuite of Artificial Paradise_.
	New York: Tutton, 1989.
Gawin, Frank H., and Herbert D. Kleber.  "Abstinence Symptomatology and
	Psychiatric Diagnosis in Cocaine Abusers:  Clinical Observations."
	_Archives of General Psychiatry 43_ (1986): 112.
Kleber, Herbert D., and Frank H. Gawin.  "In Reply."  _Archives of General
	Psychiatry 44_ (1987): 298.
Kleber, Herbert D.  Epidemic Cocaine Abuse:  America's Present, Britain's
	Future?"  _British Journal of Addiction 83_ (1988: 1364.
Kleber, Herbert D.  "Introduction:  Cocaine Abuse:  Historical,
	Epidemiological, and Psychological Perspectives."  _Journal of
	Clinical Psychiatry 49_ (February 1988 Supp.): 3.
Nadelmann, Ethan A.  "Drug Prohibition in the United States:  Costs,
	Consequences, and Alternatives."  _Science 245_ (1989): 941,
	943-44.
Graham, K., et al.  "Pregnancy Outcome Following First Trimester Exposure
	to Cocaine in Social Users in Toronto, Canada."  _Veterinary and 
	Human Toxicology 31_ (1989): 143-48.
Newcomb, Michael D., P. M. Bentler, and Bridget Fahy.  "Cocaine Use and
	Psychopathology:  Associations among Young Adults."  _International
	Journal of the Addictions 22_ (1987): 1167.
Grabowski, John, and Steven I. Dworkin.  "Cocaine:  An Overview of Current
	Issues."  _International Journal of the Addictions 20_ (1985):
	1077, 1081.
Smith, David E.  "Cocaine-Alcohol Abuse:  Epidemiological, Diagnostic,
	and Treatment Considerations."  _Journal of Psychoactive Drugs 18_
	(April-June 1986): 117-18.
Erickson, Patricia G., et al.  _The Steel Drug:  Cocaine in Perspective_.
	Lexington Books.  Lexington, Mass.: C.D. Heath and Company, 1987.
Kandel, Denise B., and Victoria H. Raveis.  "Cessation of Illicit Drug Use
	in Young Adulthood."  _Archives of General Psychiatry 46_ (1989):
	109-16.
Murphy, Sheigla B., Craig Reinarman, and Dan Waldorf.  "An 11-year
	Follow-Up of a Network of Cocaine Users."  _British Journal of
	Addiction 84_ (1989): 427-36.
Raymond, Chris.  "Researchers Say Debate over Drug War and Legalization Is
	Tied to Americans' Cultural and Religious Values."  _Chronicle of
	Higher Education 36_ (March 7, 1990): A6-A7, A10-A11.


There you go.  200 lines more than you ever wanted to see about cocaine
dependance. :-)
-- 
Pete Hartman		       Bradley University	pwh@bradley.bradley.edu
        People say that I'm out of touch with reality.  That I'm insane.
    Sometimes I forget things.  Who I am.  Where I am.  Unimportant things.
                       But I'm not insane.  I am a tick.
Newsgroups: alt.drugs