[Marxism] Reply to Melvin on addictions

Jurriaan Bendien bendien at tomaatnet.nl
Thu Mar 25 14:13:55 MST 2004


Hi Melvin,

You said: You and I have got to stop smoking. Yep. I'm still addicted, it's
difficult to get motivated to stop. Usually what they say is that you should
do it, when you're away from your ordinary surroundings, i.e. on holiday or
on a trip for some time etc. I've quit before, but I start again.
Personally, I'm not fat. I'm 6'3" tall, and then if you blow up with lards
of fat, it strains the heart more. I've got nothing against fat people or
anything, but I never aimed to get fat. I just have to get fit again,
somehow, that's all. I used to jog a fair bit, when I was younger, and play
sport, but I don't do it here anymore really. Typically adult sport in
Holland is either about sex, money or violence. So, it's not pleasant.
Here's my notes on the addiction topic, if interested:

Nicotine

- Nicotine addiction is acknowledged to be among the hardest addictions to
break. It can take just a few cigarettes to become addicted or become
addicted again. Symptoms of nicotine withdrawal creates within 24 hours at
least four (or more) of the following: irritability, insomnia, impatience,
hostility, anxiety, depressed mood or mood swings, difficulty concentrating,
restlessness, decreased heart rate, increased appetite, weight gain. The
symptoms peak within the first week, and generally return to near baseline
levels within a month. Increased appetite and weight gain can continue for
at least ten weeks after smoking cessation, and can last longer. Part of
this gain in weight is attributable to slower metabolism after smoking
cessation. Craving for a cigarette peaks in the first week, and then tapers
off gradually over a period of months. Many ex-smokers report only mild and
occasional craving after six months without a cigarette, but stronger
craving may
continue to be elicited by triggering stimuli (e.g. stress, being offered a
cigarette in a bar, etc.) for over a year or more. It is the combination of
unpleasant mood created by nicotine withdrawal, the perception that smoking
a cigarette will provide a sense of wellbeing or better performance,  the
strength of the smoking habit and the very widespread nature of smoking cues
or triggers, which make it difficult for regular smokers to stop smoking.

- Nicotine enhances the availability of neurotransmitters, such as
dopamine.  These neurotransmitters influence memory, attention, performance,
pleasure, tension, anxiety, appetite and pain.

- Nicotine causes short-term increase in blood pressure, heart rate and the
flow of blood from the heart. It also causes the arteries to narrow. The
smoke includes carbon monoxide, reducing the amount of oxygen the blood can
carry. This, combined with the nicotine effects, creates an imbalance
between the demand for oxygen by the cells, and the amount of oxygen the
blood can actually supply.

Smoking also increases the amount of fatty acids, glucose and various
hormones in the blood. Carbon monoxide can damage the inner walls of the
arteries, encouraging fatty build-ups in them. Over time, this causes blood
vessels to narrow and harden. Nicotine can also contribute to this process.
My own cholesterol level is below average, even so, I can still get problems
with arteries & heart. Smoking makes blood clotting, haemorrhages and heart
attack more likely.

Addiction generally

Robert B. Millman, an intelligent addiction expert at New York
Hospital-Cornell Medical School says an influential factor in the
susceptibility to addiction is that:

 "Addicts tend to believe [correctly or wrongly] that they are not the
masters of their own fate, that control lies outside of them".

We all experience this at times, but the interesting thing is what causes
that perception. Harassment from stupid people can get very intense, so you
don't feel free. The difference between an addict and the non-addict is,
that the addict chooses addictive practices, habits and substances as a
solution to an unwanted problem, distress or discomfort. This must imply at
some level a demoralisation or abandonment of self-care.

In the theory of it, addiction means being given up or having yielded, to a
habit or practice or
to a habit-forming substance, to such an extent that its cessation is
traumatising. An addict is thus a person who is addicted to a practice or
habit, giving himself over to a habit. Addiction means a self-destructive
behaviour
pattern of compulsive abuse characterized by overwhelming involvement with a
"habit" and the securing of its supply, as well as the tendency to relapse
after completion of withdrawal. Even when use of a substance
does not create physical addiction, some people may overuse, or abuse, it
because it gives them temporary
self-confidence, enjoyment or relief from tension.

Addiction appears to combines genetic disposition, psychic distress, habit
formation, social circumstances and biochemical imbalance in varying
admixtures.  The distinguishing feature of addictions is simply ability of a
habit to dominate the addict's behaviour, regardless of whether physical
dependence is also produced by the habit. All mind-altering substances can
produce addiction or dependence, develop intolerance, and induce a
withdrawal
syndrome after stopping chronic use.

Food, drugs and sex share a common pathway within the brains' survival and
reward systems, leading into the area of the brain responsible for our
higher thinking, rational thought and judgment about money. The brain thus
effectively tells the addict that the addiction is good, the same way it
tells us that food is good when we are hungry. These brain changes translate
into an obsession and exclusion of other interests, compulsive behaviour
despite negative consequences, and failed attempts to limit or terminate the
addiction.

Causes of addiction patterns

Addiction could be caused by lack of willpower, lack of love, poverty,
destruction of dignity, moral or emotional weakness, mental illness, genetic
disposition, deficient family socialization, antisocialism, disorganisation,
traumatic events, or societal/environmental problems.

Statistically, the addicts often come from dysfunctional families or
organisations, and are more likely than non-addicts to have been abused in
some way, physically/sexually, emotionally, intellectually, spiritually or
socially. Genetic disposition is however really less a factor in addiction,
than prolonged drug use. Genes can only just make you more, or less,
susceptible, for the rest it depends more on the history of interaction
between the person and his environment.

Some drugs are definitely more addictive than others are. This varies with
the nature of the substance and how it affects the mood of the particular
user. People who feel bad about themselves always have a higher
susceptibility to addiction and a higher likelihood of becoming addicted.
Generally, people who are content with themselves are less likely to use and
abuse psychoactive substances.

Addicts can have deficiencies in their brain reward systems, fewer natural
opiates circulating, for instance, partly due to lifestyle and lack of
physical exercise, or else anatomically just fewer receptor sites. In
addicts, years of constant abuse also desensitizes brain receptors further,
and addicts end up with altered pleasure thresholds.

Many addicts also exhibit a profound inability to calm and soothe themselves
when stressed. The ability to self-regulate moods (maintain psychic
homeostasis) is learnt between the ages of 1 and 3, when a toddler normally
internalizes such a function from caring parents.

But parents of addicts are typically relatively experienced as
unsatisfactory (e.g. cold, or unresponsive, or rigid, or underprotective
etc.) by the addict. Regarding their children's accomplishments, the parents
seem to somehow send out a mixed message: they exert pressure on the child
and may be excessively interested in the
performance of the child, yet do not offer an encouragement or reward
experienced as such, or as appropriate, by the child. If the inability or
unwillingness to soothe oneself is due to a distant or rejecting parent,
friend or lover, addiction can be a surrogate for the loss.

Self-absorbed behaviour can mean people don't understand that the world
outside them is real, and that it contains danger. Risk-takers (adrenaline
junkies etc.) are also vulnerable to drug abuse.

Addiction is also often thought of as an escape, but becomes so in ways the
abuser hadn't anticipated. Just as a compulsive gambler's hyper-involvement
in the betting process blocks out personal problems, an addict's pursuit of
his addiction becomes so monomaniacal, that all else is forgotten.

Pornography or sex addiction for example suggests an exaggerated craving for
love or approval from others, means of getting attention or response to
sexual harassment/injury, cultural pessimism or negative self-image, lack of
sense of direction, personal norms, or purpose in life, discovery of the
high intensity of sexual excitement associated with novel sexual stimuli,
loneliness,  feelings or perceptions of personal inadequacy, pain from the
past, self-sabotage, or self-hatred. It usually seems to imply a need to
find some kind of love, association, comfort, fulfilment, and sense of
purpose which is lacking.

In bourgeois society, however, we get very mixed messages about the use of
different drugs, and consequently no good objective education or
awareness-raising about the use and effects of drugs is given. Drugs
education is influenced by politics, morality and ideology. Some drugs
(alcohol, cigarettes, coffee, antidepressants, tranquillisers etc.) are
accepted, but the use of recreational drugs is condemned, according to the
prevailing fashion. Different countries have different standards of
tolerance for intoxication. All of this makes it easier for people to accept
drug use as normal, and it enables their use, as a mask for psychopathology
or sociopathology.

Addiction patterns seem to vary according to cultural practices and the
social environment. Addiction rates can rise or fall rapidly, in response to
cultural changes, such as when people move from their own culture of origin
into another, that has different rules. Policies of enforcing total
abstinence tend to increase rates of addiction, rather than reduce them. It
is rather, that people have to learn clearly a sensible level of use of
addictive substances, which is appropriate in their case. In fact, not all
addicts have withdrawal symptoms, when they stop taking a drug. Addiction
does not depend on properties of the drug alone, but also very much on the
reason or cause for taking it.

Function of addiction patterns

It is generally agreed that addictive substances and practices are basically
painkillers and distractors. They remove or distract physical discomfort or
emotional pain, and alter the mind's perception of reality. They have a
numbing or dissociative effect. For drugs to be attractive to a person,
there is usually first some underlying unhappiness, dissatisfaction,
ignorance, sense of hopelessness, or physical pain. The book of 'Alcoholics
Anonymous,' refers to alcoholism as "a hopeless state of mind and body".

The ability of addictive drugs to strongly activate brain reward mechanisms,
and their ability to chemically
alter the normal functioning of these systems, produce an addiction. Because
addictive substances activate the brain's reward systems, the perceived
promise of reward is very intense, causing the individual to crave the drug,
and to focus activities around taking the drug. Addicts obtain a sense of
euphoria from their habit. This experience is typically not about love or
intimacy however. Rather, the habit is a search for, or enhancement of
pleasure, and/or avoidance of unpleasant feelings/discomfort/distress or the
need to respond to
outside stressors, and/or to decrease a constant moral-emotional pain being
lived with. Any reward gained from the experience can give rise to guilt,
remorse and promises to change.

Often addiction reduces a person's level of consciousness, harming the
ability to think or be fully aware of present surroundings. Because of the
effects of the addiction on the mind, a person with a history of addiction
isn't fully aware of what is going on around him in some respects. Although
he seems to be experiencing
the same events as everyone else, his perceptions are typically, to some
degree, altered or restricted by the presence of the addiction.

This causes the person to make unnecessary and simple mistakes, which can be
fatal, or, in extreme cases, it can cause psychosis. It isn't that the drug
user doesn't really know what is happening. Rather he perceives there's
something else going on, instead of reading the real series of events
objectively happening around him, and the real causal concatenation of those
events.

The addiction cycle

The life cycle of an addiction begins with a problem, discomfort or some
form of emotional or physical pain a person is experiencing. He find this
overwhelming and very difficult to deal with. A person then becomes addicted
because he attempts consciously or unconsciously  to compensate for some
personal deficiency or adverse life situation. For example, a child may be
painfully shy and fears meeting new people, isolating himself. He avoids
having to talk to anyone new, and consequently avoids the anxiety associated
with new encounters.  This avoidance of anxiety is rewarding, and reinforces
the response.  Then he is likely to engage in this escape again. The habit
or practice therefore offers a reward, a payoff. This becomes reinforcing,
and so the cycle continues.

So the addict initially encountered some problem or discomfort that he does
not
know how to resolve, or cannot confront. This could be anything, social
adjustment problems, sexual problems, identity problems, something missing,
traumatic experiences, physical discomfort, etc.

The addict develops his habit both for the reward or"pleasure" it gives him,
and also to avoid the mental and physical horrors of withdrawal. Point is,
after a certain amount of use, the addict no longer responds to the drug in
the way that he initially responded. Tolerance develops rapidly to the
painkilling effects of the addiction. While the development of tolerance is
not addiction, many substances that produce tolerance also increase
addictive potential. The addict is then caught in the addiction cycle.

The addict then begins to display the physiological symptoms of addiction,
becomes more difficult to communicate with, withdrawn and begins to exhibit
the behaviours associated with addiction. Loss of control means the addict
cannot predict what will happen when he submit, or does not submit to his
addiction. One day he may be able to stop, the next day he may not be able
to stop at all. The addict spends a great deal of time thinking about his
habit.

Craving is an extremely powerful urge, and can cause a person to create all
kinds of "reasons" they should begin the habit again. They are now trapped
in an endless cycle of trying to quit, craving, relapse and fear of
withdrawal. The craving for cocaine can be so powerful, that a recovered
addict who avoided the drug for years, may start feeling his heart
race just by seeing anything associated with drug use, such as a $100 bill
or a familiar street corner.  A craving response can also be triggered just
by watching films.

The habit becomes obsessive; the addict is trapped. Whatever problem they
were initially trying to solve by the habit, fade from memory. At that
point, all he can think about is the habit. He loses the ability to control
his usage, and ignores the horrible consequences the addiction might have.

The addict's ability to get "high" from his addiction gradually decreases as
his body adapts to the addicted lifestyle. He must have more and more of it,
not just to get an effect, but often just to function at all. At this
point, the addict is stuck in a vicious, dwindling spiral. He is changed by
his addiction, both physically and mentally. He has crossed the line.

Addiction effects

The more the addict "uses" to counter the effect of his habit, the larger
the burden of his guilt or shame can become. This results in an exacerbation
of discontent, depression, and desperation. In addition to the mental stress
created by their behaviour, the addict's body adapts to the presence of the
habit. The addict experiences an overwhelming obsession with the habit, and
will do anything to avoid the pain of withdrawing from his addiction.

Addiction also can begin to affect the addicts relationships, job, bank
account, and anything of previous value to the addict. Increasingly, the
person's entire focus becomes centred on satisfying the habit, regardless of
costs. The addict sacrifices everything to avoid the pain of withdrawal. He
will sacrifice his personal integrity, relationships with friends and
family, job, savings, and anything else he may have for the addiction.

The "addict personality" is really an artificial personality created by the
habit. An addiction can change the attitude of a person, from their original
personality to one secretly harbouring hostilities and hatreds they don't
permit to show on the surface. The "addict personality" includes
characteristics like: mood swings, unreliability, inability to finish
projects, lack of personal discipline, unexpressed resentment and secret
hatreds, dishonesty, lies, withdrawal from loved ones, isolation, chronic
depression, criminality, etc. This addict personality can easily mask
another psychopathology.

When a person is addicted over a period of time, the body cannot completely
eliminate the poison. Residues remain stored in the bones and fatty tissue
for years. Specifically, tissues in our bodies that are high in fats are
replaced more slowly. When they are replaced, the stored drug metabolites
are released into the blood stream, and reactivate the same brain centres,
as if the person actually took the drug. The former addict then experiences
a flashback, and renewed drug craving. This is common in the months after an
addict quits, and can continue to occur for years, or even decades.

Possible curatives

The cure for addiction generally seems to be: (1) recognize patterns of
excess and basic symptoms; the addict must admit to being powerless over a
habit making his life hell.   (2)  identify the precise nature of underlying
problems (3) devise and act out a plan to work through the problem, rather
than escape it.  (4) take steps to stop the addiction itself and provide an
alternative to it.

The addict must know that feeling good about oneself comes from being
compassionate, take care and be social, halt the desocialisation process,
and find new purpose and direction in life by learning how to live well.
Uncontrolled craving stops, once the addict can stops being withdrawn and
focusing on himself all the time, and starts to focus more sympathetically
and objectively on others' well-being.

Jurriaan








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