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NetflixAndZzzzzz t1_j2evxtl wrote

Reply to comment by seanmorris in Will we ever cure addiction? by 4ucklehead

I kind of disagree. Maybe it's semantics, but when addicts choices are driven by chemical dependence, that's a vastly different "choice" than someone who's addicted to, for example ham sandwiches.

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nauseacomaneci t1_j2eyrdd wrote

Except that there are neurological changes to the brain in people who are addicted to food that mirror those present when someone is addicted to a substance. The pathology creates neurological changes, not necessarily the substance itself. It is easier for us to accept chemical dependence as more legitimate only because of our social history with pharmaceuticals, but people with eating disorders, for example, display brain changes, too!

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NetflixAndZzzzzz t1_j2f2qa2 wrote

I guess I want to clarify, I take no issue with treating eating disorders and other dangerous, addictive behaviors with the severity they deserve. Dying from anorexia isn't more of a failure of willpower than overdosing, or anything like that, and I'm not trying to gatekeep a psychological disease. I understand that's a fine line.

What I mean to suggest is that chemical dependence is absolutely the biggest factor driving addictive behavior in millions of people, and to say that addiction is just the psychological component feels inaccurate to me, and like it could be used as rhetoric to shift blame back onto users (which is often the discussion) as opposed to the pharmacological forces driving the behavior.

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nauseacomaneci t1_j2fa8s8 wrote

Chemical dependence is a necessary but insufficient precondition for addiction. Addiction is a biopsychosocial disorder & one needs a particular constellation of biological, psychological, & sociological symptoms or risk factors to be diagnosed.

Anyone who says that addiction is purely biological, or purely psychological is missing part of the puzzle.

Being chemically dependent on something doesn't necessarily mean you're addicted to it.

Take the example I wrote about elsewhere in this thread. I am chemically dependent on my antidepressants. Meaning, if I stopped taking them, I would experience deleterious physical symptoms. However, I am not "addicted" to these medications as such, because, for one, I am not abusing them [I take them as prescribed], & taking these medications does not impact my ability to live my life or meet social or familial obligations, &c.

So, chemical dependence needs to be present to diagnose a substance use disorder, but chemical dependence on its own is insufficient in terms of meeting the criteria of substance use disorder.

Addiction & substance use disorder are different, too. Eating disorders are process/behavioral addictions, but not substance use disorders as there is no, well, substance involved per se.

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NetflixAndZzzzzz t1_j2f0v5k wrote

Go to an NA meeting and explain to everyone that, because the structural changes in their neural pathways resemble those found in people with non-chemical dependencies, this means that chemical dependence to an addictive substance is not the primary impetus driving their addictive behavior.

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nauseacomaneci t1_j2f1txw wrote

I would, except that is not what I said, nor was it the point of my comment. Your retrograde defensiveness over whose addiction is "real" clouded your ability to understand what I was trying to point out. Moreover, chemical dependence is not the only thing that drives addictive behavior, but I suspect you were not replying in good faith.

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NetflixAndZzzzzz t1_j2f3lgz wrote

If someone is chemically dependent, but they abstain from using the chemical, are they addicted to it?

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nauseacomaneci t1_j2fakxl wrote

It depends on why they are abstaining from the substance! I am copying my reply to your other comment as it is relevant here, too:

"Chemical dependence is a necessary but insufficient precondition for addiction. Addiction is a biopsychosocial disorder & one needs a particular constellation of biological, psychological, & sociological symptoms or risk factors to be diagnosed...
...Being chemically dependent on something doesn't necessarily mean you're addicted to it.
Take the example I wrote about elsewhere in this thread. I am chemically dependent on my antidepressants. Meaning, if I stopped taking them, I would experience deleterious physical symptoms. However, I am not "addicted" to these medications as such, because, for one, I am not abusing them [I take them as prescribed], & taking these medications does not impact my ability to live my life or meet social or familial obligations, &c.
So, chemical dependence needs to be present to diagnose a substance use disorder, but chemical dependence on its own is insufficient to meet the criteria of substance use disorder."

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