Is abstinence the solution to the addict's problems?
Recent studies suggests that merely abstaining
from opioids has disappointingly little effect on the
other medical, emotional, and social problems of addicts
The subjects of the study
were 150 patients who applied for treatment at an
addiction clinic. Three-fourths were men, and they had
used opioids for an average of 10 years. Two-and- a-half
years later the researchers interviewed most of them
again. Some were now abstinent, and some were using
even more opioids than before; most were in-between.
All their problems had, on the average, improved,
and drug abuse had improved most . But neither at the
time the addicts were admitted to the clinic nor at the
follow-up interview was the level of drug abuse correlated
with any other problems except legal difficulties.
The percentage of time spent drug-free during the
period of the study was also unrelated to any other aspect
of the outcome. The severity of a patient's drug problem
at the time of admission to the clinic was
weakly correlated with psychological problems at the
follow-up. The severity of medical, family, and psychological
problems at the time of the follow-up depended
mainly on how serious those problems were to begin with.
The authors concluded that Laaqicts need family
therapy, psychotherapy for depression, vocational counseling,
and other types of treatment at least as much as
they need help in achieving abstinence. Psychodynamically
and cognitively oriented therapies have been found
to be helpful with opioid addicts, particularly those with
longstanding addictions and severe psychiatric disorders.
A drug dependence clinic in England.
Cocaine is the main active ingredient in the leaves of
the coca bush which grows on the eastern slopes of the
Andes Mountains in South America. The Indians of
Peru and Bolivia have used its leaves for centuries to
increase endurance and decrease hunger so that they can
cope better with the rigors of their economically marginal,
In 1860 cocaine was isolated
and purified. Whereas the opioids are "downers"
that quiet the body's responses, cocaine is an "upper”
of euphoria which is distinguished from the euphoria
after consumption of alcohol by the absence of any
feeling of alteration. . . . One can perform mental
and physical work with great endurance and the
otherwise needs of rest food and sleep are
thrust aside as it were. During the first hours after
cocaine it is even impossible to fall asleep. This effect
of the alkaloid gradually fades away after the
after said time and is not followed by any
depression. . . .
"I could not fail to note however
that the individual disposition plays a major role in
the effects of cocaine perhaps a more important role
than with other alkaloids. The subjective phenomena
after ingesting of coca differ from person to person
and only few persons experience like myself a pure
euphoria without alteration. Others already
experience a slight intoxication hyperkinesia and
talkativeness after the same amount of cocaine while
still others have no subjective symptoms of the effects of
coca at all". (Freud, 1936)
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