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Tuesday, January 10, 2012

An Addiction by Any Other Name. . .

When is an addiction not an addiction?  When it's a cure.

New research suggests that nicotine patches and gum don't increase the likelihood of someone's quitting smoking; indeed, among heavy smokers, nicotine replacement therapy was associated with a higher likelihood of relapsing than using nothing at all ("Nicotine Gum and Skin Patch Face New Doubt").

I've always thought that nicotine patches and other medicinal addiction cures posed a sort of logical quandary: If you need a drug in order to keep from using a drug, aren't you just substituting one addiction for another?  If you get hooked on methadone to keep yourself from using heroin, are you qualtitatively better off?  The answer depends on whether the replacement addiction is better for you--or less harmful--than the addiction of choice.  I suppose nicotine patches are better for one's lungs--and for the lungs of those around one--than smoking.  And rehabilitative drugs like methadone, suboxone, and others certainly provide social benefits if nothing else: Prescribed legally, they provide an imprimatur of social acceptability, suggesting that one has made the decision to improve one's life and battle one's demons.  This is no small thing.

The study cited today, however, reinforces the notion that, ultimately, the only way to kick a habit is, indeed, to kick it.  I don't minimize the difficulties faced by those who battle addictions.  But this study suggests that, when it comes to smoking at least, substitutes for cigarettes don't help one quit, and may simply lead one back to the real thing.  Maybe the problem is inherent in the very purpose of nicotine patches and similar "crutches": to minimize the suffering of those trying to quit an addictive habit.  I am not suggesting that addicts somehow "deserve" to suffer, but maybe suffering strengthens one's resolve to stay away from the addictive substance.  The more pain one has to go through to achieve a goal, the less likely he is to casually relapse--no one wants to suffer needlessly.

Obviously, I'm not a psychiatrist, and I have been lucky enough to avoid addictions.  I can certainly be accused of an "easy for him to say" attitude.  But if scientific studies cast doubt on scientific (pharmacological) solutions, maybe it is time to face the logic of the situation.

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