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The idea that marijuana cessation (at very high levels of tolerance, mind you) is anything like alcohol or tobacco is laughable.

The DSM is still a political document, I don't consider it any more authoritative for psychological ailment than a dictionary is an authoritative representation of spoken language. It is useful, but anyone who is serious about mental ailments must necessarily take it all with a grain of salt.

It is not long ago that hysteria and homosexuality were both pathologized in the DSM, let that stand as an example of how the political environment can occlude the truth in diagnosis.

Marijuana can absolutely create a pathological addiction, but I assert (in bold defiance of the DSM) that it does not form a physiological dependency on the order of tobacco and alcohol. I'm not at all surprised if a ream of literature contradicts me, because illegal things have a way of being arbitrarily labeled abnormal in the history of the DSM.


Interesting. I made those comments not based off the DSM but based off my own observations with clients I see everyday. Opiates and Benzos are the worse for physical symptoms but as far as actually having a desire to quit and being motivated to be able to do, so every drug is about the same. All drugs interact with individuals differently. Some people do not become physiological dependent on tobacco, for instance, while others do.

My point was and still is that quitting a drug is hard no matter which one it is. Many people think it is easy to quit marijuana but I have found that it is just as difficult for people to quit as other drugs. The only advantage that marijuana has is that it does not have any nasty side effects from reducing or stopping use.


I've had doctors tell me Tobacco is just as addictive as heroin. When you're addicted to Tobacco, there is physical withdrawl symptoms such as nausea and vomiting. That's why many smokers/users do not want to quit, because they don't feel like getting sick, and they want to stay comfortable in their relaxed state of use. It's a tough habit to kick, I've watched my uncle struggle with the addiction for many years. Also, some people have highly addictive genes in them which makes it even more difficult to kick substance abuse problems.


Evil Lincoln wrote:
The DSM is still a political document, I don't consider it any more authoritative for psychological ailment than a dictionary is an authoritative representation of spoken language. It is useful, but anyone who is serious about mental ailments must necessarily take it all with a grain of salt.

Completely agree, the DSM is very much bent by what the society of the day considers normal. It's gotten better, and I think it's progress and evolution provide a window into the evolution of psychology. It's still a pretty soft science, but it's improving, even if only slowly.

The Exchange

Evil Lincoln wrote:

The idea that marijuana cessation (at very high levels of tolerance, mind you) is anything like alcohol or tobacco is laughable.

The DSM is still a political document, I don't consider it any more authoritative for psychological ailment than a dictionary is an authoritative representation of spoken language. It is useful, but anyone who is serious about mental ailments must necessarily take it all with a grain of salt.

It is not long ago that hysteria and homosexuality were both pathologized in the DSM, let that stand as an example of how the political environment can occlude the truth in diagnosis.

Marijuana can absolutely create a pathological addiction, but I assert (in bold defiance of the DSM) that it does not form a physiological dependency on the order of tobacco and alcohol. I'm not at all surprised if a ream of literature contradicts me, because illegal things have a way of being arbitrarily labeled abnormal in the history of the DSM.

Psychoactive drugs of all kinds work because they have some sort of impact upon brain chemistry. As such, they have physical effects. I can't remember everything from my drugs course at university twenty-hmmm years ago (that was acedemic, by the way, not hands-on applied study, before you ask) but I remember that nicotine mimics the effect of acetyl choline, a neuro-transmitter, while heroin and other opiates mimic the effects of endorphins. There are "behavioural" triggers to addiction, but also chemical, physiological ones too.

That said, physical addicition is slightly beside the point. The vaunted "terrible effects" of going cold turkey on heroin aren't more severe than a does of the flu, for example. Plus, as someone who took morphine for pain, I felt no desire to continue its ongoing use. The issue with addiction is the desire to do something, and that is down to a number of factors like enjoyment of the act, fear of withdrawal, social milieu, genetic factors and so on. The physical side doesn't make you do anything. All "addiciton" - the desire to do something and act upon it - is ultimately mental and behavioural. My father gave up cigarettes when he simply decided not to smoke them anymore. I know it's not that easy for everyone, but at its root that is the basic decision.

As for the predicament of the OP's friend, I'd agree with Sissyl that his activities are not necessarily unhealthy. If he's single he will have a sex drive and will want an outlet, irrespective of what is on his computer. Is his issue that it is interfering with his life, or is this simply masturbatory guilt? If this is simply a case of having nothing better to do, he should try filling up his day with more productive activities (and maybe try harder to get a sexual partner). If this is affecting his life, relationships and so on, he should consider getting help.


SuperSlayer wrote:
I've had doctors tell me Tobacco is just as addictive as heroin.

I've not tried heroin, but quitting smoking was one of the most difficult things I've ever done. It required a level of discipline that actually changed me as a person afterward.


Irontruth wrote:
Evil Lincoln wrote:
The DSM is still a political document, I don't consider it any more authoritative for psychological ailment than a dictionary is an authoritative representation of spoken language. It is useful, but anyone who is serious about mental ailments must necessarily take it all with a grain of salt.
Completely agree, the DSM is very much bent by what the society of the day considers normal. It's gotten better, and I think it's progress and evolution provide a window into the evolution of psychology. It's still a pretty soft science, but it's improving, even if only slowly.

It is great for cutting down on synonymous diagnoses... although it could be a little better at that too, methinks.


It is the ONLY attempt so far at making psychiatry into a harder science. DSM brought criteria-based diagnoses, which meant that countries where DSM was the diagnostic basis could actually compare their research findings with each other. This is only for the diagnosis side, and does not necessarily improve the process of putting a diagnosis, which can be difficult in many circumstances, but it ensures a common language and opens up for very large scale research. It is far from perfect, but it is revised in a transparent process. Sum total, it is probably the best we can hope for unless fMRI gives us serious breakthroughs in neuropsychiatry.

As for homosexuality, it was a diagnosis because there was a need for a diagnosis for those patients who suffer because of their homosexuality. Note that it was removed for political reasons, alone, leaving things like masochism and fetishism, which likely should rank at about the same level as homosexuality.


IIRC the alcohol is one of the few substances that can cause so serious biochemical addiction that using cold turkey quitting method at that step of addiction is potentially lethal. It requires many years of serious alcohol abuse to develop that level of biochemical dependency and many alcoholics don't drink enough or don't live enough to reach it.


Sissyl wrote:

It is the ONLY attempt so far at making psychiatry into a harder science. DSM brought criteria-based diagnoses, which meant that countries where DSM was the diagnostic basis could actually compare their research findings with each other. This is only for the diagnosis side, and does not necessarily improve the process of putting a diagnosis, which can be difficult in many circumstances, but it ensures a common language and opens up for very large scale research. It is far from perfect, but it is revised in a transparent process. Sum total, it is probably the best we can hope for unless fMRI gives us serious breakthroughs in neuropsychiatry.

As for homosexuality, it was a diagnosis because there was a need for a diagnosis for those patients who suffer because of their homosexuality. Note that it was removed for political reasons, alone, leaving things like masochism and fetishism, which likely should rank at about the same level as homosexuality.

Right, I'm not saying the DSM is bad.

Likewise, dictionaries are terrific tools!

But, something not being in the dictionary doesn't mean it isn't a word. Something being used with a different definition or connotation is not wrong because of what the dictionary says. And there is a rich history of past definitions in the DSM that would be considered mistakes by modern standards, which exist because of the shift in cultural norms.

Basically, I feel the DSM is wrong in this case. Since it was being offered in evidence, I felt the need to explain why I was dismissing that evidence. I actually think it is great that people are looking this stuff up to support their claims! It just happens to run contrary to a lot of anecdotal evidence that I weight heavily.

In debate, the fact that I am choosing anecdotal evidence over the DSM means I "lose", and for all intents those asserting that marijuana creates a physical dependency have "won". However, losing the debate doesn't mean I'm wrong.


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The two substances that cause lethal abstinences are alcohol and bensodiazepines. Everything else can feel terrible, but for a relatively healthy person should not be lethal. Exception, naturally, for new and untested drugs. This means that heroin, for example, does not kill you after withdrawal. It does kill you in other ways, though.

As for marijuana, it's a divisive issue. If we are to discuss what dependency is, it's a good thing to break it down into physical/chemical on one hand, and behavioural/psychological on the other. The chemical dependency acts through adaptation of receptors in or on our neurons. If you use a drug the first time, you get a serious rush because you have naive receptors that still fire according to the standard pattern. When you keep using that drug, your receptors react less strongly, but you also get more of them, meaning you will need more drug to get the same reaction as before. If you stop using the drug after this happens, your receptors cause an abstinence reaction, basically they scream for the drug. With time, this reaction gets milder, and your receptors "calm down". There are still many more of them than in a brain that hasn't used this drug, though, and this matters if you ever get that drug into your blood again: As soon as you feel that drug, the screaming starts again, about as strong as when you quit. This is quite sensitive and can, for example, start a drinking binge in a sober alcoholist who just managed to inhale alcohol or smell it.

The psychological reaction is different. We all have anxiety, and we use all sorts of strategies to fight it. Perfectionism, climbing mountains, praying, distraction, avoidance... and all sorts of drugs, all these things solve that problem for various people. Once you learn that a certain strategy makes the anxiety go away, this typically calcifies in people's minds. You get a behaviour where anxiety -> strategy, and this becomes a remarkably stable part of our personalities. The problem here is that drugs are EXTREMELY effective at fighting anxiety. They do not, however, remove the anxiety, they mask it, and thus, they allow you to live with a very high anxiety level without feeling that bothered about it. So, when you one day quit, you get an abnormally high anxiety level that you entirely lack strategies for handling. We're talking anxiety levels that will flatten most people completely, simply because if your body doesn't get a reaction for a certain anxiety level, it will increase the signal to make you respond. Anxiety is one of our, if not THE, most important reason to act, and we can't live without it.

So... marijuana? Well, it's a VERY good anxiolytic. If you were to stop it, you'd have to handle a monstrous level of anxiety. This is not the same as a chemical dependency... but it's quite simply bad enough. Especially considering that THC clears from your body VERY slowly, since it gets tied up in fatty tissue, that then keeps leaking THC for months. If you get more THC in that time, well, the concentration keeps going up. Keep at it for a while, and you have a problem. Apart from the anxiolytic effect, you see, you also become tired and have problems focusing due to the massive concentration in your blood. Getting calm might be a good idea sometimes, but for several months, or years, straight? And when you decide to quit, well, are you prepared for several months of harsh anxiety? Yeah, it's a tough process even with marijuana.


I should add that the efficacy as anxiolytic is the relevant part here. Singing in choirs, watching porn and the like have an anxiolytic effect, but it is virtually nonexistent compared to that of most drugs. Claiming that people have an addiction to world of warcraft is rather silly. Certainly, the person loves playing it, and prefers having an identity in a guild, have a relevant social role online, compared to the social desert of his or her life, and to being an outcast. Anger when that game is threatened is not a strange reaction. There is an inflation in the term addiction that is a serious problem today. Excessive online gaming can certainly be a problem, but it's not an addiction.


I should add a comment about gambling. Gambling hits your reward center sharply, and might qualify for the title addictive. Certainly, it is a hard thing to shake. The question is if you can't see a chemical dependency, given that we know you do get a dopamine rush from it. I have not read enough to say more than this.


Sissyl wrote:

So...marijuana?....Getting calm might be a good idea sometimes, but for several months, or years, straight? And when you decide to quit, well, are you prepared for several months of harsh anxiety? Yeah, it's a tough process even with marijuana.

Huh? What?


I am not saying everyone does this, but there are those who use marijuana quite often, and reach very high blood levels. Naturally it takes them a while to get to the raised anxiety levels, since the metabolism is so slow.


Doodlebug Anklebiter wrote:
Sissyl wrote:

So...marijuana?....Getting calm might be a good idea sometimes, but for several months, or years, straight? And when you decide to quit, well, are you prepared for several months of harsh anxiety? Yeah, it's a tough process even with marijuana.

Huh? What?

I've never experienced "a monstrous level anxiety" from not smoking marijuana. I have however known more than a few people who used it daily because they didn't want to experience about 48 hours of low grade mood swings and it was very accessible to them.

Gambling is also distinct from pornography in that 1) masturbation doesn't really exploit the risk half of the risk/reward system and 2) games of chance are based on random systems. It's pretty basic to human behavior to keep doing things until you get better at them. After a certain point, you can keep playing the same game of chance and you won't get any better; not getter any better will give an emotional reason to try keep doing it and trying harder.

I assume the OP was asking about pornography and/ or masturbation. If that's the case, I think the person suffering said addiction is either bored and needs to get away from their computer, or suffering from depression and turning the only means of pleasure at hand, in which case there's medicine for that.


One of the "funniest" things about marijuana is how good it makes you at driving. If people who are under influence try to drive a car in a test situation get to grade their own performance, it's brilliant. Rules of traffic wise, it's to put it mildly catastrophic. Things like driving on the wrong side of the road... Yeah, brilliant.


Sissyl wrote:
I am not saying everyone does this, but there are those who use marijuana quite often, and reach very high blood levels.

By all accounts, Doodlebug may be one of "those".


I think so too. And by keeping at it, never letting the blood concentration too low, he isn't going to get that anxiety, is he? AFAIK, he has never talked about quitting, right?


Quitting is for losers!!!


QED.


Latin abbreviations mean nothing to me!

[bubble bubble bubble]


Sissyl wrote:
One of the "funniest" things about marijuana is how good it makes you at driving. If people who are under influence try to drive a car in a test situation get to grade their own performance, it's brilliant. Rules of traffic wise, it's to put it mildly catastrophic. Things like driving on the wrong side of the road... Yeah, brilliant.

You drive better when you're high because you can't go faster than 45 mph.

Of course, if you're on the highway, that doesn't make better driving, but, whatevs.


Speaking as someone who smoked multiple times a day for years (really, no exaggeration), I experienced none of the anxiety you're talking about.

I'd also love to see someone so high that they can't tell which side of the street they're on manage to get into a car and start it.


I'm also addicted to porn, btw.

[Rubs one out]


Hitdice wrote:
Speaking as someone who smoked multiple times a day for years (really, no exaggeration),

[fistbump]


And you quit, successfully, and you never experienced heightened anxiety for any serious period of time, and you did not find some other drug to fight it? Congratulations. I just know I have seen enough people who got exactly that reaction.

RPG Superstar 2008 Top 32

Folks, I think the discussion of the effects of various drugs probably belongs in another thread.


Sissyl wrote:
And you quit, successfully, and you never experienced heightened anxiety for any serious period of time, and you did not find some other drug to fight it? Congratulations. I just know I have seen enough people who got exactly that reaction.

I was smoking tobacco at the time when I stopped smoking marijuana, so my best guess is that I still had a "inhaled chemical vapor" outlet, but I found marijuana laughably easy to quit; if it's addictive so are tacos. (I like tacos, but would fine if I never ate another one for the rest of my life.)

Edit: In eighth or ninth grade health class (somewhere between 84-86), I was taught that there were two kinds of addiction, physical and psychological; Since then, at least here in the US, addiction has been classified as what I was taught was psychological addiction. Physical addiction is now termed chemical dependance. I assume the change in terminology is wrapped up in the war on drugs (Heroine and weed? Both addictive drugs), but it's made addiction a rather useless term. Nevermind internet adult entertainment, if you're so emotionally dependent on having tacos that you feel depressed when you don't, you really are addicted to tacos.


Okay Ross.


[scurries away to Bang Brothers]


Sorry, was editing my post during yours Ross; will comply.


It was apropos of addiction, but yeah, we got bogged down in details. Moving on.


Masturbation: The Musical Interlude

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