5 years ago

Addiction and Opiates

Addiction and Opiates


CHAPTER 5 PROCESSES IN ADDICTION experimental work of any direct relevance to the analysis and interpretation of human responses to opiates as manifested by the addict had been done with lower animals. 1 noted at that time in the process of defining the basic characteristics of addiction behavior that this behavior was not found in the lower animals and could not be induced in them because it presupposes the higher cortical functions associated with language behavior and found only in man. While this conclusion still seems generally valid, some qualification of it is now necessary in order to take account of subsequent experimental work with animal subjects. The work of J. R. Nichols is of special relevance in this connection. He began his work by taking my theory as his point of departure and reformulating it in the terms of reinforcement theory and concepts as developed in B. F. Skinner's theories of operant conditioning. He then developed ingenious experimental techniques designed to test the idea that the book in morphine, for animals as well as men, comes from using the drug to alleviate withdrawal distress rather than from positive euphoric effects. In one of Nichols' experiments rats were first given morphine injections over a considerable period of time so as to establish physical dependence. Using some of these rats as his experimental group and the others as controls, Nichols then subjected the experimental group to "training sessions" which involved depriving them of morphine and all fluids for 24 hours. For the next 24 hours they were given nothing to drink but a bitter morphine solution which rats ordinarily dislike and reject. Since the rats during the second day of the training period were suffering both from thirst and from drug withdrawal, drinking the bitter morphine solution simultaneously relieved both the thirst and the withdrawal. After a number of repetitions of such training periods the morphine was withdrawn and, after 14 and 49 days when the withdrawal symptoms were largely gone, the rats were offered the alternatives of drinking either plain water or the morphine solution in any quantity. Nichols found that the rats that had learned to drink the morphine solution in connection with withdrawal now spontaneously drank much more of the bitter morphine solution and that some of them drank enough to reestablish physical dependence. The control animals, on the other hand, in this and other similar experiments, showed no similar interest in the drug, even though they had in some instances received much more of it than had the experimental animals .(37) The controls were not subjected to the two-day training periods but received the drug continuously. While the control devices used by Nichols and others who have made similar experiments cannot be adequately described here, it is relevant to note that Nichols' conclusion that the attachment to morphine which he succeeded in inducing in rats (which he called "sustained opiate directed behavior") depended upon negative reinforcement involved in the relief of withdrawal distress and not upon the positive effects of the drug has been accepted and corroborated by a number of other investigators who have performed similar experiments on the same issue. Among the latter are Abraham Wikler, J. R. Weeks, and H. D. Beach.(38) Other aspects of Nichols' conclusions, such as those connected with his attempt to interpret his findings and the phenomena of addiction generally in terms of operant conditioning, are more dubious and debatable and will be considered in a subsequent chapter. While my statement of 1947 that relapse behavior had never been induced in lower animals and probably could not be, has been shown to be incorrect, and while the gap between animal and human responses to opiates has been narrowed by experimental work of the type described, it still appears unwarranted to argue that the behavior of rats and Monkeys in response to opiates in these experimental situations is essentially identical with the behavior of human addicts or that it is justifiable to call these animals addicts. A conclusion of this sort appears untenable both because it is inconsistent with existing knowledge of the differences between men and animals and also because the necessary point-by-point empirical comparison between the behavior of human addicts and their animal counterparts has not yet been made. Summary In this chapter, the theory outlined in earlier chapters has been further elaborated and evidence that tests its consistency, validity, and applicability to the data of addiction behavior has been presented. It was noted that the theory is indirectly confirmed in the addict's argot and directly supported by evidence which indicates that persons who knowingly experiment with severe withdrawal distress invariably become addicts while those who experience it without understanding it do not. Persons who have Only very brief encounters with this distress of withdrawal or whose understanding of it is incomplete or blurred, although they may not become addicted, manifest some of the initial changes in behavior and attitude which characterize the beginning of the fixation of the habit The practice of file:///I|/drugtext/local/library/books/adopiates/chapter5.htm[24-8-2010 14:23:36]

CHAPTER 5 PROCESSES IN ADDICTION preventing addiction in patients, even when they appear to be addiction-prone, by keeping them in ignorance of the drug and its effects, fits neatly into the proposed analytical scheme. Finally, the theory is directly and strikingly confirmed by the instances in which persons become physically dependent on the drug on one occasion without becoming addicted and subsequently become addicted. It is also confirmed somewhat indirectly by a considerable number of experiments with lower animals which suggest that whatever book opiates have for animals is derived from the alleviation of withdrawal distress and not from the positive effects of the drug. 1. Charles E. Terry and Mildred Pellens, The Opium Problem (New York: Committee on Drug Addictions and the Bureau of Social Hygiene, 1928), p. 134. 2. Quoted in Terry and Pellens, op. cit., P. -'97. 3. See Chapter 4. 4. See Chapter 2. 5. Ernst Joe] and Fritz Frankel, -Zur Verhutung und Behandlung der Giftsuchten," Klinische Wochenschrift (1925), 4: 1716. 6. Lawrence Kolb, "Types and Characteristics of Drug Addicts," Mental Hygiene (1925), 9: 307. 7. "Pleasure and Deterioration from Narcotic Addiction," Mental Hygiene (1925), 9: 700. 8. Friedrich Dansauer and Adolph Rietb, "Ueber Morphinismus bei Kriegsbeschadigten," Arbeit und Gesundheit: Schriftenreihe zum Reichsarbeitsblatt (1931) p. 96, Case 58. 9. Kurt Pohlisch, Die Verbreitung des chronischen Opiatsmissbrauchs in Deutschland, Monatschrift fur Psychiatrie und Neurologie (1931), 79 (1): 27. 10, Ibid., Table 1. 11. William H. Willcox, "The Prevention and Arrest of Drug Addiction," British Journal of Inebriety (1926-27), 24: 4- 5. 12. "Medico-legal Aspects of Alcohol and Drug Addiction," British Journal of Inebriety (1933), 31: 132. 13. Jansen B. Mattison, "Morphinism in Medical Men," Journal of the American Medical Association (1894), 23: 187- 88. 14. Ibid. Writers on drug addiction who experimented upon themselves through motives of "scientific curiosity" are Louis Faucher, Contribution a l'etude du reve morphinique et de la morphinomanie (thesis, University of Montpellier, No. 8, 1910-11) F. S. Quere Contribution a l'etude comparee de l'opium et de I'alcool au point de vue physiologique et therapeutique (thesis, University of Bordeaux, 1883); H. Libermann as described in Roger Dupouy, Les Opiomanes (Paris: Alcan, 1912), p. 83. For authors who have commented upon the fatal results of experimentation and have cited cases, particularly of medical men, see Daniel Jouet, Etude sur le morphinisme chronique (thesis, University of Paris, 1883); Alonzo Calkins, Opium and the Opium Appetite (Philadelphia: J. B. Lippincott, 1871). "Curiosity" and 11 ex perimentation" are often cited as "causes" of addiction. 15. Quoted in Terry and Pellens, op. cit., p. 149. 16. Charles E. Sceleth, "A Rational Treatment of the Morphine Habit," Journal of the American Medical Association (1916), 66: 862. 17. C. C. Wholey, "Morphinism in Some of Its Less Commonly Noted Aspects, Journal of the American Medical Association (1912), 58: 1855. 18. See Terry and Pellens, op. cit., chapter 5, on this point. file:///I|/drugtext/local/library/books/adopiates/chapter5.htm[24-8-2010 14:23:36]

Opioid Addiction