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sensitization, and addiction-related terminology » jodeye

Posted by viridis on January 13, 2003, at 0:52:36

In reply to Re: addictive/non-addictive = double talk » viridis, posted by jodeye on January 11, 2003, at 18:37:36

Sensitization is a process by which exposure to a substance "primes" the brain such that further exposure produces a stronger, often pleasurable response. There's certainly anecdotal evidence of this with marijuana -- quite a few people don't get high (or not very) the first few times they smoke, and then bam -- it really hits them. In the case of some stimulants, there's evidence to suggest that after a certain amount of use, the brain actually starts to respond differently, such that even the same dose may produce a more euphoric effect than previously.

Sensitization is a particular concern with respect to use of stimulants in children with ADD/ADHD; the fear is that even if the treatment is effective, it may predispose these individuals to stimulant abuse later in life. A study that was in the news in the last week or so seems to contradict this (at least with respect to behavior), suggesting that children treated with stimulants for attention disorders are actually less likely to abuse drugs later in life than peers who didn't receive such treatment.

While looking this up, I also ran across the recommended definitions of addiction, dependence, etc. on the American Society of Addiction Medicine website (these are given in a discussion of terminology that should be used regarding opiates, but obviously are intended as general definitions). They're pretty much what I described in my earlier post, but here's the wording:

The American Society of Addiction Medicine (ASAM), the American Academy of Pain Medicine (AAPM), and the American Pain Society (APS) recognize the following definitions and recommend their use:

Addiction: Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

Physical Dependence: Physical dependence is a state of adaptation that often includes tolerance and is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

Tolerance: Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug's effects over time.


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