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Re: Addiction VS Dependence????

Posted by Viridis on April 6, 2003, at 0:27:34

In reply to Addiction VS Dependence???? » bretbe, posted by Krissy P on April 5, 2003, at 23:52:46

Klonopin is definitely an antidepressant for me, because the worst of my anxiety is anxiety-driven. It seems to have this effect for many others too. Xanax is also very helpful in this respect (for me).

Re: the addiction issue, I post this every couple of weeks, but will do so again:

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.

Benzos like Klonopin have a high potential for inducing dependence, so have to be discontinued gradually. This is standard for all sorts of meds. Tolerance to the sedating effects seems to be pretty standard (so they're not great as sleeping pills long-term), but interestingly, once the correct dose is identified, anxiety patients don't seem very likely to develop tolerance to the anxiolytic effects. As far as true "addiction" goes, benzos don't seem to be much of a problem for those who need them (i.e., anxiety patients and sometimes epileptics), so why they're considered "addictive" by many seems to be mainly a PR issue, perhaps due to the fact that most are off-patent, so inexpensive. When people have trouble getting off an antidepressant that's still under patent, the drug companies prefer to call it "discontinuation syndrome". Some popular ADs (e.g., Paxil, Effexor) rank much higher than benzos in terms of difficulty of discontinuation, but since they're still under patent, it's not advantageous re: marketing to label them "addictive"..


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poster:Viridis thread:215674
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