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PostPosted: Thu May 24, 2012 11:30 pm 
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Apparently drugs, and routes of administration that make a drug that kick in faster have more addictive potential. ie swallowing a drug is less addictive than snorting a drug, which is less addictive than smoking a drug ... and most addictive of all is injecting a drug. That's because when a drug kicks in faster it gives more of a rush.

One of the big selling points of the film is that it's absorbed faster. I remember when I took it it certainly kicked in much faster than the tablets. Does that mean that the film is more addictive?


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PostPosted: Thu May 24, 2012 11:44 pm 
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Many people go back to the tablets after trying the film. Does that mean the tablets are more addicting?

In my opinion neither is more addicting, they are both the same drug taken sublingually. Even if the film is absorbed faster and more efficiently it still takes the same amount of time for the buprenorphine to "kick in" or act. Less of the film may be needed for the same effect but I think it's negligible especially once stabilization occurs. I have been on both for long periods of time - over 1 year each. And notice no difference except for the convenience of the film.

:)
Gb


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PostPosted: Fri May 25, 2012 3:33 am 
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Very interesting question, I’m going to take a shot at it based on my knowledge. I would think that if there wasn't a ceiling for suboxone, or if you were getting high from it, then it would be more addicting. But depending on your dose could also affect how much of the drug your tongue actually absorbs and you digest. If you are prescribed 16mgs a day, then I would think it wouldn't make much of a difference. If you are only taking 4mgs a day, then I think your body would react differently but I am not sure if addicting is necessarily the right word. I am going to make these numbers up for the sake up understanding how it works, so here is an example. If you take 10mgs at one time of the tablet, you actually absorb 30% of the total 10mgs you only absorb 3mgs. Let’s say if you take the strip of the same dose, 10mgs, and you absorb 50% of the total 10mgs your actually only digesting 5mgs.

So depending on what ever dose your blood level of buprenorphine reaches to the point where taking any more would not change your blood level of buprenorphine, or the ceiling, it could effect it in that way. So from the same example above, if your blood level requires you to digest 4mgs of the drug to reach the ceiling, taking 10mgs of the tablet would not reach the same level as the film would. So basically, taking the tablet depending on your dose, it could affect you differently and make you feel in need of more suboxone, but you would only notice this if you switch from one to the other or change your dose. Keep in mind, I made all of these numbers up so you can understand this principle of the drub buprenorphine. I also am not a doctor and am basing all of this information on my understanding. Hopefully this made sense to you and didn't confuse anyone too much.


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PostPosted: Fri May 25, 2012 4:14 am 
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The reason I brought it up was because in another thread someone mentioned they felt their first dose of sub kicking in when the film was still dissolving. I remember when I tried the film, when I left the pharmacy (I have to be dosed in the pharmacy each day) I actually felt it start to effect me when I crossed the street after leaving the pharmacy.

You're right glen bee about a lot of people switching back to the film. For me it was because of weird side-effects than anything else.

I dunno why I was thinking of this. People say that snorting a drug, smoking it or injecting it is more addictive because it's more bioavailable (ie you waste less) and it hits you harder / faster. That is why injecting Sub is more addictive than taking it under the tongue.

But what Fireman was getting at is interesting. I think you were suggesting it'd only make a difference if the dosing is under the ceiling level. I wonder if the same applies for those people who inject or snort Suboxone but who are still above the ceiling, and why they'd choose to inject or snort their medication if it doesn't make any difference anyway because of the "ceiling effect". Is it just psychological?


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PostPosted: Sun Jun 03, 2012 3:28 am 
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The addictive potential of a drug is independent of the route of admnistration.

What does this mean? This means that crack cocaine is no more addictive than cocaine itself though because crack is smoked it hits the brain faster, but inevitably cocaine is a drug and a molecule and independent of the way it is administered has the same addictive potential abuse liability. Ask Dr. J, he'll concur with me.



Keith


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PostPosted: Sun Jun 03, 2012 3:56 am 
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I'll explain this again as in my last post you must've not understood what I was trying to relay.

Drug dependence liability or "addiction" liability is Independent of the route of administration. At the end of the day what people become addicted to are drugs. These drugs are made up of molecules. People are addicted to cocaine, so can crack cocaine be more addictive than cocaine freebase or hydrochloride because of the method of ingestion? Absolutely Not. Crack is the same molecule as cocaine. Cocaine. Just because the method of administration is altered or different, does not make that drug more or less addictive. It is the same.



Pseudopharmacologist,
Keith


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PostPosted: Sun Jun 03, 2012 9:08 am 
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If you're a pseudopharmacologist... then I'm a pseudorockstar.

You really know how to put a pseudointellectual bent on everything man ... the problem with that is some people are not all the wiser to your antics, and may interpret what you're saying as having some kinda professional credence, which couldn't be further from the truth. You are a googlademic, which I am also to a degree. The only thing is I don't pretend to be someone I'm not - ie a Dr, or a medical professional of some kind.

What you're saying is very wrong. How rapid a drug's onset is means A LOT towards its addictive potential. Fentanyl is considered one of the most addictive opioids BECAUSE of its rapid onset and short half life, which means its need for continual use provides many more opportunities for daily reinforcement of taking the drug. I used many drugs before I moved up to the world of IV drug use, and I can attest, as can everyone else I know who moved to the steel, that IV drugs are MUCH more addictive than using them through other means. I have even known people to, when offered lines of coke in a club, use their own straw with a piece of cotton or a filter in the middle so they could collect it to later inject it.

What you're basically saying is that the "rush" a person feels by having a more rapid onset - ie from smoking crack opposite to snorting cocaine - adds nothing to the addictive potential. This is bullshit. When I was using coke, the moment I started shooting it I could NOT take it any other way. I would ONLY use it for the rush that came from that route.

You are viewing addiction in an incredibly naive scientific aspergerish perspective and not taking into account the far more important psychological allure of the "rush" of taking a drug by means of faster onset.

Sure I hear you that a drug has exactly the same dependence forming capability no matter how it is taken. But we are talking ADDICTION here, which is much more complex and takes a degree of insight into the human psyche to understand, something that your posts here neglect to consider. By your logic, a nicotine patch has the same addictive potential as smoking a cigarette. The thing about a nicotine patch is that you can't exactly use them when you feel the need to "self medicate" shit that's happened. ie feeling anxious before a test? You don't exactly have the power to bump up the levels of nicotine and use it as a crutch to calm the nerves.

This is EXACTLY why addiction pharmacotherapy moves people onto longer acting opioids, because they pull the addict away from the ability to self-medicate when the need arises, thus removing the powerful addictive reinforcement. Not to mention the rituals that come from the pharaphenalia of shorter acting drugs, ie crackpipes, needles, spoons, straws, bongs, cigarettes.

You're basically saying that taking a drug by the needle isn't any more addictive than swallowing a drug. It's incredibly naive, and I suggest maybe you do more "self research" before you make dumb statements like that.

Actually, maybe you should ask Dr. J ... it's funny you use the word "concur"... Reminds me of this:

[youtube]http://www.youtube.com/watch?v=i5j1wWY-qus[/youtube]

pharmakon_logy .... do you concur? :lol:


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PostPosted: Sun Jun 03, 2012 9:45 am 
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TJ, I agree with you 100%. Route of administration has a lot to do with severity of addiction.

For me, I can use the example of cocaine vs. crack. Right now, if I think of a line of cocaine, it gets me about 10% or 15% "turned on", BUT, if I think of a hit of crack, those numbers jump exponentially. My severity of addiction is much higher on crack than it is cocaine, even though they're the same molecule.

I guess the same is true if I were to think about an OC 80. To crush that thing in my teeth and swallow it was a complete waste of time for me, that sucker has to be crushed and snorted for me to enjoy it properly.

Pharmakon_logy seems to be trying to reduce addiction to a simple molecular interaction and addiction is anything but a simple molecular interaction, it's WAY more involved and complex.

Oh Yeah, I wanna be a pseudorockstar too!! lol

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PostPosted: Sun Jun 03, 2012 10:02 am 
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Agreed, TJ. You made some excellent points that needed to be made clear. Thanks.

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PostPosted: Sun Jun 03, 2012 10:34 am 
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You're still not understanding. If you don't agree with my ideals than that is your right and you are entitled of your opinion. As for the whole thing, I AM going for my Pharm.D. and within a few years will have my doctorate. What degree in the medical field do you have? Or are you going for one at all?

What you're talking about is how reinforcing a drug is. I am talking about it's ability to be dependence-producing. Heroin is far more alluring than simply morphine and the only difference between the two is the two acetic acid groups attached to the morphine molecule, However, they're one in the same. Morphine isn't less addictive than heroin nor more addictive, once in the systemic circulation they are one in the same.

Now, heroin is more reinforcing, especially if one administers it intravenously, than say, morphine per os; however, they are just as addictive and one is not independent of the other.

You're speaking of mechanisms in which you are unfamiliar with. Please find me some scholarly cited evidence that says that cocaine freebase is more/less addictive than cocaine hydrochloride. The difference is how it is administered. They're both cocaine. The only difference is the route of administration And because one is more reinforcing than the other because smoked cocaine freebase hits the brain within 5-7 seconds, versus insufflated cocaine hydrochloride that's peak effects are achieved at steady-state plasma concentrations in approximately 15 minutes and snorted cocaine is much less intense than smoked cocaine.

I'm not here to change your mind, I shouldn't even have written this reply to Try to convince you that you are dead wrong; however, everyone is foolish at times. I just feel I need to set the record straight, but I'm not about to waste any more time to change the ideals of some one who believes they've learned it all and do not have room for improvement. I deal with people like this all day long in class and it's extremely frustrating but I do genuinely have this pervasive urge to attempt to explain to them why they're wrong, but as it goes, if people are unwilling to change, then it's not my problem and I don't have to justify anything to anyone all I can do is snicker in my head and remember that I'm correct and others in my league will either listen, or apologize once they've realized that I was right all along. With that said, I feel a little better.

Remember, I'm not here to make friends or enemies, I'm here to educate. If you're unwilling to have an open mind, at the end of the day, that's on you and I can at least sleep comfortably knowing that some just can't live up to my rigorous standards and aren't as well-versed in pharmacology and the study of drugs as I am.


Post-sciptum:
In all of my other blogs and forums I write on I use the pseudonym Dr. I because I do have a wealth of knowledge and it's considered a tongue-in-cheek joke, a laugh, as well as pseudopharmacologist. Look it up and you'll find no such thing. What I am is a student and within a year or two I'll be going to the U of R where Dr. J went to school, I live a half mile away, I'm on the campus all the time, and it's only a matter of time.



Until then,

Keith


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PostPosted: Sun Jun 03, 2012 10:54 am 
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Do you think maybe we can find some middle or common ground or grey area between us? The psychological component of addiction cannot be ignored and I think that's what we're all saying is that you're missing, by hyper-focusing on only one thing.

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 Post subject: RE: HAT
PostPosted: Sun Jun 03, 2012 11:50 am 
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No problem Hatmaker, remember I'm trained traditionally and via textbook but I also have a ton of experience in the drug underground subculture in the surrounding Rochester area, however, I don't disagree there's a psychological component to chemical dependency but what we're talking about here is a drug's reinforcing properties not addiction.

Anyway, we'll just have to agree to disagree.



KeefSom


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PostPosted: Sun Jun 03, 2012 8:11 pm 
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The process of smoking crack is most definitely more addicting than snorting it. The onset is much quicker, more intense, and you are getting much more out of it than snorting it. When snorting cocaine, there is a lot of the drug that is wasted compared to smoking it because burning crack releases much, much more of the drug, which is why users tend to snort cocaine at first and then resort to smoking it to get more bang for your buck. Tearj3rker gave a great example with the nicotine patch compared to smoking.

Pharmakon_logy, I too am in school working to become a pharmacist, yet I don't write it in all of my posts to defend myself. It is great and all that you are doing the same, but I do not know why you pose as a doctor and refer to yourself as a doctor because you are not. Maybe you will become one in the future but right now you aren't, so what's the good to remind everyone in all of your posts? I think it's safe to say that I have read in much detail various topics regarding addiction and have spent much free time learning about information many of these topics contain from the plenty of resources I have and people I know, and because I am a drug addict and have used drugs for some time, I would consider myself trained traditionally via textbook and also have a ton of experience in the drug underground subculture in Atlanta, just like most of the people who are responding to threads on this website.

It seems like you already have your mind made up on everything and don't seem to have an open mind. You act that just because you are going for your pharmaceutical degree means that you have everything figured out and know everything there is to know in all of your posts. I know plenty of other people working to earn their degree in chemistry to later go on to graduate school to become a surgeon, pharmacist, anesthesiologist, etc. just like myself but the reason to do all this is to get all of the necessary education required for these jobs. Just because you say you are working for a job like this does not mean you already have all of the credentials to do so. There is still a ton of schooling left so you can learn. If you had all of the credentials to have a pharmaceutical degree then you would have had it already, but because you don't there is still much to learn. Just because you have taken some of the required classes, "trained traditionally via textbook", and have experience in the drug underground subculture does not give you that degree.

You can keep on reminding me and everyone else who is reading these posts all of the other things you have done just like everyone else that earns a degree like this, but you still haven't. I am all for you and anyone else who wants to educate others but posing as a doctor is not the way to do so. I also realize I have only been here for a few months, but you have only been here for a few days. I am not trying to come off with an unpleasant tone, but I think this is something that needs to be said. This is also the internet where people are trying to acquire accurate information from liable sources. This is an internet forum for the field of addiction, not a place to compare your credentials to one another to be taken as seriously as a licensed professional to debate topics. It’s great that you are trying to help people on here, but that just doesn't seem like the proper and honest way of doing it.


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PostPosted: Sun Jun 03, 2012 8:51 pm 
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I haven't even read this entire thread yet, but I had to stop and comment before I even read anyone else's opinions on this. I have both snorted coke and smoked crack plenty of times, and I just have to say with 100% certainty, that for me, smoking crack is waaaaaaaaayyyyyyyyyyyy more addictive than snorting coke. I'm sure once I read the rest of this thread I'll have more to say, but I just had to get that out.


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PostPosted: Sun Jun 03, 2012 11:15 pm 
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One thing I wanted to point out about addiction is that applies to my situation is that I know I didn't become addicted to pain pills by swallowing them whole every 4-6 hours as needed, just as i was one time prescribed for my scoliosis, sciatica and degenerative disk disease. I'm not saying that people can't become addicted to pills this way, but for me, back in the day, when I would get a prescription for vicodin (and took them as directed), I didn't have that physical "need" for them, or any problems with addiction. Granted, I didn't get a prescription every single month, but my doctor would prescribe them as I needed them and I would only take them as I needed them.
It wasn't until I was with some friends one night and was advised to break the pill up or crush it before swallowing it, that I really started to enjoy them, and then i started doing this more regularly. And then, of course, I found oxycontin (my drug of choice) - and I can tell you that I've never even one time swallowed one of those pills. They were always crushed and snorted. Had I never "learned" about crushing pills to make them hit you quicker, or that crushing and snorting oxy's was so much fun, I don't know if I'd be where I am today.
but who knows, I could have probably gotten to the same place just by taking more of the vicodin than I was prescribed - maybe I would have started taking 2 or 3 at a time, and maybe every couple hours, instead of as directed. I think its possible for people to become addicted to pills even if they are taking them as directed, especially if they take the pills consistently for a long period of time. I just wanted to point out that in my situation, I didn't find the addict in me until I started misusing pain pills, specifically when I started to snort them. That's when it all went downhill for me.


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PostPosted: Mon Jun 04, 2012 12:38 am 
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Are you tellin me all this time I was sposed to be swallowin them damn pills??!!


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PostPosted: Mon Jun 04, 2012 2:44 am 
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pharmakon_logy wrote:
The addictive potential of a drug is independent of the route of admnistration.


pharmakon_logy wrote:
What you're talking about is how reinforcing a drug is. I am talking about it's ability to be dependence-producing. Heroin is far more alluring than simply morphine and the only difference between the two is the two acetic acid groups attached to the morphine molecule, However, they're one in the same. Morphine isn't less addictive than heroin nor more addictive, once in the systemic circulation they are one in the same.


Dude... Someone as educated as yourself MUST know the difference between addiction and dependence, yes?

Perhaps I may have to educate you here Keith. A drug does not have to be dependence forming to be addictive. In fact, for something to be addictive it doesn't even need to be a drug. Addiction and physical dependence are actually two different things entirely, though often they can go hand-in-hand.

An example of dependence? Someone who takes an SNRI antidepressant, say Venlafaxine. If they stop taking it, they feel incredibly sick for a period. But they do not get "urges" or "cravings" to take the drug. They don't obsess over it and pawn their grandma for it. Once they get over the sickness, they don't reminisce about it or think "God some Effexor would be great right now."

An example of addiction? Cocaine is addictive, but it actually has little potential to create physical dependence. People crave the rush, the feeling, and an addict can obsess over it and put it above everything else in their life. Because of the power it holds over a person's psyche, they can end up selling their grandma for it. Gambling is addictive as well, because of the want to get that "rush" that comes from the win, from waiting for that final card to go on the table.

Opioids are no doubt dependence-forming, but only a certain group of people find themselves addicted to opioids. Say a person prescribed Oxycontin for an injury who finds themselves dependent - ie they will suffer withdrawals if they stop immediately ... they are not necessarily addicted. But once that person comes to psychologically crave the drug, take more than prescribed and get up to sneaky shit to try and get more.... THAT is addiction.

When I started this topic, I used the word "addictive", not "dependence forming". You're talking about something completely different.

Concur?


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PostPosted: Mon Jun 04, 2012 3:53 am 
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pharmakon_logy wrote:
People are addicted to cocaine, so can crack cocaine be more addictive than cocaine freebase or hydrochloride because of the method of ingestion? Absolutely Not. Crack is the same molecule as cocaine. Cocaine. Just because the method of administration is altered or different, does not make that drug more or less addictive. It is the same.


Just curious Keith, have you ever smoked crack before?

pharmakon_logy wrote:
I can at least sleep comfortably knowing that some just can't live up to my rigorous standards and aren't as well-versed in pharmacology and the study of drugs as I am.


I don't care how well-versed someone is in pharmacology or any ology for that matter...all I know for sure is that I've snorted coke and I've smoked it, and right now if I could choose one...I'd smoke it, hands down. If they are exactly the same, then why would I prefer one over the other?

pharmakon_logy wrote:
The addictive potential of a drug is independent of the route of admnistration.


This might be true if addiction had nothing to do with psychological effects, but the fact is, addiction has a lot to do with psychological effects, so the level and speed of dependence can have a lot to do with method of ingestion.

pharmakon_logy wrote:
I don't disagree there's a psychological component to chemical dependency but what we're talking about here is a drug's reinforcing properties not addiction.


You just stated that "the addictive potential of a drug is independent of the route of administration".....note the word "addictive" in your statement...so we are talking about addiction.

pharmakon_logy wrote:
What degree in the medical field do you have? Or are you going for one at all?


I don't need a degree in any field to know that smoking crack made me feel way different than snorting cocaine. You can read all the books you want, but that doesn't mean squat compared to someone who has experienced it, and is telling you that for them, the route of administration has a lot to do with their addiction, which in turn, has a lot to do with their dependence.

pharmakon_logy wrote:
You're speaking of mechanisms in which you are unfamiliar with. Please find me some scholarly cited evidence that says that cocaine freebase is more/less addictive than cocaine hydrochloride. The difference is how it is administered. They're both cocaine. The only difference is the route of administration And because one is more reinforcing than the other because smoked cocaine freebase hits the brain within 5-7 seconds, versus insufflated cocaine hydrochloride that's peak effects are achieved at steady-state plasma concentrations in approximately 15 minutes and snorted cocaine is much less intense than smoked cocaine.


If you want to base everything in life on "scholarly cited evidence", and discount the testimony of the very addicts that you are studying, then you are going to have one hell of a time understanding this addiction/dependence thing. Again, when the peak hits is not what my main concern is when I'm hittin the crack pipe. Yes, that is an added bonus, but smoking crack FEELS different than snorting a line of coke. You even said it yourself, "snorted cocaine is much less intense than smoked cocaine." It might be the same molecule or whatever, but I never got hooked on coke, and I've done it plenty of times. I could always leave it after a weekend of partying, and go about my business until the next time it came around...whether it be a week, a month, or a year. When I smoked crack, there was nothing else I thought about and I had to have it morning noon and night. Why would it effect me so differently if they are exactly the same thing, and route of administration doesn't matter?

pharmakon_logy wrote:
If you're unwilling to have an open mind, at the end of the day, that's on you


And I could say the same for you, because right now, you are unwilling to acknowledge what people with first hand experience are telling you. I don't know if you've ever done these drugs that you are referring to before, but it sure doesn't sound like it to me.


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PostPosted: Mon Jun 04, 2012 6:20 pm 
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I'll be upfront I am not a fan of the word "addiction". The terminology should be changed as it is vague, unscientific and you won't find it in the DSM-IV, the worlds leading text on psychiatric disorders. What "addiction" is is the compulsive and out-of-control use of a drug that is dangerous despite negative consequences. So tell me, can a person be addicted to the Internet, a cell-phone. I'm a scientist and I do not work with imprecision. Plus, you cannot categorize such a diverse plethora of "addictive" substances (drugs, food, sex et cetera) and disorders with one word. It is far too complex. The misinterpretation of "addiction" is now viewed as a pejorative and that is just not right either.

"Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors. it is characterized by behaviors that include one or more: compulsive use, continued use despite harm, impaired control over drug use, and craving." (Savage, Joranson & Covington, 2003, p. 662). Physical "addiction" is not a component of "addiction" as the definition of "addiction" is a biopsychosocial disorder that is characterized by preoccupation with the drug (psychological), compulsive use of the drug (behavioral), and loss of control and using more than intended, despite an honest conscious effort to attempt to control use (social) and continued use despite negative consequences. Furthermore, addiction is used as a blanket-statement and piles up all the drug-use problems and clumps them together and fails to acknowledege the difference that is critical between conscious drug abuse ("bad judgment" not a disease and use of drugs) and pathological chemical dependence which as I've just covered, is impaired drug use that is out of control and is a brain-disease. Therefore, when I mention chemical dependence, it's actually more accurate than the word "addiction". Sic, I'm quite in the know when it comes to "addiction".

I do have a considerable bit of drug use, since the age of 13 with a full-blown cocaine "addiction" by the age of 15, just turning 15. I have smoked crack, though, less than a dozen times as it wasn't my cup of tea, but I loved cocaine. I agree with you when you say that you believe crack to be more "addictive" than cocaine powder. You're right, in a way, but it is not the word "addiction" that explains this phenomena, it's how reinforcing and rewarding a drug is, when the cocaine, whether smoked or injected or snorted or skin-popping, once in the body it is a single chemical, benzoylmethylecgonine, cocaine, no matter how you slice it, dice it, cut it, whatever, once in the body cocaine is cocaine, thus, independent of the route of administration cocaine is just as "addicting" as...cocaine, go figure?

In the mean-time, let's play nice and I'll just conclude that we'll agree to disagree. Some one has got to be the bigger person here, so allow me.



Keith I. Pseudopharmacologist


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PostPosted: Mon Jun 04, 2012 6:28 pm 
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By the way, riddle me this, how can the film be more "addictive" than the tablets. They're both administered sublingually. How does that even make sense? Better bioavailability does not increase a drugs ability to produce dependence. Still buprenorphine. And once in the body is buprenorphine. So buprenorphine sublingually in a film is more addictive than buprenorphine in a tablet and even though the route of administration- sublingual- is the same?








Keith
Pseudopharmacologist


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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