Thursday, November 15, 2012

Addiction: A Problem Created by Doctors for Monitory Gains

The ancient goal of medicine carved on a statue honoring physician E. L. Trudeau’s work at Saranac Lake is: “To cure sometimes, To help, often, To console, always.”[1] Pharmaceutical companies and drug manufacturers have not yet developed medicines that can cure most of our common diseases such as the common cold, cancer, heart diseases, diabetes, hypertension, mental disorders and so on. Hence physicians, who depend on pharmaceutical drugs for treating illnesses, are unable to cure most diseases, and are left with no alternative but to adopt palliative treatments – treatments that relieve pain and ease the symptoms without curing the disease.

Narcotic drugs and psychoactive substances are excellent painkillers and are also capable of giving instant relief, and opium has been prescribed by physicians to console patient since ancient times. After the discovery of the cocoa plant, physicians also began prescribing cocaine in the late nineteenth.[2] In 1898, the German pharmaceutical company Bayer started marketing a highly potent opioid painkiller – morphine diacetate or diacetylmorphine – under the trade name of Heroin.[3] So by the beginning of the twentieth century physicians had started prescribing the narcotic drugs and psychoactive substances such as heroin and cocaine.

Today we know that, “Virtually all the psychoactive substances exert their actions either directly or indirectly by altering neurotransmitter-receptor interactions in the biogenic amine—particularly dopamine—pathways. … most psychoactive substances act on the mesolimbic dopamine pathway. … the mesolimbic dopamine pathway allows a person to experience pleasure in response to pleasurable events or in response to certain substances.”[4] And, as “the major neurotransmitter implicated in addiction is dopamine,”[5] most psychoactive drugs, or substances, lead to addiction – drug dependence and tolerance. 

A hundred years back, when physicians began prescribing heroin and cocaine, they might not have known about the addictive nature of these drugs, but they must have soon realized it. Because, once a person starts taking these drugs, he soon becomes addicted to the drugs and requires a larger dose, or a more potent drug, to give him the same affects that earlier required a smaller dose. Soon, laws were put in place, in most countries, making the use of narcotic drugs and psychoactive substances illegal, unless prescribed and monitored by a registered medical practitioner.

But once a person gets addicted to these psychoactive drugs, the physiological urge to take more drugs that he develops is so overpowering that the anti-drug laws have not helped us much in curbing illegal drug usage. And as the physicians and psychiatrists continued prescribing the psychoactive drugs to their patients, the tolerance to the drugs developed by the patients made them seek out for more potent drugs. The pharmaceutical companies have given them the highly potent narcotic analgesics and psychoactive drugs for them to prescribe. 

However, now, after prescribing narcotic drugs and psychotropic substances to the nation for over a century, America has woken up to face the worst addiction crisis in its history – the prescription drugs abuse crisis.[6] And the number of people dying due to prescription drugs has skyrocketed: “Since 2003, more overdose deaths have involved opioid analgesics than heroin and cocaine combined” according to the January 13, 2012 report of the US Centers for Disease Control and Prevention (CDC).[7]

Addiction costs the US governments almost half a trillion dollars each year, $200 billion of which is spent on healthcare costs.[8] When healthcare institutions and their affiliates – physicians/psychiatrists, clinical psychologists and pharmaceutical companies – make hundreds of billion dollars each year that they would lose if the addiction problem vanished, it would be unrealistic to expect psychiatrists, psychologists and physicians to tell everyone about the simple existing solution to the addiction problem. So let us now examine the solution. 

In 1943 Abram Maslow gave us a definitive theory of motivation in his paper A Theory of Human Motivation.[9] The theory, Maslow says, is based on his clinical observations. Every human organism has the need to attain self-actualization – that is, to attain one’s full potential, which Maslow calls ‘self-fulfillment’ and ‘becoming what one is capable of being’. 

In order to attain self-actualization, Maslow’s theory states, one has to first satisfy his deficiency needs – the physiological needs and the three psychological needs, namely the Safety needs, the Love and Belonging needs, and the Esteem and Achievement needs. These psychological needs are the same as the needs/drives contained in the inventory analysis (psychodynamics) that had been described in the 1939 book Alcoholics Anonymous (Big Book). The inventory technique/path as followed by the AA founders had helped AA grow a thousand-fold in the 1940s, from 100 members in 1939 to 100,000 members in 1949. Maslow’s paper explains the psychology of the technique. 

The inventory analysis has been explained in details in the book “12 Steps in aDay” and can be used by anyone to help addicts and alcoholics to recover. It has also been reviewed by the professor of Self-management at the Drucker’s Collage of Graduate Management. 


[1] Randolph Nesse and George C. Williams, Why We Get Sick, Vintage Books (1996), page 11
[4] Vander et al, Human Physiology: The Mechanism of Body Function, 9th Edition(2004), Chapter 8 Consciousness, The Brain, and Behavior, pages 258-259
[5] Ibid., page 259

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