Addiction: Physical vs. Psychological

February 11, 2006 3:37 PM

Is Cocaine physically addictive? I once read that it is psychologically addictive but not physically addictive. While I realize there is a physical, chemical reaction when a user takes the drug, do they ever show signs of phyiscal addiction? Heroin is physically addictive. Marijuana is psychologically addictive. I have googled this subject quite a bit but still haven't found any conclusive answer.

This is a debate between family members and I am really looking like a moron for taking my stance that cocaine is not physically addictive. Please some one help me win this arguement. I am probably wrong (usually am (negative outlook)) but if anyone has any substantial evidence for either side of this arguement, that would be great.

Thanks.

posted by Gankmore to health (24 comments total)

if by physically addictive, you mean 'ceasing intake causes physiological effects', then yes, it is. lots of pubmed links here.

That said, would suggest that body/mind physical/psychological distinction is hard to make unless very carefully defined. Example here discusses cocaine withdrawal effects on amygdala, a part of brain (limbic system, specifically) that does some work with encoding emotional memories.

If, by physically addictive, you mean your heart will stop if you don't get your fix, then it isn't that I'm aware of.
posted by gage at 4:00 PM on February 11, 2006

I'm not a doctor, so please take what I say with a grain of salt, but the distinction between physical and psychological addiction, as far as I know, is that physical addiction results in a desire to obtain the drug because of metabolic need, as if it were food or water, whereas psychological addiction results in a conscious desire to obtain the drug out of a perceived need for its effects so that the user might, say, "feel good," or "calm down."

As far as I know, both types of addiction result in physiological withdrawal symptoms, but for different reasons. The effects of withdrawal from a psychologically addictive drug are probably psychosomatic.

Cocaine, from what I've read, is mostly psychologically addictive. Its withdrawal symptoms result from the tendency of the brain to reorganize its function around the effects of the drug, resulting in cocaine becoming the only source for positive stimulation. So, when the drug is taken away, your brain experiences something akin to deep depression, where no real-life stimulus produces any type of positive feedback.

As always, erowid.org is a useful resource for this type of thing, although it's always probably a good idea to try and cross-check it with another trusted source (hard to come by when the subject is drugs, though).

On a sidenote, I think its generally accepted that marijuana is only psychologically addictive for a statistically small subset of the population, and so is not usually classified as psychologically addictive except by maybe the DEA, but...
posted by invitapriore at 4:28 PM on February 11, 2006

Wikipedia has a ton of info.
posted by tiamat at 4:29 PM on February 11, 2006

I am an RN, so I do know what I'm talking about. :-)

You're confusing addiction, which is a psychological problem, with dependence and tolerance, which are physical problems.

Example: I take narcotic pain medication, and have for several years. Am I dependent on this medication? Yes, obviously, because my body has changed itself to cope with the amount of medicine I take, and to stop suddenly would be very uncomfortable if not life-threatening. That's a physical problem, not a psychologic one.

Because I have taken this stuff for so long, over time it takes more of the medication to produce the desired pain-relieving effect. Is that addiction? No - it's tolerance, another purely physical problem that has nothing to do with psychology.

Addiction is use of that medication to avoid coping with life or problems. Again, I'll use myself as an example: Am I addicted to the medication because I have developed a physical tolerance and dependence? No. I don't use the medication to avoid coping with life and its ups and downs, and if they found a cure for my particular problem I could and would wean the dosage down until I didn't have to take it anymore. Taking the stuff is no picnic.

People get addicted to cocaine and crystal meth and other recreational drugs because they began to use it as a panacea, starting out to try and escape their problems in the first place. I'm not doing that - I'm using a medication along with other modalities to control pain from multiple surgeries.

Drug rehab has two parts: the first is to clean the drug out of the addict's system, to end the physical dependence, and the second is to teach the addict to cope with life in different ways from then on. Unless an addict can find a better way to deal with his/her problems, they will fall right back into using illegal drugs to escape.

I hope that helps. You can contact me by email if you have more questions.
posted by lambchop1 at 5:03 PM on February 11, 2006

lambchop1 : "No. I don't use the medication to avoid coping with life and its ups and downs, and if they found a cure for my particular problem I could and would wean the dosage down until I didn't have to take it anymore."

You're contradicting yourself.

Back on-topic, The World Health Organization conducted a global study on cocaine use, back in the early 90s. That report didn't paint as stark a report as the prohibitonist US would like, and so they threatened to withhold funding if it was published. The report was shelved but some parts have been leaked.

The British government also prepared a report on the drug war. The first part dealt with the impact of various drugs, which includes the addictive potential of various popular drugs. For quick reference, this blog has the relevant slides.
posted by Gyan at 5:14 PM on February 11, 2006

A lot of people in the 80's thought coke was not addicting and then found themselves to be addicts. Don't fool around with this stuff.
posted by caddis at 5:36 PM on February 11, 2006

Shit yes.
posted by The Jesse Helms at 5:59 PM on February 11, 2006

I mean, check out the Positive Reinforcement Model.
posted by The Jesse Helms at 6:05 PM on February 11, 2006

I don't think cocaine is physically addictive. You want more and more of the stuff when you're on it, but once it wears off it's pretty easy to go without. It's certainly less addicting than cigarettes or alcohol.
posted by TonyRobots at 6:17 PM on February 11, 2006

In one sense, yes, it is physically addictive. You don't get heroin-type withdrawl, but you physically lose the ability to feel "comfortable and happy" when you come off a coke bnge.

The BBC had a pretty sympathetic documentary about various common drugs and how they work - pot, extasy, coke. Apparently what coke does is make your brain flood with endorphins - something like "pleasure chemicals." After an hour or so your brain uses them up and would like - pretty pleeeeease - some more. So you desire more coke to release more endorphins.

The time it takes to replace and use endorphins decreases, and you want more coke sooner. The more you take the more you want.
posted by zaelic at 6:30 PM on February 11, 2006

The concept of "addiction" is meaningless. It has been defined so many different and contradictory ways that the word should not be used until all parties to the conversation agree on its definition.

The remainder of discussion in this thread will, doubtless, be taken up with particular definitions and their implications. If participants in such discussions do not realize they are in fact battling over the definition of a word, they are going to start bandying around questions of "truth" and "who's right." Sounds like that's what's going on in your family.

Here's my recent take on three ways that habit-forming compounds affect people. No point in repeating it verbatim here.
posted by ikkyu2 at 7:02 PM on February 11, 2006

i've seen people who were in rehab after years of cocaine addiction ... two weeks in, they were still spacey, somewhat incoherent, looking pale, sweating a bit and a little shaky ... i don't know if that could be considered the equivalent to heroin or alcohol withdrawal, which are truly nasty, but it's too damn close for comfort in my book ...

i don't know how physical addiction should be defined, so i can't offer you a definative answer on that

i know how i define fucked up, though ... and cocaine addiction and detox more than qualifies for that
posted by pyramid termite at 7:19 PM on February 11, 2006

Thanks everyone! Very helpful. I love this website.
posted by Gankmore at 7:53 PM on February 11, 2006

I am a cocaine addict from years back (I recovered about 10 years ago). I was and am still physically addicted to cocaine. Your brain is part of your body. Your brain addicted to cocaine = your body addicted to cocaine. There is no severing those two. Emotional states are caused by brain chemistry. Brain chemistry is physical. Ergo, in my opinion, it's physical.

Being a former crackhead, I can tell you from deep, deep experience that anyone talking about "addiction" that hasn't felt it is completely full of shit. You can poke about with your endorphins, your brain chemistry classes, and your rehabs - but there is nothing like having the most emotionally satisfying 8 minutes of your life, followed by having your soul sucked through the floor, to make you want to go sell your car for some dope.

For about 8 minutes, cocaine satisfies every instinctive human need. It hits you right in the brain stem. Sex, sleep, hunger, emotional need - all filled, instantly and fully, for 8 minutes. Even covering your "fight or flight" instincts. And then the rug is pulled out, followed by paranoia, delusions, deep anxiety, and apathy bordering on psychosis. That's the "more" part.

I know that in deep craving I was willing to give up anything - and I mean anything, up to and including amputation - to get more crack.

In rehab I was told that I had damaged my brain's ability to manage endorphin levels. Withdrawal from cocaine is a much more emotional state than physical - I was on suicide watch for a week, and that was after the week on lithium.

I haven't used it in a long time and I never *want* to use it again - *want* is a subjective state - because I want to use it right this minute - a feeling I'll have forever. And at the same time I don't, because I have commitments to meet this summer.

The addiction is still there. Were I to go cop some shit right now, I'd be right back where I was - using and abusing - within a week.

Withdrawal from cocaine is not a "dt's" scenario although seizures do happen. More commonly (and certainly in my case), brain chemistry is altered permanently. I no longer have control over emotions, nor do they have any real "impact" as they used to.

So, y'all dither on about defining it. I know my definition pretty intimately.

You lose the bet. It's physically addictive. There is a withdrawal state associated with it. There is a very high physical and emotional cost.
posted by Slap Incognito at 8:12 PM on February 11, 2006

The concept of addiction is actually pretty well understood psychologically and neurologically. Most addictive drugs act either directly or indirectly on dopaminergic nerves in the reward centers of the basal ganglia. This is the same area that is activated when we eat food we like, or have sex or do other rewarding behaviors. Very addictive drugs like cocaine will override normal behaviors, so for example if you give a rat a choice between two levers one which give him food, and another which gives him cocaine, he will starve himself before he chooses the food lever over the cocaine one.

As other people said there is only psychological addiction and physical dependence. Addiction happens because of a psychological (and neurological) change that makes it more likely for you to do a certain action. It's a behavioral change. While physical dependence is a change that happens because you take a chemical over a long period of time and stopping to take it abruptly will cause your body to go through withdrawal.

Cocaine is very addictive, as for as physical dependence goes I don't think it's as bad as other drugs but the possibility of ill effects in heavy users is probably there.
posted by afu at 8:23 PM on February 11, 2006

So, y'all dither on about defining it. I know my definition pretty intimately.

Not to diminish SI's experience unduly, and thanks to him for sharing it, but the key idea here is that he knows his own definition intimately, but that has absolutely nothing to do with other people's 'definitions' or experiences. I do agree, though, that those who try talk with some authority about the experience of addiction (whatever that actually is) without having had the experience themselves are talking out their bottoms.

Everyone has different experiences with chemicals, and different abilities to moderate and exercise willpower over their own reactions to them.

Or, what ikkyu2 said: "The concept of "addiction" is meaningless. It has been defined so many different and contradictory ways that the word should not be used until all parties to the conversation agree on its definition. [...] The remainder of discussion in this thread will, doubtless, be taken up with particular definitions and their implications."
posted by stavrosthewonderchicken at 9:35 PM on February 11, 2006

A late friend of mine was an American MD who trained in China as an acupuncturist and specialised in using acupuncture to treat addictions. As part of his training, he used to try every drug he would eventually have to treat - heoin, speed, coke, alchohol, whatever - and said it would be hypocrasy to understand addiction if he didn't have first hand experience of the drugs' effects.

He tried crack cocaine one, and said it was the best high he ever tried, and for days afterwards he seriously couldn't stop thinking about how he would really like to try it just one more time. He didn't, but he claimed it was the most psychologically attractive - and thus addictive - drug he had ever encountered. Six months after trying it that one time he said that there wasn't an hour in the day that he didn't get the thought in his head to try a little bit more.
posted by zaelic at 5:14 AM on February 12, 2006

Okay, so let's clear the air then:

- There is no such thing as "addiction". It's all in your head.

- Physical reactions to drugs are different for everyone. Ergo, do whatever you want. Once you find your own level of tolerance, it's all good. (Unless it's too late. In which case, god help you).

- This discussion is pointless because no one could possibly tell the original poster the answer to their question, because the definitions are meaningless anyway.

OR, you could take it from a crackhead that there is a physical, permanent desire to use cocaine (that I've had since the second time I used it).

...and in my opinion, most of this thread is self-justifying nonsense disguised as "brain chemistry 101" so that the concept that physical addiction/dependence vis a vis cocaine can be safely discarded and world views can be left intact and everyone shall be safe in the knowledge that they can happily pursue their drug of choice because it might, or might not, addict you. Maybe.

Or maybe y'all missed the point: With regard to the effects of being addicted to drugs, there is no functional difference between the physical state of dependence on the drug and the psychological state of dependence on the drug.

You can hypothesize all you want about the distinctions between the two, and say they're individual in nature, but I, and the rest of us recovering addicts, can tell you that in the real world, divorced from the keyboard and the dictionary, there is no difference. If you are physically dependent or psychologically addicted, they are exactly the same state of mind.

Sorry if this seems strongly worded. But the answer to the original poster's question remains - cocaine is physically addictive.
posted by Slap Incognito at 6:47 AM on February 12, 2006

zaelic - the first time I used crack was in 1989. The next time I tried it was in 1995. From 1989 to 1995? Every day, just like your MD friend, it was on my mind.
posted by Slap Incognito at 6:50 AM on February 12, 2006

According to the 1996 Household Survey on Drug Abuse (cited by Malcolm Gladwell in The Tipping Point), only .9% of the people who tried cocaine had beome regular users. (The figure was about 9% for heroin)

What does this tell us? My guess is that to become addicted to something, you probably have to have a number of factors in place - enrvironmental, psychological, and hereditary.

So, instead of asking, "How addictive is cocaine?" a better question may be, "Do you have an addictive personality?"
posted by Afroblanco at 7:34 AM on February 12, 2006

Slap Incognito : "OR, you could take it from a crackhead that there is a physical, permanent desire to use cocaine"

You're making two mistakes here.

1)Physical addiction and psychological addiction are traditional terms, defined before there was a detailed understanding of the psychopharmacology of drugs. By those traditional definitions, (powder) cocaine is not physically addictive. Yes, it is psychologically addictive. Yes, ultimately, the distinction doesn't matter much: it's an addiction. But the OP didn't claim that cocaine wasn't addictive. He was asking whether within the traditional paradigm, cocaine was "physically" addictive. It's not.

2)You're conflating crack cocaine with powder cocaine. Yes, both are chemically cocaine, but the kinetics are very different, and that makes all the difference. If you had followed my link to the British govt. report, you would have noticed that

a)of 180,000 crack users (in England & Wales), 142,000 are classified as dependent i.e. 78.9%
b)of 588,000 cocaine users, 73,000 are classified as dependent i.e. 12.41%

What that shows is that cocaine coloquially refers to the powdered salt, and isn't a generic term for all formulations, including crack.
posted by Gyan at 11:25 AM on February 12, 2006

i'm not smart enough to know whether cocaine is physically addictive or not ... after years of living with a crack addict, i'm not really sure i care

it's a lot like asking if the flames in hell are gas or charcoal fueled ... and believe me, that's not an exaggerated metaphor

i tried crack once ... it made me feel sick

many of you have no damned idea how incredibly grateful i am for that

even with powdered cocaine, there's this thing going on where you feel like you just have to do one more toot ... it's a drug that is incredibly hard to forget about

and slap, co-dependents of addicts know a few things about addiction, too ... congratulations on your sobriety
posted by pyramid termite at 2:55 PM on February 12, 2006

Long story short:
Crack -- very addictive, even on first use
Powder coke -- meh, not so much, unless used heavily and habitually (impractical for the non-wealthy)
posted by desuetude at 8:10 PM on February 12, 2006

[a few comments removed, please take it to email or MetaTalk]
posted by jessamyn at 3:55 AM on February 13, 2006