Addiction vs. Physical Dependence

Phillip Leveque has spent his life as a Combat Infantryman, Physician, Toxicologist and Pharmacologist.

(MOLALLA, Ore.) - My articles on medical marijuana have piqued the interest of many cannabis user-street pharmacologists with many very astute remarks and emails to us.

One of the recent ones was berating me for stating that a person on long-term oxycontin was an “addict”. She preferred the term “dependent”. I guess I must be an oldtime-pharcomologist. Call me a geezer or old fogey. I’ve been at this for 60 years now.

I have witnessed the switch from Laudanum to morphine, wrote about the sulfa drugs in 1940 before they were released, I remember penicillin production and first use. I saw barbiturates, amphetamines and valium come out of nowhere to become three of the most addicting and lethal drugs ever produced.

Yes, I’ve been there and seen a lot. Things are still more complicated and worse. The most addicting drugs (I prefer that term) are:
1) opiate and opioid analgesics;
2) general CNS depressants (solvents and barbiturates);
3) amphetamines;
4) nicotine (it acts like a drug);
5) Cannabis (it really doesn’t belong here);
6) Psychedelics/hallucinogens

Many people believe narcotic means pain killer. They may have heard of narcolepsy. These patients, if they sit down, fall asleep. Narcosis is a Greek word meaning “stupor” or sleep. Narcotics cause sleep. Most are pain killers also. I have used the words physical dependence above. Skid Row bums use opiates, valium and speed (methyl amphetamine) and they are said to be addicted. If they are nice, gentile, demure upper class ladies and use them and Dexedrine (amphetamine) to control weight, they are called “dependent”.

To me, the criterion for addiction or dependence is if they cause withdrawal symptoms when they stop using the drug, not that they cause a “high”; some do, many don’t.

For those six classes of drugs I mentioned, all of them cause severe withdrawal- except cannabis. In fact, cannabis was for a time used to lessen withdrawal symptoms for most of the above drugs.

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More information on the history of Leveque can be found in his book, General Patton's Dogface Soldier of Phil Leveque about his experiences in WWII.
Order the book by mail by following this link: Dogface Soldier.
If you are a World War II history buff, you don't want to miss it.

Watch for more streaming video question and answer segments about medical marijuana with Bonnie King and Dr. Phil Leveque.

Click on this link for other articles and video segments about PTSD and medical marijuana on Salem-News.com: Dr. Leveque INTERVIEWS & ARTICLES

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Amphetamine Addiction December 8, 2008 1:46 am (Pacific time)

Types of amphetamine addictions There are various types of amphetamine addictions are available today. Amphetamine is the most common addiction problem. To get of amphetamine addiction is very difficult. Rehabilitation centers provide long term programs for amphetamine addiction recovery. http://www.edrugrehabs.com/SubstanceAbuse/Amphetamine-Addiction-Treatments/Rehabs/index.html

Another Definition April 27, 2008 2:07 pm (Pacific time)

ADDICTION Addiction is a primary, chronic, neurobiologicneurobiological 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. (http://www.cpmission.com/main/addiction.html)

Thanks in Advance April 27, 2008 2:06 pm (Pacific time)

Dear Dr. L: Is there a way to get a medical marijuana card without meeting with a doctor directly? I live out of town and can't get into town easily or often.

Jim Stephens April 27, 2008 8:43 am (Pacific time)

Dr. Leveque if the biggest problem we had in the fields of addiction and recovery was getting our terms perfectly adjusted to the latest DSM definitions, we'd all have an easy time of it. The is the first time I've read one of your articles and I immediately sensed a voice of experience and reason. And the latter is sorely lacking today. Thank you. Jim Stephens Chief Information Officer All Positive Options

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