Would appreciate any feedback on the following scenario - especially how to think about it in biological and science related to consciousness studies:
I am an addiction psychiatrist and I have ample time to explore the subjective aspects of addiction - specifically how it starts and is maintained. Many people tell me that the addictive compound they are using no longer has the desired effect, does not treat the target symptom, and may in fact make them slightly ill but they keep taking it any way.
Example: Patient A is taking very high doses of benzodiazepines for anxiety. He does not notice any anti-anxiety effect but wants to continue taking them anyway. He is seen to taper and discontinue the benzodiazepines and a standard approach is to take gabapentin for this process. He notices a marked antianxiety effect from the gabapentin but not the benzodiazepines. It is not a tolerance effect because he never got any relief from the benzodiazepines and described that to me as "always having a high tolerance".
I have seen the identical phenomenon with opioids and stimulants.
Any ideas about how to conceptualize this in terms of neurobiological substrates?
Hi Dear Professor Dawson. One of my Pharmacology Professors investigated on Gabapentin and its effects on pain. You can check his articles: 1.Intraventricular gabapentin is antinociceptive and enhances systemic morphine antinociception in rat tail flick test 2. Gabapentin action and interaction on the antinociceptive effect of morphine on visceral pain in mice
I'm lost-if they have no effect on anxiety, except perhaps the somatic effect common to drugs as a whole, why keep on giving them? Is it because they are addicted?
That is the question.
Of course the evaluation is retrospective but it is a common one. The question would seem to me to be - are there two separate mechanisms for the perceived effect? And if so - why does that imply?
What George if there is only one? Addiction? I still see occasionally clients who have experience of such drugs and their effects, and the diminishment of anxiety, for example, comes only at the very beginning but in a somatic fashion. All the effects seem the same.
Andrew, is it really as easy as that, at least to explain? Where, for example, does habit become addiction and hedonism (reasons certainly) have a decided range. Comfort can be seen as one form, risk another.
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