hollombe@ttidcc.UUCP (Jerry Hollombe) (03/14/85)
Since we're discussing it, here's my $.02 of knowledge on the subject of
Valium.
According to the experts at the local drug rehab hospital (St. John's, for
those in the area) Valium is one of the most dangerously addictive and hard
to kick drugs on the market. In these respects it far exceeds both heroin
and alcohol.
As an example of the seriousness of this statement, they told me that when
a heroin addict comes in for treatment they typically reserve a bed for 3
or 4 days. For an alcoholic, they reserve a bed for about a week. For
someone trying to kick Valium they reserve a bed for _three weeks,
minimum_, and make sure it's equipped with padded restraints.
Part of the danger lies in the fact that Valium is generally thought of as
a mild tranquilizer for minor problems. Some doctors prescribe it for all
kinds of minor tension problems (I once got a valium prescription for
hiccoughs) and low grade anxiety. Patients tend to assume such a drug is
harmless, and don't even realize they're hooked on it 'til they try to stop
taking it.
--
-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-
The Polymath (aka: Jerry Hollombe)
Citicorp TTI If thy CRT offend thee, pluck
3100 Ocean Park Blvd. it out and cast it from thee.
Santa Monica, CA 90405
(213) 450-9111, ext. 2483
{philabs,randvax,trwrb,vortex}!ttidca!ttidcc!hollombesdyer@bbnccv.UUCP (Steve Dyer) (03/15/85)
> Since we're discussing it, here's my $.02 of knowledge on the subject of > Valium. > > According to the experts at the local drug rehab hospital (St. John's, for > those in the area) Valium is one of the most dangerously addictive and hard > to kick drugs on the market. In these respects it far exceeds both heroin > and alcohol. > > As an example of the seriousness of this statement, they told me that when > a heroin addict comes in for treatment they typically reserve a bed for 3 > or 4 days. For an alcoholic, they reserve a bed for about a week. For > someone trying to kick Valium they reserve a bed for _three weeks, > minimum_, and make sure it's equipped with padded restraints. > > Part of the danger lies in the fact that Valium is generally thought of as > a mild tranquilizer for minor problems. Some doctors prescribe it for all > kinds of minor tension problems (I once got a valium prescription for > hiccoughs) and low grade anxiety. Patients tend to assume such a drug is > harmless, and don't even realize they're hooked on it 'til they try to stop > taking it. > If you look at the number of doses of Valium prescribed versus the number of cases of abuse, not to mention addiction, it is vanishingly low. This seems to be forgotten in the rather sensational stories one often hears about drugs. Therapeutic doses of Valium don't cause physical addiction. Like almost any minor tranquilizer or sedative, prolonged high doses can cause physical dependence. Given to a person who has an "addictive personality", that is, prone to abuse drugs, you'll see problems. Prescribing any drug indiscriminately and without supervision is bad medicine. Used appropriately, Valium is a safe, useful drug. That includes all the readers here who have used it for muscle spasm or even (horrors) mild anxiety. They needn't worry too much about Jerry's scare story, which describes hard-core abuse. -- /Steve Dyer {decvax,linus,ima,ihnp4}!bbncca!sdyer sdyer@bbnccv.ARPA
carter@gatech.UUCP (Carter Bullard) (03/18/85)
> If you look at the number of doses of Valium prescribed versus the number > of cases of abuse, not to mention addiction, it is vanishingly low. This > seems to be forgotten in the rather sensational stories one often hears > about drugs. Therapeutic doses of Valium don't cause physical addiction. I can't agree with these statements. Addiction is not a dose dependant type of behavior, that is the amount one takes at a given time doesn't appear to influence the level or intensity of a persons addiction to the particular drug. Don't confuse the properties of addiction with that of tolerance. Many addicts do inevitably move toward higher doses due to tolerance, but the process of addiction development is not dose dependant. > Like almost any minor tranquilizer or sedative, prolonged high doses can > cause physical dependence. Given to a person who has an "addictive > personality", that is, prone to abuse drugs, you'll see problems. Prescribing > any drug indiscriminately and without supervision is bad medicine. > All of this is ok except the "high doses" part, (and this minor tranquilizer biz, and this almost any sedative). You can easily become addicted to 5mg tablets of valium by taking them 3-4 times a day for about 2-5 months, and this is not an unusual therapy for general anxiety. A few people have become addicted to a drug called Librax, which is an ulcer medicine that contains rather small amounts of librium. > Used appropriately, Valium is a safe, useful drug. That includes all the > readers here who have used it for muscle spasm or even (horrors) mild > anxiety. They needn't worry too much about Jerry's scare story, which > describes hard-core abuse. This use of the term hard-core here is, in my opinion, misleading and very reminescent(sp?) of popular myths about alcohol abuse. I can't get down on valium, part of my graduate thesis in pharmacology was on valium's effect on postnatal brain development and responsiveness. And I must say that valium is very interesting, but I can't give as cavalier an opinion as the one above with regards to long term valium use. -- Carter Bullard ICS, Georgia Institute of Technology, Atlanta GA 30332 CSNet:Carter @ Gatech ARPA:Carter.Gatech @ CSNet-relay.arpa uucp:...!{akgua,allegra,amd,ihnp4,hplabs,seismo,ut-ngp}!gatech!carter
sdyer@bbnccv.UUCP (03/19/85)
>> If you look at the number of doses of Valium prescribed versus the number >> of cases of abuse, not to mention addiction, it is vanishingly low. This >> seems to be forgotten in the rather sensational stories one often hears >> about drugs. Therapeutic doses of Valium don't cause physical addiction. > > I can't agree with these statements. Addiction is not a > dose dependant type of behavior, that is the amount one takes at a > given time doesn't appear to influence the level or intensity of a > persons addiction to the particular drug. Don't confuse the properties > of addiction with that of tolerance. Many addicts do inevitably move > toward higher doses due to tolerance, but the process of addiction > development is not dose dependant. > I think we need to define our terms better. Are we speaking about physical or psychological dependence? Also, what are you defining as "addiction"? And how does that relate to actual "abuse"? Opioid addiction doesn't seem to be dose-dependent, in that a dose needed to treat pain will generally lead to some sort of physical withdrawal syndrome (although the INTERPRETATION and REACTION to that event varies wildly depending on the context of the administration of the drug.) On the other hand, at least in a therapeutic setting, regular administration of sedatives (15mg of phenobarbital 4 X day, 200mg of a fast-acting barbiturate at bedtime, maybe 30mg of flurazepam at bedtime) certainly won't have the same kind of withdrawal syndrome that you see with higher doses of the same or similar drugs. People are treated with such doses regularly, and their withdrawal is uneventful. Now, at the microscopic level, there may be observable changes due to the removal of the drug, but I think the "synaptic" eye-view of addiction, taken alone, isn't really too useful in a therapeutic setting. Even mild observable psychic or behavioral effects upon withdrawal do not alone constitute "addiction" in a clinical sense. The situations which Jerry was describing (reserving a bed with restraints for a week) are not typical of 20mg of Librium, or 15mg of Valium, a day, and to infer that they are is simply fear-mongering, in my mind. I stand by my comment on the number of dosages of Valium dispensed versus the number of cases of abuse. My point is not to be excessively cavalier about Librium or Valium or other drugs, but that comments like "Valium is the most dangerous and addictive drug..." are simply silly: more political statements than scientific facts, much like the earlier comments on vitamins and laetrile. Whether a drug will be abused depends a lot on who is taking it, why it's being taken, how much is being taken, and how long it's been taken. The typical Valium user taking the drug for muscle spasm or a brief period of anxiety, under a doctor's care, hasn't got too much to worry about as far as becoming addicted. -- /Steve Dyer {decvax,linus,ima,ihnp4}!bbncca!sdyer sdyer@bbnccv.ARPA
hollombe@ttidcc.UUCP (Jerry Hollombe) (03/19/85)
>From: sdyer@bbnccv.UUCP (Steve Dyer) >Subject: Re: Valium >Message-ID: <191@bbnccv.UUCP> >Date: Fri, 15-Mar-85 09:05:19 PST > >Used appropriately, Valium is a safe, useful drug. That includes all the >readers here who have used it for muscle spasm or even (horrors) mild >anxiety. They needn't worry too much about Jerry's scare story, which >describes hard-core abuse. I agree. I posted my original article because a large number of people (some of whom are doctors) are unaware that Valium can be abused, with drastic consequences. There have been cases of people becoming accidentally addicted. Though I haven't read it, I believe the book _I'm Dancing as Fast as I Can_ documents one of these from the patient's viewpoint. -- -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- The Polymath (aka: Jerry Hollombe) Citicorp TTI If thy CRT offend thee, pluck 3100 Ocean Park Blvd. it out and cast it from thee. Santa Monica, CA 90405 (213) 450-9111, ext. 2483 {philabs,randvax,trwrb,vortex}!ttidca!ttidcc!hollombe
carter@gatech.CSNET (Carter Bullard) (04/10/85)
Sorry that this is late for a followup, but Gatech has been down for a while. Much of the previous article was included to remind us of what is being replied to. >>> If you look at the number of doses of Valium prescribed versus the number >>> of cases of abuse, not to mention addiction, it is vanishingly low. This >>> seems to be forgotten in the rather sensational stories one often hears >>> about drugs. Therapeutic doses of Valium don't cause physical addiction. >> >> I can't agree with these statements. Addiction is not a >> dose dependant type of behavior, that is the amount one takes at a >> given time doesn't appear to influence the level or intensity of a >> persons addiction to the particular drug. Don't confuse the properties >> of addiction with that of tolerance. Many addicts do inevitably move >> toward higher doses due to tolerance, but the process of addiction >> development is not dose dependant. >> > >I think we need to define our terms better. Are we speaking about >physical or psychological dependence? Also, what are you defining >as "addiction"? And how does that relate to actual "abuse"? Neither the word dependence nor abuse has been mentioned in my discussion. It could be safe to say that addiction to a substance generates a "drug-seeking" behavior. This seems general enough for the discussion. Drug withdrawl is not, in my opinoin, a criteria for the development of an addiction. A dependance, maybe, but not an addiction. >Opioid addiction doesn't seem to be dose-dependent, in that a dose >needed to treat pain will generally lead to some sort of physical >withdrawal syndrome (although the INTERPRETATION and REACTION to >that event varies wildly depending on the context of the administration >of the drug.) This is absolutely wrong. When I say dose-dependant, I mean that the dose of drug is not a contributing factor with regards to the etiology of the addiction. It is not true that any therapeutic dose of codiene, morphine, heroin or demerol will produce a withdrawl syndrome. > On the other hand, at least in a therapeutic setting, >regular administration of sedatives (15mg of phenobarbital 4 X day, >200mg of a fast-acting barbiturate at bedtime, maybe 30mg of flurazepam >at bedtime) certainly won't have the same kind of withdrawal syndrome >that you see with higher doses of the same or similar drugs. People >are treated with such doses regularly, and their withdrawal is uneventful. I am afraid that you seem to think that severity of withdrawl is some indication of the "severity" of drug addiction. My point has nothing to do with "how bad an addiction you get". The point is that you can become addicted to 15mg of phenobarbital 4 X /day. >Now, at the microscopic level, there may be observable changes due to >the removal of the drug, but I think the "synaptic" eye-view of addiction, >taken alone, isn't really too useful in a therapeutic setting. >Even mild observable psychic or behavioral effects upon withdrawal >do not alone constitute "addiction" in a clinical sense. The situations >which Jerry was describing (reserving a bed with restraints for a week) >are not typical of 20mg of Librium, or 15mg of Valium, a day, and to >infer that they are is simply fear-mongering, in my mind. I'm afraid that you do not have any practical experience with Valium addicts, or even Valium from a "therapeutic" standpoint. Your statements do not sound like that of an experienced practitioner. > >I stand by my comment on the number of dosages of Valium dispensed >versus the number of cases of abuse. Just remember that Valium is a prescription compound in the U.S. There is a reason for this. > >My point is not to be excessively cavalier about Librium or Valium >or other drugs, but that comments like "Valium is the most dangerous >and addictive drug..." are simply silly: more political statements >than scientific facts, much like the earlier comments on vitamins >and laetrile. Whether a drug will be abused depends a lot on who is >taking it, why it's being taken, how much is being taken, and how long >it's been taken. The typical Valium user taking the drug for muscle >spasm or a brief period of anxiety, under a doctor's care, hasn't got >too much to worry about as far as becoming addicted. You have completely missed the whole point. HOW MUCH YOU TAKE DOESN'T HAVE THAT MUCH TO DO WITH IT. Carter Bullard School of Information and Computer Science Georgia Institute of Technology Atlanta, Georgia 30332 CSNet:Carter @ Gatech ARPA:Carter.Gatech @ CSNet-relay.arpa uucp:...!{akgua,allegra,amd,ihnp4,hplabs,seismo,ut-ngp}!gatech!carter -- Carter Bullard School of Information and Computer Science Georgia Institute of Technology Atlanta, Georgia 30332 CSNet:Carter @ Gatech ARPA:Carter.Gatech @ CSNet-relay.arpa uucp:...!{akgua,allegra,amd,ihnp4,hplabs,seismo,ut-ngp}!gatech!carter
sdyer@bbnccv.UUCP (Steve Dyer) (04/11/85)
> >I think we need to define our terms better. Are we speaking about > >physical or psychological dependence? Also, what are you defining > >as "addiction"? And how does that relate to actual "abuse"? > > Neither the word dependence nor abuse has been mentioned in > my discussion. It could be safe to say that addiction to > a substance generates a "drug-seeking" behavior. This seems > general enough for the discussion. Drug withdrawl is not, in > my opinoin, a criteria for the development of an addiction. A > dependance, maybe, but not an addiction. > I think this clarifies the confusion here. I was identifying "addiction" as physical dependence, whereas Carter, if I understand him finally, is using a much more inclusive term, which could roughly be described as "reinforcing" from an animal behavior point of view. I stand by my previous statements when viewed in this context. The word "addiction" actually is rather frowned upon as jargon these days simply because it can be construed in so many different ways. Physical dependence, psychological dependence (when speaking unscientifically) or, simply, causing "drug-seeking" behavior, are more apt. I still have trouble with his definition in his comments below, which may mean that I am not perceiving his point. > >Opioid addiction doesn't seem to be dose-dependent, in that a dose > >needed to treat pain will generally lead to some sort of physical > >withdrawal syndrome (although the INTERPRETATION and REACTION to > >that event varies wildly depending on the context of the administration > >of the drug.) > > This is absolutely wrong. When I say dose-dependant, I mean that > the dose of drug is not a contributing factor with regards to the > etiology of the addiction. It is not true that any therapeutic dose > of codiene [sic.], morphine, heroin or demerol will produce a > withdrawl [sic.] syndrome. > This is a misstatement made in the heat of typing. I meant to say that prolonged administration of therapeutic doses of opioids will generally lead to physical dependence. Naturally, a single (or a few) therapeutic doses will not produce a physical withdrawal syndrome. > I am afraid that you seem to think that severity of withdrawl is > some indication of the "severity" of drug addiction. My point > has nothing to do with "how bad an addiction you get". The point > is that you can become addicted to 15mg of phenobarbital 4 X /day. > The key here is what does it mean to be "addicted" to 15mg 4 X day? If you allow that that means that the person taking it WANTS to take it, makes sure s/he always has enough, and gets quite anxious if the supply runs out, well, I can agree that that would agree with your definition of addiction. But I think it's important to get the meaning of your definition across when you make statements about a drug being "addicting", simply because the colloquial use of the word, and even its use in much scientific literature, does not convey this. CAN we expect restraints in people with 15mg of phenobarbital (or Valium)? That would be news to me (all it takes is some evidence for me to change my mind.) Or is your analogy more along the lines of cigarette smoking? > > > >I stand by my comment on the number of dosages of Valium dispensed > >versus the number of cases of abuse. > > Just remember that Valium is a prescription compound in the > U.S. There is a reason for this. Irrelevant. No one is asking for Valium to be sold over the counter. > > > >My point is not to be excessively cavalier about Librium or Valium > >or other drugs, but that comments like "Valium is the most dangerous > >and addictive drug..." are simply silly: more political statements > >than scientific facts, much like the earlier comments on vitamins > >and laetrile. Whether a drug will be abused depends a lot on who is > >taking it, why it's being taken, how much is being taken, and how long > >it's been taken. The typical Valium user taking the drug for muscle > >spasm or a brief period of anxiety, under a doctor's care, hasn't got > >too much to worry about as far as becoming addicted. > > You have completely missed the whole point. HOW MUCH YOU TAKE > DOESN'T HAVE THAT MUCH TO DO WITH IT. No, I think you aren't seeing MY point. To use your definition of "addiction" here, the great majority of people who are given Valium clinically don't present a "drug-seeking" syndrome during or after therapy. This is not to dismiss that fact that it can occur, but that WHY it occurs and in WHOM, isn't quite clear. Some people seems to be predisposed to this: others can stop taking an "abuse-prone" drug, even in the face of physical withdrawal symptoms, without any problems. -- /Steve Dyer {decvax,linus,ima,ihnp4}!bbncca!sdyer sdyer@bbnccv.ARPA