General info on addiction.

[robin_himself]

I think that before explaining how a person changes when addicted... the term addiction must be fully understood.


Addictive behaviors represent confusing and complex patterns of human activity (Shaffer, 1996, 1997). These behaviors include drug and alcohol abuse, some eating disorders, compulsive or pathological gambling, excessive sexual behaviors, and other intemperate behavior patterns. These behaviors have defied explanation throughout history. In this essay, I will attempt to clarify the nature of addiction and provide an introduction to the field of addictive behaviors.

The field of addictions rests upon a variety of disciplines. Medicine, psychology, psychiatry, chemistry, physiology, law, political science, sociology, biology and witchcraft have all influenced our understanding of addictive behavior. Most recently, biological explanations of addiction have become popular. These approaches seek to understand alcoholism, for example, by identifying the genetic and neurochemical causes of this problem. It is interesting to recognize that as we understand more about the biology of addiction, social and cultural influences become more—not less—important. To illustrate, not everyone who is predisposed genetically to alcoholism develops the disorder. Some people who are not prone bio-genetically to alcoholism or other addictions will acquire the condition. Therefore, social and psychological forces will remain very important in determining who does and who does not develop addictive behaviors.

Now it is common to think of drugs as "addictive." Warning labels inform us that tobacco is an addictive substance. We think of heroin and cocaine as addictive. Yet, addiction is not simply a property of drugs, though drugs are highly correlated with addiction. Addiction results from the relationship between a person and the object of their addiction. Drugs certainly have the capacity to produce physical dependence and an abstinence syndrome (e.g., neuroadaptation). New evidence suggests that neuroadaptation also results from addictive behaviors that do not require ingesting psychoactive substances (e.g., gambling).

Altlhough neuroadaptation (i.e., tolerance and withdrawal) can result from a variety of repetitive behaviors, neuroadaption is not the same as addiction. If neuroadaptation and its common manifestation of physical dependence were the same as addiction, then it would be incorrect to consider pathological gambling as an addictive behavior. It would be inaccurate to talk about sex and love addicts. Many people who use narcotics as post-operative pain medications never display addictive behavior even though they have became dependent physically on these psychoactive substances. Stopping drug abuse will not end addiction, since addictive behavior patterns (e.g., gambling) can exist in the absence of drug abuse. Addiction is not simply a qualitative shift in experience, it is a quantitative change in behavior patterns: things that once had priority become less important and less frequent behaviors become dominant. Addiction represents an intemperate relationship with an activity that has adverse biological, social, or psychological consequences for the person engaging in these behaviors.

Conceptual Confusion About the Definition of Addiction

Absent a clear definition of addiction, researchers will continue finding it very difficult to determine addiction prevalence rates, etiology, or the necessary and sufficient causes that stimulate recovery. Absent a working definition of addiction, clinicians will encounter diagnostic and treatment matching difficulties (e.g., Havens, 1982; Marlatt, 1988; Shaffer, 1987, 1992; Shaffer & Robbins, 1995). Satisfactory treatment outcome measures will remain elusive. Without a functional definition of addiction, social policy makers will find it difficult to establish regulatory legislation, determine treatment need, establish health care systems, and promulgate new guidelines for health care reimbursement.

Scientists and treatment providers are not the only ones with a problem when the meaning of addiction is fuzzy. The average citizen will find that, without a clear definition of addiction, the distinctions among an array of human characteristics (e.g., interest, dedication, attention to detail, craving, obsession, compulsion and addiction) will remain blurred. Finally, the contemporary conceptual chaos surrounding addiction must be resolved to clarify the similarities and differences—if these exist—between process or activity addictions (e.g., pathological gambling, excessive sexual behavior) and psychoactive substance using addictions (e.g., heroin or alcohol) (Shaffer, 1997).

Paradigms Serve Both Organizing and Blinding Functions

In response to my preceding comments, some clinicians, researchers and policy makers may argue that they indeed have an explicit definition of addiction. Since these individuals have a model, they incorrectly assume that they also have the truth; they assume that their model is accurate. In addition, they incorrectly assume that their model will work for the rest of us if only we could see the light (cf., Shaffer, 1994). However, this is the problem with worldviews in general and scientific paradigms (Kuhn, 1962) in particular: as a conceptual schema organizes one person’s thoughts, simultaneously, it blinds that person to alternative considerations (Shaffer & Gambino, 1983). Rigid thinking sets in and science fails to progress until anomalies challenge the conventional wisdom.

Distinctions Among Use, Abuse, Dependence, and Addiction

Absent a consensual definition of addiction, clinicians and social policy makers often are left to debate whether patients who use drugs also "abuse" drugs. Treatment programs regularly mistake drug users and "abusers" for those who are drug dependent. Too often the result is unnecessary hospitalization, increased medical costs, and patients who learn to distrust health care providers; alternatively, absent a precise definition of addiction, some patients fail to receive the care they require. As a result of these complex conditions, practice guidelines in the addictions are equivocal and health care systems experience management and reimbursement chaos. [Although a full discussion of this matter is beyond the scope of this essay, it also is important to note that not all people with addiction are impaired in every aspect of their daily life. Despite some exceptions, substance addictions tend to be more broad-spectrum disorders while pathological gambling tends to be a more narrow-spectrum disorder.]

Even under most established constructions of addiction, not all drug dependent patients evidence addictive behavior. For example, in most civilized countries, under nearly all traditional circumstances, people who are nicotine dependent do not evidence addiction with its attendant anti-social behavior pattern. When tobacco is recast as a socially or legally illicit substance, however, these antisocial aspects of addictive behavior have emerged (e.g., Reuters News Service, 1992).

Complicating matters, neuroadaptation and physical dependence can emerge even in the absence of psychoactive drug use. For example, upon stopping, pathological gamblers who do not use alcohol or other psychoactive drugs often reveal physical symptoms that appear to be very similar to either narcotics, stimulants, or poly-substance withdrawal (e.g., Shaffer, Hall, Walsh, & Vander Bilt; 1995; Wray & Dickerson, 1981). Perhaps repetitive and excessive patterns of emotionally stirring experiences are more important in determining whether addiction emerges than does the object of these acts.

Addiction with Dependence and Without Dependence: Substances and Process

If addiction can exist with or without physical dependence, then the concept of addiction must be sufficiently broad to include human predicaments that are related to both substances and activities (i.e., process addictions). Although it is possible to debate whether we should include substance or process addictions within the kingdom of addiction, technically there is little choice. Just as the use of exogenous substances precipitate impostor molecules vying for receptor sites within the brain, human activities stimulate naturally occurring neurotransmitters (e.g., Hyman, 1994; Hyman & Nestler, 1993; Milkman & Sunderwirth, 1987). The activity of these naturally occurring psychoactive substances likely will be determined as important mediators of many process addictions.

The Neurochemistry of Addiction: Shifting Subjective States

We may be able to advance the field by considering the objects of addiction to be those things that reliably and robustly shift subjective experience. The most reliable, fast-acting and robust "shifters" hold the greatest potential to stimulate the development of addictive disorders. In addition, the strength and consistency of these activities to shift subjective states vary across individuals. Currently, we cannot predict with precision who will become addicted. Nevertheless, psychoactive drugs and certain other activities like gambling, exercising, and meditating will correlate highly with shifting subjective states because these activities reliably influence experience—and therefore neurochemistry. Consequently, psychoactive drug use and other activities (e.g., gambling) that can potently and reliably influence subjective state shifts will tend to be ranked high among the full range of activities that can associate with addictive behaviors.

Objects of Addiction: Cause, Consequence, or Relationship

To this point, I have implied tacitly that simply using drugs or engaging in certain activities do not cause addiction. Now let me be explicit: from a logical perspective, the objects of addiction are not the sole cause of addictive behavior patterns. The teleological aspects of addiction theory and practice contribute much to contemporary conceptual chaos. If drug using were the necessary and sufficient cause of addiction, then addiction would occur every time drug using was present. Similarly, if drug using was the only cause of addiction, addictive behaviors would be absent every time drug using was missing. However, as I described before, neuroadaptation and pathological gambling are often present when drug using is absent. Therefore, either drug using is not a necessary and sufficient cause to produce addiction or gambling disorders are not representative of addictive behaviors. Furthermore, using psychoactive drugs may not be a primary cause of addiction. Even though drug using is highly correlated with addiction—because psychoactive substances reliably shift subjective experiences—drug taking is neither a necessary nor a sufficient cause of addiction. Pathological gambling and excessive sexual behaviors that do not fall within the domain of obsessive compulsive disorders reveal that addiction can exist without drug taking. These observations serve to remind us that the objects of addiction do not fully explain the emergence of addiction. Consequently, scientists need to develop a model of addiction that can better account for a more complex relationship between a person who might develop addiction and the object of their dependence. One strategy for developing a new model is to emphasize the relationship instead of either the attributes of the person struggling with addiction or the object of their addiction.

To emphasize the relationship between the addicted person and the object of their excessive behavior serves to remind us that it is the confluence of psychological, social and biological forces that determines addiction. No single set of factors adequately represents the multi-factorial causes of addiction (e.g., Shaffer, 1987, 1992; Zinberg, 1984). Unfortunately, the parameters of this unique relationship also are difficult to define. Therefore, until experience provides more insight into the synergistic nature of these factors and helps us determine the interactive threshold(s) that may apply, we are forced to operationalize addiction so that researchers, clinicians and policy makers can share a common perspective (Shaffer, 1992; Shaffer & Robbins, 1991; 1995).

Using an Operational Definition: A Simple Behavioral Model:

In the field of addictions, workers need precise operational definitions. To avoid confusion, researchers and clinicians have developed handy operational schemes to reduce inconsistency. One simple model for understanding addiction is to apply the three Cs:

Behavior that is motivated by emotions ranging along the Craving to Compulsion spectrum

Continued use in spite of adverse consequences and

Loss of Control.

Vague definitions of addiction, encouraged Vaillant (1982) to note that recognizing alcoholism (and perhaps other addictions) ultimately was similar to identifying a mountain or season; when confronted with these situations, we know these things implicitly. However useful, tacit knowledge is insufficient architecture upon which to rest the advancement of a science.

As a young science, the addictions represents a growing body of knowledge and a variety of emerging biological and social science methodologies—with all of the attendant rules and regulations of science—for expanding and verifying the emerging knowledge base. If the field of addictions is to mature, as have other domains of science, we must diligently work toward conceptual clarity. To develop theoretical precision, the field of addictions must escape from the cloak of partisan ideas. Conceptual clarity does not require that clinicians, researchers and social policy makers agree. However, it does require that as addiction specialists we define our concepts and work precisely and operationally. Under these conditions, treatments and research become replicable. The full tapestry of addiction patterns begins to emerge. The freedom to explore important issues develops. Conceptual chaos diminishes and, with all of its inherent debates, science progresses (e.g., Shaffer, 1986).

by Howard J. Shaffer, Ph.D., C.A.S.

Reputation Comments on this post:

excellent post

[jesusfreak666er]

I think its important to not judge drugs as a whole when talking about the impact of drugs on society, swim thinks a great documentary on drugs impact on culture is drug years on VH1/sundance. One must look at all the amazing music and art that blossomed from psychedelics but then look at the Manson cult and murders, whom were avid trippers. Overall I believe that the positives of the 60s psychedelics era easily surpassed the few negatives, but one must also address the so called "narcotics" as the FDA labels so many of them. Opiates and other "hard drugs" are linked to many poets and writers but more often then not they are also linked to their deaths (Elvis, hendrix...so on) Though much of the creativity that these artists displayed (especially 60s psychedelic music phenoms) are linked to hallucinogens all their deaths are linked to ludes and sleeping pill/opiate/alc mixes. So one can not simply say they had a good or bad effect. If i had to though Id say that psychedelics as a whole had a positive effect and "hard drugs" destroyed what the psychedelics had created. (I must point out that these are not complete original ideas and many of them stemmed from the documentary which i mentioned earlier).

Now addressing weed. Swim thinks that in limited amounts weed can spur creativity and great artist work as a muse of sorts but one must also note the "I dont care attitude" that almost always occurs with daily use. One loses the motivation that used to be supplemented by MJ.

Well that was swim's adderall induced rant... hope u enjoyed it

[nikonikad]

What means Addiction?

Reputation Comments on this post:

excellent question

[Nature Boy]

Physical dependance and a physical withdrawal once usage is stopped. I don't believe in psychological addictions as such. "Psychological addiction" is a prohibitionist buzzword for soft drugs use IMO. I think the words "fondness" or "obsessed" better fit someone who uses a non-physically addictive drug excessively. It's misleading to call these people addicts when real addiction is no joke.

[nikonikad]

You will say that: daily use of a Substance is Addiction.


What is with the Weekend? If you use only Weekends (or every second weak) drugs (like in Swims case), is this also addiction?




What is a responsible Drug use? Or does this not exist?

[DrMuffy]

Originally Posted by Nature Boy

Physical dependance and a physical withdrawal once usage is stopped. I don't believe in psychological addictions as such. "Psychological addiction" is a prohibitionist buzzword for soft drugs use IMO. I think the words "fondness" or "obsessed" better fit someone who uses a non-physically addictive drug excessively. It's misleading to call these people addicts when real addiction is no joke.

Well SWIM has to disagree with this statement. although SWIM havnt gone thru herion withdrawal or anything that hardcore, but SWIM has quit cocaine (.2-.5 grams a night binge that lasted 3 weeks) and the physical withdrwal was really nothing compared to to psycological part. A $200 test say that SWIM has an addictive personality, so SWIM psycological dependency issues may very well differ from all you others out there. SWIM think that the psycological withdrawal is much worse than physical (With the exeption of hardcore junkies), because its in your head, and youll always have that craving, that urge just to do "it" one more time. Even the worse cases of phisical withdrawl only last anywhere from 2 weeks to a month, but the psycological part will always be there in the back of your head for the rest of your life.

[Nature Boy]

Daily use is addiction? I don't agree with that.

SWIM drinks coffee and smokes pot every day (usually has a glass of wine with dinner too) but wouldn't say he's addicted to either of these things.

[nikonikad]

Originally Posted by Nature Boy

Daily use is addiction? I don't agree with that.

SWIM drinks coffee and smokes pot every day (usually has a glass of wine with dinner too) but wouldn't say he's addicted to either of these things.

I think there are Several Levels:

1. Never
2. a few time per year
3. Weekends (no consumption Workingdays)

(I would say that consumption during Workingdays is crossing the red line)

4. Daily
5. Several Times per day

[Nature Boy]

Originally Posted by nikonikad

I think there are Several Levels:

1. Never
2. a few time per year
3. Weekends (no consumption Workingdays)

(I would say that consumption during Workingdays is crossing the red line)

4. Daily
5. Several Times per day

It depends on the substance though doesn't it? Each individual's susceptibility to whichever substance is also a factor. I don't think addiction can be defined by the use of a substance several times a day. That would be like suggesting that someone who drinks three cups of coffee a day is addicted to caffeine. I don't agree with this. Someone who drinks three cups of coffee a day can be described as someone who enjoys their coffee but is far from an addict in my opinion although copious amounts of caffeine can be potentially addictive in the true sense i.e. dependance and withdrawal. This is unlikely to happen with drinking coffee though. We're talking caffeine pills here.

[wellhelm]

Coffee can be physically addicting. The most common withdrawl symptom being headache's Swim is not saying swin is addicted, just that it can be.

Swim also believe's mental addiction comes right before physical addiction then they both stay hand and hand.
Swim still fiends for smack but has not done it in months, is not this mental addiction? Swim does not believe this to be obsession because he knows the dangers and its use has negative results. Yet sometimes he feels the urge to use it.

Coffee can be physically addicting. Headache's are the most common withdrawl symptom.
Why does swim drink coffee every day if he's not addicted to it? Swim also dares you to stop coffee and mj for a month. What should it matter if swim is not addicted to it?

[Alfa]

There is lack of consensus on the definition of addiction.

The medical definition of addiction is:
Habitual psychological and physiological dependence on a substance or practice beyond one's voluntary control.

DSMIV describes the indications of dependence as follows:

DSM-IV Substance Abuse Criteria
Substance dependence is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one (or more) of the following, occurring within a 12-month period:
1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (such as repeated absences or poor work performance related to substance use; substance-related absences,
suspensions, or expulsions from school; or neglect of children or household).
2. Recurrent substance use in situations in which it is physically hazardous (such as driving an automobile or operating a machine when impaired by substance use)
3. Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct)
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (for example, arguments with spouse about consequences of
intoxication and physical fights). Alternatively, the symptoms have never met the criteria for substance dependence for this class of substance.

DSM-IV Substance Dependence Criteria
Addiction (termed substance dependence by the American Psychiatric Association) is defined as a maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring any time in the same 12-month period:
1. Tolerance, as defined by either of the following:
(a) A need for markedly increased amounts of the substance to achieve intoxication or the desired effect
or
(b) Markedly diminished effect with continued use of the same amount of the substance.
2. Withdrawal, as manifested by either of the following:
(a) The characteristic withdrawal syndrome for the substance
or
(b) The same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.
3. The substance is often taken in larger amounts or over a longer period than intended.
4. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of substance use.
7. The substance use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been caused or exacerbated by the substance (for example, current cocaine use despite recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).

What do you think?

Reputation Comments on this post:

Useful information. I was going to post DSM IV criteria inter alia, and found you'd already done. Hooray for the Search ...

[Forthesevenlakes]

To add to Alfa's post, there are some individuals (usually teens) who meet 3 of the criteria when both abuse AND dependence are considered, but not three criteria for abuse alone, or three for dependence alone. Do these people not have a problem with alcohol or drug use? Or perhaps, could the DSM methodology be revised to include a gradient of substance use problems rather than an either/or classification.

Daily use of a substance may or may not lead to abuse and dependence, or addiction. A person who has a glass of wine daily would be a regular user of alcohol, but as long as it does not impair their functioning, and they dont suffer problems with going without that glass of wine, they would have neither abuse nor dependence. By contrast, a person could use cocaine once a month, but during this use have a long binge which leads to them missing work or having social or legal problems. This once a month user would then be considered to have an abuse problem, even if they arent addicted.

Addiction is usually characterized by meeting the DSM-IV substance dependence criteria, in most cases. However there are rare cases where a person can be addicted to something and not meet these criteria. The DSM-IV isn't perfect, after all.

[Nature Boy]

^^^

Cocaine is one of the odd ones out. Highly addictive physically but physical withdrawal is virtually unrecognisable in some cases. The withdrawal is more psychological in this case but that psychological torment is triggered by physiological impulses caused by heavy use.

[stoneinfocus]

Note that some problems, like with the job only occur due to way too strict testings that, otherwise, substance use woulnd´t even be obvious, or that people might get problems by getting mobbed for the drug use, which again is an asocial behaviour of the users enviroment and includes judging and mobbing the wrong ones, not even those using drugs, and mobbing´s always the wrong way.

and as a matter of fact, most of the adolescents are alcohlolics by that definiton, but mange to cut it back to "normal" use... which I think is the same with any drug-use, you go through a learning-curve first checking the subtances advantages and sides, then you go to the edge, to see what´s all about and later you mange to control it using the benefits mostly...

[Nicaine]

Originally Posted by nikonikad

What means Addiction?

In a word, ambivalence. You want to quit *and* you want to keep using, and neither desire is strong enough to overcome the other for very long. Such a state is termed 'addiction'.

This is of course my personal definition, not the medical profession's .

Reputation Comments on this post:

Good personal definition

[DrMuffy]

Originally Posted by Nicaine

In a word, ambivalence. You want to quit *and* you want to keep using, and neither desire is strong enough to overcome the other for very long. Such a state is termed 'addiction'.

This is of course my personal definition, not the medical profession's .

That is a very good definition for Addiction, probably the best I have heard so far!

[ProteinBlast]

SWIM is in complete agreement with Nicaine's definition. SWIM has been trying to stop cocaine use (light use, 2x monthly for about 4 yrs), and it's been almost 2 weeks straight now. Physically all is great. Mentally it's a battle, daily.
With so many reasons for SWIM to NOT use, why in the world would he ever consider using again? SWIM asks himself that, everyday. But every day, there is a little voice saying, "but do you really want to quit, forever...?" Five minutes of desiring it. Then it's gone. Only to return randomly, throughtout the day. And then there are dreams about it. Dreams where SWIM is in possession of a nice large stash, and he and his friends are having a blast.
SWIM thinks addiction is this struggle he's facing now. He wants to stop - for good. It's really for the best. But there is always that tiny voice in his head that tells him to get some, and his mind starts thinking of the next
"special occassion" where he wouldn't feel so bad using again. He wants to stop, but he doesnt want to stop. It's funny how all the bad comedowns are so easily forgotten, but the 15-30 minutes of bliss are forever remembered. The fight continues.

[bewilderment]

I certainly agree with Nicaine (actually was about to post the same thing before I saw that). Also, if the substance is impairing one's life in a significant way and yet one continues to use despite the fact. Or if you feel as if you genuinely need it, as opposed to simply wanting it.

[Sklander]

Addiction to a substance is when you choose to use the substance instead of doing something that actually needs to be done. When your life revolves around the drug and you feel like you cannot go without it, you have become addicted to the substance.

Addiction is a touchy subject that varies greatly from person to person.

As far as physical, painful addictions go, SWIM thinks that Heroin/Opiates, tobacco, and alcohol are the worst.

[INodHardOhYeah]

Discounting strict definitions involving physical dependence, as well as the AMA definition, a good working definition that is used very often is "you use when you don't want to, or don't mean to"

SWIM looks at it as a seemingly necessary "habit" which negatively interferes with your life, please don't respond trying to skew this definition or attack it, blah blah "well snow boarding causes me injuries and negatively interferes with my life blah blah bullshit". It is not for someone else to decide whether or not you suffer from addiction, that is personal.

If you are trying to recover, 12 step and other support groups have helped a lot of people. As well as cognitive "talk" therapy with a psychologist or counselor. But the most important step to recovery is not using (drugs)... anything... at all. (lets try and avoid discussing what a "drug" is, you know what I'm refering to)

Thread merger again, I responded to a post which asked for a definition of addiction as well as a question about recovery, I wasn't just randomly talking about treating addiction, the tone of my post doesn't fit too well, but I don't really feel like further editting, I gotta go eat.

[Nicaine]

Originally Posted by INodHardOhYeah

If you are trying to recover, 12 step and other support groups have helped a lot of people. As well as cognitive "talk" therapy with a psychologist or counselor. But the most important step to recovery is not using (drugs)... anything... at all. (lets try and avoid discussing what a "drug" is, you know what I'm refering to)

Sort of, but not really. For example, SWIM has had several inpatient treatment facilities complain about the fact that he takes a measly 0.5mg of clonazepam twice/day, and has never abused it (in fact, often he skips a dose and just takes 0.5 mg on any given day). But it's a benzodiazepine, and everyone whines their privates off about it. SWIM has in fact been denied treatment because of the aforementioned prescribed benzo. Idiots.

[Irish]

SWIM wants to know what defines addiction, and when using drugs is not advised. SWIM would also like to know if drug are really any more dangerous than sky diving, i.e. if done correctly with proper "training", is relatively safe.

[Forthesevenlakes]

Addiction can be defined in a physical sense, that is, when one needs a drug to function without physical withdrawals, or in a mental sense, when one perceives that they NEED a drug to function properly in a given situation. Many drugs are dangerous if used improperly or without much knowledge of the drug, and some are obviously more dangerous than others, such as cocaine or heroin. Also since drugs have varying degrees of potency or purity between batches, this increases these risks, but SWIM does honestly not know if they are more or less dangerous than sky diving, thats like comparing apples to oranges. Does SWIY means in terms of addiction or lethal dose?

[~lostgurl~]

This doesn't answer SWIY's question but SWIM used to compare sky diving and drugs. What SWIM thinks is why are some risks ok by the govt and other risks not, if only oneself is to be affected by it. Even driving or being a passenger in car is more likely to kill someone than taking drugs. There are risks everywhere, and yes driving serves a purpose, but skydiving is a way for someone to feel an adrenaline rush, to do something risky. Anybody can do it but there are guidelines, rules, laws, physics and common sense that go with it. Yeah drugs are totally different to sky diving, especially if you want to break it down to the different drugs and the different effects, but SWIM still thinks there are some valid points comparing the two.