Reason behind the peculiar addiction profile of alcohol?

[keats]

This is a discussion that's come up many times among friends, and SWIM has yet to see anyone provide a halfway decent explanation. Alcohol is (as far as SWIM knows) a relatively unique drug in terms of it's potential for addiction. There are more addicts who choose alcohol as their drug of choice than any other drug, yet there are also more responcible alcohol users than any other drug. This is largely a matter of scale, there are more consumers of alcohol than any other drug (except caffeine) by far. But there's more to it than that. How many other drugs do you know that has a significant percentage of users badly addicted, a significant portion dependent but not neccesarily addicted, a significant portion using frequently but not dependent or addicted, significant portion using occasionally, and a significant portion who've used and choose not to at all.

By all accounts alcohol is really a pretty hard drug. Putting aside the legal issue (which is one thing members of this forum are good at) alcohol is much harder, more dangerous, more addictive, and all around "worse drug" than many illegal ones like marijuana. Yet there IS a difference between the addiction potential of alcohol and say, cocaine, in the average user. It's not impossible to use cocaine on a regular basis without getting addicted, but I think most would agree that's very, very rare. If you're doing cocaine every day you're almost certainly addicted to cocaine, whereas many people don't have any trouble drinking every day and then stopping when the situation calls for it. Then again there are also plenty of people who only drink occasionally and yet get addicted very quickly.

These days alcoholism is largely accepted as a "disease", a genetic problem. SWIM wouldn't disagree with this, nor with the idea certain people have addictive personalities. But alcoholism does seem at least partially seperate from the quality of being predisposed to other drug addiction. SWIM has known many ex hard drug addicts who still drink on a regular basis without any trouble, but it's rare to hear of heroin addicts who starting doing meth after they quit h and don't have a problem with it.

SWIM could go on with this longer, but he thinks SWIY gets the point. To summarize his question: why is it that alcohol is unique (or perhaps it isn't, if someone would like to refute/disagree with this idea) in its quality of being simeltanously extremely addictive to some, and not addictive to others? It seems there is no other addictive, dependence building, physically dangerous drug which can be used so often in so many people without causing a serious addiction for most of them.

[Jatelka]

There's a document here...

http://www.drugs-forum.com/forum/loc...1871&catid=132

on the neurobiology of alcohol abuse, dependance and withdrawal

[bcubed]

Actually, I'm not really convinced alcohol is unique in this regard.

At one time, ALL illegal drugs were portrayed as a sure-fire ticket to insanity and/or addiction. The public has become sufficiently clued in to realize that's factually false W/R/T drugs such as cannabis, but it still persists for drugs such as cocaine and heroin.

I seem to recall reading a study that tracked recreational cocaine users over a decade plus and found that the majority had stable or decreasing use patterns, but a minority had real problems. I also recall reading in The Heroin User's Handbook that only something like 15% of H users meet the definition of "junkie" (though I can't exactly recall how defined), which surprised me. By comparison, I believe 10% of American drinkers meet the (exceedingly generous) definition of alcoholism and something like 4% are physically addicted.

I do not doubt that the euphoric effects of alcohol are different for different people: alcohol is the most euphoric drug SWIM has ever done (with the sole exception of IV Fentanyl). SWIM's half sister, however, drinks so little as to be virtually abstinent, which would be physically impossible if she derived similar pleasure from the drug. This exceedingly strong euphoria *might* have something to do with the fact that SWIM found it necessary to set down the booze for the forseeable future...

[samm2]

Some food for thought swim read about:

One interesting fact is that among the Jewish population their are very few alcoholics. This population has had alcohol in it's culture probably the longest time out of all cultures on the planet. Theory goes that all the alcoholics in that culture killed themselves off, or otherwise didn't reproduce, whereas in the European/American culture alcohol hasn't been around as long, thus higher addiction rates. In the native american culture, alcohol has been around much less, hence the really high alcoholism rates. This would more or less support the arguments saying that genetics plays a good part in the pharmacology of alcohol addiction and swim has seen evidence of this in real life.

Reputation Comments on this post:

A really interesting perspective about genetics and alcoholism.

[Rio Fantastic]

One thing to bring into the equation is that some people don't drink alcohol to get really drunk, whilst on the other hand, there are no heroin users who use heroin for purpouses other then to get high.

[hoodabudda]

genetics probably has to do somthing with it but anyone can get addicted.just depends if ur a happy person or not.

[Nature Boy]

Originally Posted by samm2

Some food for thought swim read about:

One interesting fact is that among the Jewish population their are very few alcoholics. This population has had alcohol in it's culture probably the longest time out of all cultures on the planet. Theory goes that all the alcoholics in that culture killed themselves off, or otherwise didn't reproduce, whereas in the European/American culture alcohol hasn't been around as long, thus higher addiction rates. In the native american culture, alcohol has been around much less, hence the really high alcoholism rates. This would more or less support the arguments saying that genetics plays a good part in the pharmacology of alcohol addiction and swim has seen evidence of this in real life.

I'm pretty sure alcohol use outdates Judaism.

Although I would not completely dismiss genetics as a factor-- it's well documented for example that many Asians have an unusually bad reaction to low doses of alcohol which results in very rapid dehydration; as far as addiction is involved, this is largely down to the subjective appreciation of the drug and an individual's decision-making in regards to levels of consumption. Lack of alternative choices is also a factor. Take for example a friend of SWIM's. He couldn't use any other drugs because he was in the navy and got tested and he ended up drinking at an unusually high rate (even for an Irish person) which eventually resulted in a dishonourable discharge. Ironic isn't it?

[samm2]

Swim thinks you have to differentiate from a physical addiction and psychological addiction.As SWIY points out the euphoria can be real nice and that doesn't necessarily indicate a physical addiction rather a psychological one. Swim thinks sometimes a psychological one can be more difficult to kick.

[El Calico Loco]

Might part of be be related to the way users take alcohol vs other drugs? When using illegals - be it coke, meth, opitates, psychedelics, or what have you - users often take the entire night's dose at once. With alcohol, this would be equivalent to doing ten shots at once because that's the amount one plans to drink that evening.

It's not a hard and fast rule, of course. Plenty of people hit the cola or bud over and over throughout the course of a day.

But I wonder. Would the abuse profile and overdose risk of things like amps and heroin be different if they came, as alcohol does, in a form that allows one to slowly work up to the desired level?


ECL

[zera]

The number one predictor of whether someone will become an addict to any substance is a novelty seeking personality. The people who are slamming H, are much more likely to have this trait than the average person drinking after work with his buddies. Remember heroin or cocaine isnt something that you just kind of start doing, its something that you seek out to obtain, probably only get offerred if you have an inclined personality and make a very large concious decision to shrug off societal taboos.

ECL also makes a good point, avoiding cocaine addiction while using daily seems unlikely, but look at the comparison of intake methods. Coke users are doing lines, and most definitely getting very high if using, when alcohol users drink on a Wednesday night, theyre most likely not getting black out drunk, but probably just a little buzzed. Swim could easily imagine someone using a little 20 mg bump in the morning to wake up or drinking a glass of Coca Wine a night avoiding addiction.

[samm2]

Originally Posted by ECL

But I wonder. Would the abuse profile and overdose risk of things like amps and heroin be different if they came, as alcohol does, in a form that allows one to slowly work up to the desired level?


ECL

Rate of increase in plasma levels of drugs has a definite bearing on addiction rates to different substances i.e. smoking crack is way more addictive than drinking coca tea. In the same way drinking hard liquor is more addictive than drinking beer.(because blood levels of alcohol go up faster with hard liquor)

[bcubed]

Originally Posted by samm2

Some food for thought swim read about:

One interesting fact is that among the Jewish population their are very few alcoholics. This population has had alcohol in it's culture probably the longest time out of all cultures on the planet. Theory goes that all the alcoholics in that culture killed themselves off, or otherwise didn't reproduce, whereas in the European/American culture alcohol hasn't been around as long, thus higher addiction rates. In the native american culture, alcohol has been around much less, hence the really high alcoholism rates. This would more or less support the arguments saying that genetics plays a good part in the pharmacology of alcohol addiction and swim has seen evidence of this in real life.

Yes, I've heard this argument, but the weakest part of it would seem to be the diparate addiction profiles for Asians and Native Americans. The American Indian is supposed to be most closely related to Asiains, having only broken off recently, when coming across the Bering land Bridge into the Americas. However, Native Americans are much more prone to alcohol addiction than Asians. Does anyone know the explanation for this?

And as for the "not all drinkers drink to get drunk" argument: I doubt that many drinkers completely don't care about the phamocological effects. NA beer and wine are perennial poor sellers in the marketplace. Rather, I think that light drinkers drink for the subtle effects of alcohol in much the same way a pot smoker might have a small toke to relax and improve mood versus getting baked. (SWIM did this for a brief while with cocaine--as an improved version of caffeine vs. using it to get coked up).