Life as an Extreme Sport

Category: …and everything else

Mostly everything else in a brain-academic way.

The Daily [05-08-06] – Dependency vs. Addiction

...and everything else, 2006, Academics, House MD, Pop Culture, The Daily

If this looks familiar to some of the longer-time readers, well… it was a busy week. And besides, the original was pretty good in and of itself.

Dependency vs. Addiction
Publish Date: 2006-05-08

I meant this column to be about the idea of informed consent. It’s a subject both House and Grey’s Anatomy have covered in their last couple episodes; something I would call a coincidence if they hadn’t been doing this back and forth of show themes for two seasons now.

But one evening I managed to find myself on the Television Without Pity Web site, in theory rereading the details of those pertinent episodes of Grey’s and House, when I decided I wanted to read recaps from earlier episodes.

That decision led me back to a first-season episode of House titled “Detox.” The theoretical point of this episode was a teenager with bleeding of unknown origin, but the actual point was to examine the vicodin use of the main character, Greg House.

For the few of you who’ve managed to miss this show, the character likes to discover novel ways to take vicodin.

In his defense, he’s missing a good part of one of his thigh muscles and has severe nerve damage from various complications of a blood clot and surgery years before.

House is accused of being a vicodin addict, and is challenged to go a week without taking any. He accepts the challenge, and during the course of the show appears to go through withdrawal, going so far as to break his hand to force his body to pay attention to different pain.

The result? Everyone crows that House is a drug addict.

I don’t agree.

Addiction is a biological and psychological condition that compels a person to satisfy their need for a particular stimulus and keep satisfying it, no matter what the cost.

Dependence is a physical state that occurs when the lack of a drug causes the body to react.

Physical dependence indicates that the body has grown so adapted to having the drug present that sudden removal of it will lead to withdrawal reactions. This can happen with almost any drug.

House is in constant, chronic pain. The physical dependency on vicodin is one that allows the character to maintain a normal lifestyle.

To use analogy to illustrate the point, imagine that a normal, healthy person is akin to a full glass of water. Someone who is in chronic pain is only half a glass of water without pain medications.

Add in a bunch of ice cubes, and the person in chronic pain is brought back up to the normal and functional level of everyone else.

In the case of the addict, toss a few ice cubes in a full glass of water, and watch everything spill everywhere in a mess. That’s addiction.

The chronic pain person needs those ice cubes of vicodin on a daily basis to provide what the body needs to function, but it’s not a situation where they would actively seek out, need, or desire any more than necessary to achieve that state of near-normalcy.

Regular use of some medications is necessary for some people to live a normal life. A diabetic is not addicted to insulin, nor is someone taking medication to control high blood pressure addicted to it.

They are, however, dependent upon it, as a person in chronic pain is dependent upon their drugs to function normally.

Perhaps that’s the thing one needs to consider when weighing notions of addiction or dependency — the person who is addicted does not have improved functionality with their addiction, while the dependent person does.

The writers of House have been irresponsible in how they’ve portrayed the character of House’s dependency, and this causes a lot of grief for actual living and breathing people with chronic pain.

There is a stigma associated with needing pain medicine every few hours. This stigma, shame and fear prevents many doctors from properly treating pain, and prevents many people from seeking out the relief they need.

My Pain, My Brain

...and everything else, life and living

My sister alerted me to this article in the New York Times that looks at chronic pain from the eyes of someone suffering it, and trying to treat it via functional MRIs. The idea is fascinating, and my immediate response is hoping there’s a trial underway in Albany (there won’t be, but a girl can dream).

I have found, repeatedly, that if I can make the time to meditate and de-stress myself, my own chronic pain fades in intensity. Likewise, distraction helps – hence hurting another area of my body earlier this weekend when the pain was unmanageable. (Pain gating mechanisms are fun!)

Distraction helps, but is harder to manage, especially when so many distractions tend to involve utilizing the areas of my body that hurt. However, kitty-heating pads are moderatley successful, and I suspect it’s why I’ve been watching so many estrogen-movies and shows recently. They bring out a different hormone response, and fully engage me in their fantasy, removing me from the pain of my reality.

Warblogging

...and everything else

Warblogging has been a popular topic over at Crooked Timber lately, with Belle Waring coming in with the latest post, which you can read here. I replied, and wanted to record said reply for posterity – I’ve learned that keeping track of my mini-rants can make it easier when, in the future, I have to write something on the topic of the rant. So here goes:

I think it’s distasteful to accuse people of being unpatriotic because you disagree with their politics, so let me just say that I think this is in very poor taste.

Well, we can lay that one at the feet of our darlin’ commander in chief — you’re either with us or against us, after all. Bush and his “no room for neutrality” take on the police action in Afghanistan and then Iraq has spread out to those who support with blind fervor; if there’s no room for neutrality, and you’re either in line behind him or a terrorist…well, does it really surprise you that the commonfolk would have that idea, if the president does?

Bloggers aren’t parasites on the body of the public any more than thinkers are; they’re a necessary part of the social whole. But there’s a really big difference between supporting the troops and supporting the police action that’s going on — something that seems to get missed in the desire to black and white the situation into soundbites. And I say this having spent quite a lot of time with folks who’ve shipped out at least once, several of them several times — folks who’ll go do their job, because that’s what they signed up for.

I think anyone who has any strong opinion about what’s going on in our foreign policey of ‘don’t ask, don’t tell — hit it with a big stick and ask questions later’ needs to make sure they’ve sat down with a few who’ve shipped out and back again, and get a firsthand opinion, devoid of the spin of politicians, of what’s going on.

Okay, sorry. Off ranting soapbox now. My best friend is married to an MP who’s seen combat in Afghanistan, and just narrowly missed being sent to Iraq because of a torn rotator cuff. It is, for me, a support the troops by bringing them home sort of thing — I don’t want my friend to become a war widow.

White Collar Crime? We Want Your DNA!

...and everything else, Bioethics

Adrian Lamo is in trouble again. Not for cracking any new computer systems, but because he won’t give the federal government a blood sample so they can isolate his DNA and add it to the FBI’s Combined DNA Index System (CODIS). He did bring nail clippings and hair samples, but those in charge will only accept blood for the sample.

Now, I’ve known about CODIS for a while. The point is to be able to store the DNA of sexual predators and violent criminals. What I hadn’t realized is that the 2004 Justice for All Act expanded the CODIS purview to include samples from all newly convicted federal criminals. Including white collar criminals – people who commit crimes that rarely leave any traces of DNA for testing.

What, then, is the point to collecting the DNA of these white collar criminals? It makes me uncomfortable, because the government has ruled in the past that elements of your body – your blood, your cancers, your spleens, anything that can be taken from your body – are no longer yours once they are removed from your body. Including DNA.

This means that your DNA can be taken, stored, sequences, analyzed, and released to the public, without your say, without your benefit. And potentially to your detriment; there are growing fears that DNA samples showing proclivities for diseases will result in insurance companies denying coverage, for example.

What happens if the government sequences the DNA of one of these incarcerated criminals, and finds something of value, something that requires more samples? Criminals have very little rights over their bodies – will they then be able to just take what they (the government they, that is) want?

It’s concerning.

Granted, these concerns existed when CODIS was implemented to begin with, but many people deemed the benefit of DNA samples and ability to match future DNA to known criminals who’re at high risk to returning to criminal behaviour, worth the potential abuses of having that DNA.

But now we’re talking about people with low rate of recidivism, who aren’t dangerous, per se, who’re having their DNA added to this system, for who only knows what reasons.

The ethics of this, and the potential for abuse of the policy, is worth thinking, and even perhaps worrying, about.