Hello, I'm Dr. Allen Battle, a psychologist with UT Medical Group and professor of psychiatry at the University of Tennessee Health Science Center. Today we are talking about addictions.
Q: Is marijuana addictive?
Dr. Battle: No, marijuana is not addictive. It isn't addictive because the active ingredient in it, THC, does not become a part of the body chemistry. So that then, that body, would be dependent on it just as it is dependent on water or food. That is the essence of addition; it is physiological!
Gambling, food, sex, are not addictive. To use the word addiction in connection with these activities is to pervert the meaning of the word addiction. These things can become obsessions, that is to say, thoughts that repeat and repeat in spite of the individual not desiring to have them. They can become compulsions, in which the individual must act upon those thoughts. They can become habitual. They may be used as a way of escaping from problems in the here and now. But none of these things are physiological.
Q: So then does an addiction become a compulsion after detoxifying oneself from the chemical?
Dr. Battle: The compulsion is more likely to precede addiction. As a matter of fact, an individual who has a very favorable response to that chemical being in the body uses it frequently and therefore may become addicted.
Q: Did you say that marijuana is not an addictive drug?
Dr. Battle: Yes, marijuana is not an addictive drug because it does not become a vital part of the user's body chemistry.
Q: So the long term treatment might be the same for addiction and compulsion?
Moderator: the doctor says yes the long term treatment can be the same depending on the psychological status of that particular patient. If there is anything we can say in this field, it is that broad generalizations can lead to serious mistreatment. All abusers are not same psychologically or physiologically.
Q: Can crack cocaine be successfully treated without being in a long-term treatment center?
Dr. Battle: Again, it depends upon the patient. For example, does this individual have strong ego strength, that is to say, does the person have emotions and urges or do the emotions and urges have him or her? If the individual has the strength to remain off of the drug in an outpatient setting, then there is no reason for hospitalization. But if they can't, they need to be in a drug-free environment until they are back in some semblance of self-control.
Q: Why is everyone down on oxycontin, I have Liver cancer, and if it wasn’t for oxycontin I would die of pain, what can I do to help this drug maker, plus I have about 20 other friends that take it.
Dr. Battle: You have my sympathy. What is happening in regard to that drug is the same phenomenon that has occurred in other situations and substances, namely, blaming the substance or the situation for its abuse. To say that such decisions are illogical is to dignify them. I wish I could help you with a political question, for that is what this is. It is not a scientific one. But unhappily, I am not a politician. Again, I'm sorry you have to suffer needlessly.
Q: I am a CIT Officer w/the Memphis police officer I was wondering if you knew why it takes over 8 hours to put a juvenile in to Le Bonheur? Is there a policy that you could sent to the precincts so we can avoid this? If you could call over there and light a fire under someone it would be greatly appreciated.
Dr. Battle: I have a suspicion that you must be one of my former students in the CIT training program and know my negative feelings about red tape. But I do believe that we can say a great deal of it is the result of just that. There is, however, a serious problem of shortage of nurses which has significantly slowed down our ability to respond in emergency rooms. Certainly this is true in our own MED ER. And I don't know how we're going to solve the problem.
Laughingly, I have to say I don't think I have that much influence with the Director, although we have worked together for many years and he's a wonderful man. These kinds of administrative problems, whether they exist in the police force or in our hospitals are really beyond the scope of just a soldier down in the trenches like me.
Q: Thanks for your time. Remember today is police memorial day 228 officers around the U S were killed last year keep them in your thoughts.
Dr. Battle: The work you police people do has my eternal gratitude. You're a terrific group of officers.
Moderator: The important thing to remember here is we are trying to help addictions and rest assured that your identity is secret.
Q: What are the chances of someone being addicted to cocaine and also have an anxiety and depression problem have good results in a treatment center in the Memphis area. What is a good treatment center for dual-diagnosis in Memphis area?
Dr. Battle: Your question is an especially interesting one in that individuals who use the so-called "uppers" very frequently are fighting against depression whereas those who use the so-called "downers" are trying to take care of anxiety and tension. This is why such patients detest the opposite type of drug, because it only accentuates the psychological problem they're fighting against.
As to the ideal treatment center, I believe you will find that as with schools, the goodness or badness of an institution's programs is as much a function of the motivation of the patient or student as it is of the therapist or teacher, much less the institution in which they happen to work. When individuals fail often they then blame the therapist or the institution. The physician can treat but cannot get well for the patient.
Q: What about fioricet?
Dr. Battle: Fioricet can be addictive, depending upon the length of time the drug has been used, the dosage, and whether or not the patient is prone to the development of addiction. People vary in the ease with which they can develop such problems.
Q: I’m another [user] of oxycontin, I read that other question from Laura and I’ve got the same problem, they’re not going to take it off market for people like me or us?
Dr. Battle: Frankly, I don't know. I think that ultimately it would be a matter of whether the voice of reason and humanity can prevail over the zealots and bigots.
Comment: Thank you very much for your knowledge!
Q: I realize the user must want to get help for himself, but all treatment centers are not equipped or qualified for helping the dually-diagnosed. So if possible what treatment centers can help this type of person in this area?
Dr. Battle: I apologize for not answering the dual diagnosis question that you included in your original statement. There are, or were, several wards that have specialized in the treatment of dual diagnosis in the city. I have not had occasion to refer a patient to any of them recently, and as you probably know, with the chaotic state of medical care now, operations open and close almost as frequently as the change of the tides.
I have had good success in recommending patients to the ward at Methodist and St. Francis. But again, I don't know whether they are still functioning.
Q: My husband has taken trezadone for sleep apnea for several years. Is this habit forming?
Moderator: The doctor says trezadone is addictive, but says there is nothing wrong with addiction when it is used properly and for good medical reasons. The problem of drug abuse is the use of mind altering substances in order to escape reality.
Q: I have been a smoker for 23 years. I started when I was 17. I have successfully quit smoking for 4 months now, but find I am now addicted to the nicotine gum. I have heard it's okay to stay on the gum for years. I think I have the type of personality that is very prone to addiction. Under those circumstances, do you think there is any harm in staying on the nicotine gum?
Dr. Battle: Whether one consumes nicotine through the patch, or through a tobacco product, does not change the fact that the body is getting the nicotine. The whole purpose of using patches is to use them as prescribed, namely, in the order of lesser and lesser nicotine. When they are not used in this way, so as gradually to relieve the body's dependence on the drug, naturally they don't work.
As to your question of whether it's just as well to use it in the form of gum or patches, you would not be getting the toxins you would be getting in the smoked form--namely tars, resin, and carbon monoxide. Your lungs, I'm sure, will thank you.
Q: Why are they trying already to sue people that has taken oxycontin for addiction when you can get addicted to anything if you take it long enough?
Dr. Battle: First of all, one cannot become addicted to anything you take long enough. Secondly, in our litigious society people have a remarkable tendency to blame the manufacturer or someone who has prescribed a drug for legitimate medical reasons or whatever rather than facing the problem that we have some responsibility for our own behavior and self-control. I am assuming that you mean lawsuits against the manufacturer and not the people who have become addicted.
Comment: Yes, you are correct. Thank you very much.
Q: Is there much progress being seen in people that are addicted to alcohol/drugs and are also Learning Disabled?
Dr. Battle: These two phenomena are not really intimately related. An individual who is learning disabled may well turn to drugs of abuse in order to help him to bear the pain of having that disability. But there is no direct relationship of which I'm aware between alcohol abuse and learning disability.
Q: Can you tell me, approximately how long it will take one's body to rid itself of marijuana toxicity of 375?
Dr. Battle: The question is what is the age of the individual, what is their general state of health, and how well are the detoxifying organs of that patient functioning? The liver and kidneys are vital in the detoxification process. If the individual suffers cirrhosis, for ex., then the detoxification process would be longer. Marijuana is typically detectable in the urine of an average user for 7-10 days.
Moderator: Good questions everyone. Just a reminder, you are anonymous here and can ask the doctor anything without fear of being identified.
Q: I have heard you can be addicted to sex. A lot of people seem to have problems with online porn, is that an addiction?
Dr. Battle: This is one of the most absurd ideas that has been promulgated in this country in many a moon. The sex drive is dependent upon the gonads, the sex glands. If it were not for testosterone, there would be no sex drive in anyone. To say, therefore, that one is addicted to sex, is saying that one is addicted to oneself. That is not possible this season.
Q: If it's not addictive then why does my husband want it all the time?
Dr. Battle: That's a good question. The sex drive is dependent upon the production of testosterone. Males and females vary in this production. As I have said previously, there would be no sex drive if it were not for testosterone. When the intensity of the sex drive builds up, it requires release in the same way that an individual whose blood sugar level is low, feels hungry, and seeks food.
Q: Is a anti-depression medication really not addictive?
Dr. Battle: There are those antidepressants which are certainly not addictive. I believe it would be important to point out here that everyone is so preoccupied with the presently magic word, "addiction" that they lose sight of the real problem which is psychological dependence. Individuals who abuse any addicting or non-addicting substance, such as LSD, which is a hallucinogenic, are using it to escape reality. And that is a problem of personality operation, not body chemistry that has been made temporarily disequillibrates body chemistry.
Q: Does the metabolisation of marijuana have anything to do with the amount of ones body fat?
Dr. Battle: Body fat can be a problem in that regard. But again, much would depend upon the measure of adiposity and one's age, along with the other factors I have mentioned that affect the speed and effectiveness of detoxification.
Q: I have a relative on Paxil. I know that anxiety disorders can sometimes be caused by a chemical imbalance in the brain. Is this something that a person has always had or is it something can develop, for example, in the teenage years, and then "go away" after a person has had treatment? In other words, do they have this chemical imbalance all their lives but it just comes out at a certain point in their lives?
Dr. Battle: You have an extremely good question in that it provides an opportunity to explain that whether we experience a symptom that may be genetically based, depends as much upon what happens to us environmentally often as it is to that predisposition in the first place.
When the person's body goes into adolescence, there are drastic physiological changes that occur. These changes can disequillibrate existing equillibria. Also, how much psychological stress is the individual experiencing? All of these kinds of questions have to be used by us in determining the onset of such questions. It would be nice if these phenomena were simple and we could make straightforward formuli to answer them. But unhappily, such is not the case.
Comment: You are a kind man for taking the time to answering our questions!
Comment: I have to say that Dr. Battle is my favorite guest on this program.
Moderator: Folks we have run out of time. Thank you for your great questions, and I hope this chat was helpful today. If you would like to talk further to Dr. Battle you can call him at 448-2400.
