1. The Nature of Addiction and Its Implications Stanton Peele Presented at 25th Annual Epidemiology Symposium of the Kettil Bruun Society May 31-June 4, Montreal

2. The Stanton Peele Addiction Web Site http://www.peele.net A Brief History of Addiction Pre-mid-19 th century – addicted to whatever Turn of the twentieth century – opiates Mid-century America – heroin 1980s – cocaine 1990s – marijuana 1980s-90s – addicted to whatever

3. The Stanton Peele Addiction Web Site http://www.peele.net Pharmacologists and Addiction 1960s –Psychic and Physical Dependence –Alcohol / heroin addictive 1980s –Cocaine is addictive –Compulsive use 1990s –Marijuana is addictive –Brain receptors

4. The Stanton Peele Addiction Web Site http://www.peele.net Addiction is not: Reducible to pharmacology/biology Limited to any one drug Separable into physical/psychic dependence Limited to drugs Reducible to neurochemical mechanisms

5. The Stanton Peele Addiction Web Site http://www.peele.net ARG Surveys MenWomen 1967198419671984 Dependence819*58* Problems111387 * Significant at p <.05

6. The Stanton Peele Addiction Web Site http://www.peele.net WHO/NIH Cross-Cultural Applicability of Alcohol Dependence: Contrary to expectation, physical dependence criteria vary as much as psych. dependence (Schmidt & Room, 1999)

7. The Stanton Peele Addiction Web Site http://www.peele.net What Addiction is: Observed behavior / subjective experience Not all-or-none Occurs with any involving/destructive exper. Person addicted to a gestalt experience –psychic and physical –pharmacological and learned Essential experiential benefits

8. The Stanton Peele Addiction Web Site http://www.peele.net Vietnam Robins, Helzer, et al. (1980) –Is addiction to heroin more or less permanent without prolonged treatment? Of those addicted in Vietnam: –Half used again in U.S. –One in 8 (12%) readdicted

9. The Stanton Peele Addiction Web Site http://www.peele.net Fundamentally Affected by: Cultural –Social Situational –Developmental –Ritualistic Cognitive –Beliefs –Social learning Values

10. The Stanton Peele Addiction Web Site http://www.peele.net Revisionists Nominalists Rationalists Libertarians

11. The Stanton Peele Addiction Web Site http://www.peele.net Contrarian Positions There is not addiction Addiction as intentional behavior Except, "in extreme cases"

12. The Stanton Peele Addiction Web Site http://www.peele.net Addiction is Important As a template As a practical/clinical tool As an experiential reality