Love and Addiction - Appendix

© 1975 Stanton Peele and Archie Brodsky.
Reprinted with permission from Taplinger Publishing Co., Inc.

A. Responses to Morphine and a Placebo

In the Lasagna experiment, patients were given injections of an allegedly pain-killing drug which was sometimes morphine and sometimes a placebo. The drugs were administered under double-blind conditions; that is, neither the patients nor the technicians who administered the drugs knew which was which. Depending on the sequence of administration of the two drugs, which was varied in several ways, between 30 and 40 percent of the patients found the placebo as adequate as the morphine. Those who believed in the efficacy of the placebo also were somewhat more likely to obtain relief from the morphine itself. The average percentage of times relief was obtained from morphine by those who never responded to the placebo was 61 percent, while for those who did accept the placebo at least once, it was 78 percent.

B. Shared Action of Chemically Distinct Substances

In grouping barbiturates, alcohol, and opiates into one category, we depart, of course, from a strictly pharmacological approach to drugs. Since these three kinds of drugs have different chemical structures, a pharmacological model cannot explain the fundamental similarities in people's reactions to them. Consequently, many biologically oriented researchers have attempted to discount such similarities. Foremost among these scientists is Abraham Wikler (see Appendix F), whose position may have ideological overtones. It is consistent, for instance, with the importance he gives physiological habituation in his reinforcement model of addiction, and with the conservative public position he has maintained on such issues as marijuana. However, nowhere have pharmacologists been able to demonstrate a link between the particular chemical structures of the major depressants and the unique addictive properties that Wikler believes each of them has. In any case, there are other biochemical researchers who claim, as do Virginia Davis and Michael Walsh, that "Because of the resemblance of symptoms occurring on withdrawal of either alcohol or the opiates, it seems possible that the addictions may be similar and that the real distinctions between the two drugs could be only the length of time and dosage required for development of dependence."

Generalizing from Davis and Walsh's argument, differences in the effects of many drugs are perhaps more quantitative than qualitative. Marijuana, for instance, would have small potential for addiction simply because it is too mild a sedative to engage fully a person's consciousness in the manner of heroin or alcohol. Even these quantitative distinctions may not always be intrinsic to the drugs in question, but may be strongly influenced by the dosage strengths and methods of administration that are characteristically employed with these drugs in a given culture. The Bushmen and Hottentots may have reacted violently to smoking tobacco because they swallowed the smoke rather than exhaling it. Coffee and tea may be prepared in milder concentrations in present-day America than in nineteenth-century England. Smoking a cigarette may provide a small and gradual infusion of nicotine, compared to the amount of heroin one gets from injecting a strong dose directly into the bloodstream. These circumstantial differences are not inconsiderable, and should not be mistaken for categorical differences between substances which in important respects operate similarly.

C. Effects of Expectations and Setting on Reactions to a Drug

Subjects in the Schachter and Singer study received an injection of the stimulant epinephrine (adrenalin), which was presented to them as an "experimental vitamin." Half of the subjects were told what to expect from the injection (i.e., generalized arousal); the other half were kept in the dark about these "side effects" of the supposed vitamin. Then each subject was left in a room with another person—a stooge paid by the experimenter to act in a specified way. Half the subjects in each of the original two groups were exposed, individually, to a stooge who acted as though he were euphoric, joking and throwing paper around, and half were put in with a stooge who took offense at the experiment and stalked out in anger. The result was that uninformed subjects—those who had not been told what their physiological reaction to the injection was going to be—picked up the mood set by the stooge, while informed subjects did not. That is, if the subject experienced an effect from the drug, but didn't know why he was feeling that way, he became very suggestible. Seeing the stooge react to the experiment in a certain way served to explain for the subject why he himself was physiologically aroused—i.e., that he was angry, or that he was euphoric. On the other hand, if the subject could link his physiological state with the injection, then he had no need to look around him for an emotional explanation for his arousal. Another group of subjects, who were grossly misinformed about what the injection would do to them, were even more suggestible than were uninformed subjects.