Gabapentin (Neurontin) Addiction

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When I was originally diagnosed with diabetic peripheral neuropathy I was prescribed Gabapentin which was still a newish drug to treat the nerve pain in my feet. Within weeks myself and my family really started noticing changes in me we didn’t like. Changes like heavy mood swings, feeling like the walking dead, nauseous always, and much more. I discussed this with my doctor and I was told my body has to get used to the very potent medication and I needed to give it time. After about 6 months I did get used to it I guess you could say, it became a crutch to say the very least. At about that same six month period is when I began using VA medical facilities and I had yet another discussion with another doctor who couldn’t prescribe Gabapentin because the VA didn’t offer it so I was switched to Lyrica. After trying it out for a few months I made the choice to stop taking either of the medications because to me the extreme pain was better than the way on felt taking them. Those of you out there with diabetic
peripheral neuropathy and the associated pain know what it’s like and how its a game changer in one’s overall lifestyle. It’s been 15 months almost to the day since I stopped taking them and I can still say the pain is still better than the side effects. In my own experience, neither worked well for me and the pain I felt while taking the either drug was reduced very little. After some digging I found an article my mother forwarded to me a couple of years back because I was talking with another family member who was recently prescribed Gabapentin and was telling me how it really wasn’t working out for her either. It all got me thinking this morning that I wanted to share with y’all what was once shared with me. I copied and pasted the article but you can find a link to it at the very bottom. Please feel free to share more information or your personal stories in the comments.

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When Neurontin was the new drug on the block, physicians believed that they had found a real breakthrough drug to help patients with all kinds of nerve pain.  The drug had fewer side effects and drug interactions than current ones on the market and was classified as non-addictive, which meant you did not have to keep extensive records on it every time you prescribed it.[i] Soon Neurontin was generating over $4 billion a year in sales.[ii]

Then the trouble began.  A whistle-blower from the drug’s manufacturer claimed the company was spinning data on the drug’s effectiveness and using illegal means to promote its off-label uses among physicians.  When the dust settled from civil and criminal lawsuits, Pfizer paid out $572 million to claimants.[iii]  But not to worry. As soon as Neurontin became a cheap drug available generically, Pfizer marketed a close cousin of it named Lyrica, which today generates $3 billion a year in sales.[iv]

What is Gabapentin?

Gabapentin is an analog of gamma-aminobutyric acid (GABA), a neurotransmitter that slows down the activity of nerve cells in the brain. This means that gabapentin has a similar structure and is made up of similar chemicals as GABA, although its effect on the body is not the same. The scientists who developed gabapentin were deliberately trying to mimic GABA.

Gabapentin does not convert into GABA, does not inhibit it, does not alter the uptake of dopamine, and does not interact with GABA receptor cells.[v]  How gabapentin works and how it relieves pain and suppresses seizures is unknown.  One theory is that it increases the level of GABA by increasing the activity of glutamic acid decarboxylase, an enzyme responsible for the synthesis of GABA.[vi]

The chemical name for gabapentin is 2-[1-(aminomethyl) cyclohexyl]acetic acid and its molecule looks like this:

Gabapentin is not a Controlled Substance, that is, one that the United States federal government classifies as having potential for addiction and regulates under the Comprehensive Drug Abuse and Control Act of 1970. However, gabapentin shares characteristics of addictive drugs in that it produces a withdrawal syndrome and certain psychoactive effects.  Its cousin drug, pregabalin, is a Schedule V Controlled Substance.

What are the Medical Uses of Gabapentin?

The United States Food and Drug Administration approved Neurontin for the treatment of seizures in adults and children, especially as a supplemental drug used for the same purpose. In 2002, the FDA approved it for treatment for pain from shingles. Horizant and Gralise are extended release versions of gabapentin that were approved for shingles pain in 2012.[vii] Gabapentin was also approved for restless leg syndrome in 2011.[viii]

When gabapentin was first introduced, doctors were excited about it because it had few side effects and drug interactions compared to competing remedies, and because it was not metabolized through the liver but rather excreted through the kidneys.[ix]  Physicians began to prescribe it off-label for various conditions, including hot flashes during menopause, pain from fibromyalgia, bi-polar disorder, pain after polio, neuropathic pain, complex regional pain syndrome, trigeminal neuralgia, migraines, alcohol and drug withdrawal seizures, and diabetic neuropathy.[x] Later it was proven that the manufacturers of this drug had exaggerated claims about its effectiveness for various conditions.[xi]  Pregabalin, commonly sold as Lyrica, is a newer drug now prescribed for nerve pain, epilepsy and fibromyalgia, and it has largely replaced gabapentin.[xii]

The usual dose for people over 12 years old who have epilepsy is 300mg three times a day. This can be increased to 1800mg a day. Doctors prescribe the drug to children with epilepsy based on their body weights.[xiii]

For post-herpetic neuralgia (shingles), the dose is the same as for epilepsy. For adults with restless leg syndrome, the dose is 600mg taken at five o’clock in the evening.[xiv]

Dosages for people with kidney problems may be different than these.[xv]

If you break a gabapentin tablet in order to take just half, you need to use the rest of the pill as your next dosage or else discard it.[xvi]

One unusual aspect of gabapentin is that its bioavailability decreases with the dose.  For example, if you take 900mg, 60% is available to your body, but if you take 4800mg, that drops to only 27%.[xvii]

What are the Side Effects of Gabapentin?

The most common side effects of gabapentin are drowsiness, unsteadiness, sleepiness, loss of coordination, clumsiness, vision changes, and dry mouth.[xviii]  Some people report the following rare side effects:  edema, weight gain, swollen hands and feet, headaches, diarrhea, trouble thinking, abnormal thoughts, suicidal thoughts, fever, ataxia, diplopia, flu symptoms, shortness of breath, chest pain, mouth sores, chills, nausea, coughing, tremor, and other cold symptoms.

If you experience certain symptoms, you should call your doctor immediately because they can be a sign of a serious health condition. These can be black tarry stools, dark urine, tiredness, chest pain, suicidal mood, swollen glands, unusual bruising, rashes, or signs of an infection such as fever, cough and sore throat.[xix]

Children react to gabapentin differently than adults.  They may experience behavioral changes, moodiness, hyperactivity, overly emotional states, and restlessness.[xx]

What Drugs Interact with Gabapentin?

In general, you should not take gabapentin products with medicines that slow down the central nervous system and make you drowsy. These may be anti-histamines, narcotic painkillers, sleeping pills, muscle relaxants, anti-anxiety medications, and drugs for depression and seizures.[xxi] Gabapentin products will react with drugs used during surgeries, even dental procedures.[xxii] Do not take gabapentin products with morphine (Kadian, MS Contin), naproxen (Aleve) or hydrocodone (Lortab, Vicodin).[xxiii]

Drugs containing gabapentin will interact with ketorolac, aluminum carbonate, aluminum hydroxide, aluminum phosphate, dihydroxyaluminum amino acetate, dihydroxyaluminum sodium carbonate, ginkgo, magaldrate, magnesium carbonate, magnesium hydroxide, magnesium trislicate, and morphine sulfate liposome. If you combine gabapentin with tobacco and alcohol and then take certain other drugs, you may cause an unpleasant or difficult reaction.[xxiv]

If you take any common antacids like Maalox and Di-Gel that contain aluminum or magnesium, you need to wait two hours before taking gabapentin.[xxv]

Which People Should not Take Gabapentin?

Gabapentin products have not been determined safe for pregnant or breast-feeding women or children, even though doctors sometimes prescribe it for children with epilepsy.  People with histories of depression, mood or mental disorders, and kidney diseases usually do not take gabapentin because it can make these conditions worse.[xxvi]  These drugs are used with caution for people with liver or heart diseases.[xxvii]

What Lawsuits Have Ensued Over Gabapentin?

At first the United States Food and Drug Administration approved Neurontin for only for epilepsy but by the year 2000, 78% of prescriptions that doctors wrote for Neurontin were for conditions other than seizure disorders. The new drug was widely prescribed “off label” for more than a dozen conditions, including fibromyalgia, nerve pain, migraines, menopausal symptoms, bipolar disorder, and even attention deficit disorder in children.[xxviii] Between 2000 and 2004, Neurontin was generating $1 to $4 billion in sales a year for its manufacturers, which were first Warner-Lambert and later Pfizer drug companies.[xxix]

In 2002, Dr. David Franklin, an employee of Warner-Lambert, went to authorities to report that his company was promoting Neurontin for uses not approved by the FDA. While it is not illegal for doctors to prescribe drugs for unapproved uses, it is illegal for a drug company to advertise and promote them for unapproved uses. [xxx] Dr. Franklin testified that Warner-Lambert paid to doctors to present themselves as authors of studies written by non-doctors employed by the company. He said that the company also paid doctors to speak to other doctors about the off-label uses of Neurontin, and offered physicians expensive retreats and dinners at expensive restaurants to promote the drug.[xxxi]

As criminal and civil lawsuits were filed against the company, more negative information came out. Pfizer had apparently delayed or suppressed publication of studies that were negative or neutral about Neurontin, and exaggerated any positive claims. For example, three double-blind studies showed that Neurontin did not improve the symptoms of bipolar patients any better than sugar pills, but the company manipulated the studies and how symptoms were defined in evaluating the success of Neurontin. Of the 12 studies of the drug’s effect on migraine headaches, two negative ones went unpublished, and some of the positive studies involved only patients who had taken 2400mg or more of the drug.[xxxii] In other studies, patients could easily figure out that they were not in the placebo group, and ordinarily this would have meant that the study could not be published. Company spokespeople denied all the charges, but Pfizer ended up paying out $430 million in claims to states enrolled in the Medicaid program.[xxxiii] In 2011, Judge Patti Saris of the U.S. District Court in Boston ordered Pfizer to pay Kaiser Health $142.1 million for duping the company into prescribing Neurontin for migraines and bipolar disorder.[xxxiv]

In 2004, gabapentin became available as a cheap generic drug,[xxxv] which drastically reduced its value as a money-maker for Pfizer. Pfizer introduced a similar but more potent drug called Lyrica, which was approved by the FDA in December 2004. Lyrica was approved for seizure disorders and pain from fibromyalgia, but it is now prescribed for many other conditions “off-label,” especially all kinds of chronic pain. Today Lyrica ranks 19th among all prescription drugs, and generates more than $3 billion a year for Pfizer.[xxxvi]

What are the Risks of Taking Gabapentin?

Gabapentin doubles the risk for suicidal thoughts and behaviors, but the risk is still low.  In one study of 27,863 patients on Neurontin and 16,029 on a placebo, 0.43% of the ones on the real drug became suicidal compared to 0.24% on the sugar pill.[xxxvii]

Gabapentin has some potential for abuse because it has psychoactive effects.   Once you have been on it for a while, you may experience a difficult withdrawal syndrome when you try to stop taking it.

Gabapentin causes drowsiness and incoordination, which means that you are at an increased risk for accidents, and probably should not drive when you take this medication.[xxxviii]

Gabapentin increases the risk for sudden death after seizures in patients who have epilepsy.  It can cause certain dangerous and sometimes even fatal reactions. Symptoms of this condition can be fever, rash, painful lymph glands in the neck and armpit, unusual bleeding, and yellow eyes and skin.[xxxix] Both of these reactions are extremely rare.

Gabapentin may slightly increase your risk for cancer.[xl]

Does Gabapentin Show up on Urine Tests?

Gabapentin has a half-life of about five to seven hours, which means it should completely clear the body within 38 hours. Standard urine tests do not test for it because it is not a controlled substance.

What is a Gabapentin Overdose?

Symptoms of a gabapentin overdose may be appearing drunk and disoriented, with slurred speech and double vision.[xli]  Such overdoses are very rare.

What is Gabapentin Withdrawal or Discontinuation Syndrome?

When gabapentin was first introduced, scientists believed that it could not cause a withdrawal syndrome.  Since that time, there have been many case studies of people who experienced such difficult symptoms when they tried to stop using the drug that many had to go back on it.  For example, one 81 year old woman with bipolar disorder took Neurontin for five years, and developed severe cold symptoms when she stopped. On the tenth day after stopping Neurontin in a gradual way, she had terrible chest pain, hypertension, and mental changes that were difficult to manage. She was back to normal within one day of taking the drug again.[xlii]

In another case study, a 53-year-old woman vomited a black substance like coffee grounds and developed abdominal pain and black stools after stopping gabapentin.  By days four and five, she developed restlessness, anxiety, agitation, disorientation, confusion, headaches, and extreme sensitivity to light.  When her doctor administered gabapentin again, she was calm and normal within a day.[xliii] Another such study found that a 41-year-old male developed insomnia, headaches, heart palpitations, and excessive sweating after stopping Neurontin, but his symptoms went away when he went back on it.[xliv]

It has now been proven that gabapentin can build up in the body and cause a severe withdrawal syndrome similar to the ones for benzodiazepines and alcohol. The syndrome can last for weeks and even months, depending on the levels you took the drug and for how long you took it.  Symptoms are agitation, confusion, disorientation, sensitivity to light, headaches, heart palpitations, and hypertension, chest pain.  If you were taking gabapentin for epilepsy, your seizures will probably come back.  Some people develop seizures during withdrawal even if they never had one before.[xlv]

What is Gabapentin Addiction?

In theory, gabapentin should not be addictive because it has no affinity for the nerve receptors associated with addictions to marijuana, benzodiazepines or opiates.  It was marketed as non-addictive, but post-marketing studies showed that some people were abusing it.  In the early 2000s, the drug was being sold to thousands of people with sales were over a billion dollars a year.  Some of these patients were asking their doctors to increase their amounts (self-escalation) as they developed physical dependencies on Neurontin.  When they tried to quit, they entered a withdrawal syndrome that caused them to go back to the drug.  The new conclusion about gabapentin, as one expert put it, “The dependence and abuse potential for gabapentin has not been evaluated in human studies.”[xlvi]

The United States Drug Enforcement Agency does not list gabapentin as a drug of concern, even though it is being sold on the Internet illegally. Its street name is “morontin” because it makes you “dopey.”

What Treatments are Available for Gabapentin Addiction?

Because the withdrawal syndrome for this drug can produce unpleasant and even dangerous symptoms, you need to consult your doctor or an addiction specialist at a drug rehabilitation clinic about how you can safely stop taking the drug. The usual method is to wean a patient from the drug by gradually lowering the dosage, but this does not always prevent the withdrawal syndrome.[xlvii]  If you have tried unsuccessfully to quit taking gabapentin, you should seek professional help.

The state-of-the-art treatment for drug addiction is to enter a residential treatment center where your withdrawal can be done under medical supervision.  If you are addicted to other drugs or alcohol as well as gabapentin, your detoxification process will become even more complicated.

Once you have completed detoxification and your body is completely clear of drugs, you need to remain at the center for a few weeks or more so that you can undergo therapy to learn to live a drug-free life.  You will work one-on-one with a therapist who can help you with any psychological problems you may have that contribute to your drug abuse.  You may learn how to deal stress through non-pharmaceutical means such as running or other sports, yoga, meditation, journaling and so forth.  You may have classes in the chemistry of drugs and why they can get such a hold on people’s lives.  You will learn how to avoid relapsing into drug abuse or alcoholism, even if you have a genetic tendency or long family history of such problems.  Most drug rehab programs offer activities that are fun to do as well as ways of self-exploration, such as social gatherings, sightseeing, outdoor sports, and participating in art, drama and music. Once you return home, you usually remain in support meetings in your community and in individual and family counseling to help you stay on track.

How Can I Tell if I am Addicted to Gabapentin?

If you can answer yes to any of these questions, you may want to consider talking to your family physician or an addiction specialist at a residential treatment center about your concerns with gabapentin.

Are you taking gabapentin without a doctor’s prescription? Do you ask your doctor to keep increasing your dose?Do you buy gabapentin from the Internet or other illegal sources? Do you experience withdrawal symptoms when you stop taking gabapentin? Have you tried to quit taking gabapentin on your own but failed? Do you consider yourself to be someone who abuses drugs or alcohol?Do you use gabapentin along with alcohol or other drugs as a way of treating emotional pain? Are you taking gabapentin even though you experience unpleasant side effects and even though you are unsure if it is effective for you? If money were no object, would you enter an intense program to help you deal with drug problems? Do your friends or family members criticize you because of your drug abuse? Do you feel guilty about how you use drugs? Are you trying to cut down on your use of gabapentin or other drugs?

[i]  Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

[ii] Peterson, Melody. “Whistle-Blower Says Marketers Broke the Rules To Push a Drug,” The New York Times, March 14, 2002; and Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[iii] “Pfizer Told to Pay $142.1 Million Over Marketing of Epilepsy Drug,” New York Times, January 28, 2011.

[iv] “U.S. Pharmaceutical Sales  2013,” The United States Food and Drug Administration, see http://www.drugs.com/stats/top100/2013/q1/sales

[v] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[vi] Hellwig, T., Hammerquist, R., & Termaat, J. (2010). Withdrawal symptoms after gabapentin discontinuation. American Journal of Health-System Pharmacy, 67(11), 910-912.

[vii] See articles on FDA approvals and clinical trials of Gabapentin at Center Watch, http://www.centerwatch.com/

[viii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[ix] Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

[x] Mack, Alicia (Ph Pharm). Examination of the Off Label Uses of Gabapentin, The Academy of Managed Care Pharmacy,  see http://www.amcp.org/data/jmcp/Contemporary%20Subject-559-568.pdf

[xi] Peterson, Melody. “Whistle-Blower Says Marketers Broke the Rules To Push a Drug,” The New York Times, March 14, 2002; and Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xiii] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xiv] Ibid, see also “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xv] Ibid.

[xvi] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xvii] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xviii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709. See also “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xix] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xx] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xxi] “Gabapentin,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/gabapentin.html

[xxii] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xxiii] “Gabapentin,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/gabapentin.html

[xxiv] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xxv] Ibid.

[xxvi] Ibid.

[xxvii] “Gabapentin,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/gabapentin.html

[xxviii] Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xxix] Ibid.

[xxx] Peterson, Melody. “Whistle-Blower Says Marketers Broke the Rules To Push a Drug,” The New York Times, March 14, 2002.

[xxxi] Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xxxii] “Pfizer’s Headache,” Newsweek Magazine, October 7, 2008.

[xxxiii] Winstein, K. J.  “Suit alleges Pfizer spun unfavorable drug studies.” Wall Street Journal. October 8, 2008.

[xxxiv] “Pfizer Told to Pay $142.1 Million Over Marketing of Epilepsy Drug,” New York Times, January 28, 2011.

[xxxv] Saul, Stephanie, “Experts Conclude Pfizer Manipulated Studies,” the New York Times, October 8, 2008.

[xxxvi] “U.S. Pharmaceutical Sales  2013,” The United States Food and Drug Administration, see http://www.drugs.com/stats/top100/2013/q1/sales

[xxxvii] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xxxviii] “Neurontin (Gabapentin),” The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR600709

[xxxix]Ibid.

[xl] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xli] “Gabapentin,” Medline, Information from the National Institutes of Health, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

[xlii] Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

[xliii] Hellwig, T., Hammerquist, R., & Termaat, J. (2010). Withdrawal symptoms after gabapentin discontinuation. American Journal of Health-System Pharmacy, 67(11), 910-912.

[xliv] Finch, C., Eason, J., & Usery, J. (2010). Gabapentin Withdrawal Syndrome in a Post–Liver Transplant Patient. Journal of Pain & Palliative Care Pharmacotherapy, 24(3), 236-238.

[xlv] “Neurontin,” the RX List, see http://www.rxlist.com/neurontin-drug.htm

[xlvi] Ibid.

[xlvii] Tran, K. T., Hranicky, D., Lark, T., & Jacob, N. J. (2005). Gabapentin withdrawal syndrome in the presence of a taper. Bipolar Disorders, 7(3), 302-304.

Original Article

Rexi’s Kitty Is Addicted To The Sting!

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Each time I see Kitty checking out my blog I joke silently to myself that she must be addicted to the sting. Well, a fan is a fan, I’m perfectly fine with it. Speaking of which, weren’t y’all supposed to send me pictures of your computer with my blog pulled up? What happened? Y’all ain’t skeered are ya?

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What is Internet Addiction Disorder (IAD)?

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What is Internet Addiction Disorder (IAD)?

  • What “Internet addiction disorder” (IAD) is still difficult to define at this time.  Much of the original research was based upon the weakest type of research methodology,  namely exploratory surveys with no clear hypothesis or rationale backing them. Coming  from an a theoretical approach has some benefits, but also is not typically recognized  as being a strong way to approach a new disorder. More recent research has expanded  upon the original surveys and anecdotal case study reports. However, as I will illustrate  below later, even these studies don’t support the conclusions the authors claim.
  • The original research into this disorder began with   exploratory surveys, which cannot establish causal relationships between specific behaviors and their cause. While surveys can help establish descriptions of how people feel about themselves and their behaviors, they cannot draw conclusions about whether a specific technology, such as the Internet, has actually caused those behaviors. Those conclusions that are drawn are purely speculative and subjective  made by the researchers themselves. Researchers have a name for this logical fallacy,  ignoring a common cause. It’s one of the oldest fallacies in science, and one still regularly perpetrated in  psychological research today.
  • Do some people have problems with spending too much time online? Sure they do. Some people also spend too much time reading, watching television, and working, and ignore family, friendships, and social activities. But do we have TV addiction disorder, book addiction, and work addiction being suggested as legitimate mental disorders in the same category as schizophrenia and depression? I think not. It’s the tendency of some mental health professionals and researchers to want to label everything they see as potentially harmful with a new diagnostic category. Unfortunately, this causes more harm than it helps people. (The road to “discovering” IAD is filled with many logical fallacies, not the least of which is the confusion between cause and effect.)
  • What most people online who think they are addicted are probably suffering from is the desire to not want to deal with other problems in their lives. Those problems may be a mental disorder (depression, anxiety, etc.), a serious health problem or disability, or a relationship problem. It is no different than turning on the TV so you won’t have to talk to your spouse, or going “out with the boys” for a few drinks so you don’t have to spend time at home. Nothing is different except the modality.
  • What some very few people who spend time online  without any other problems present may suffer from is compulsive over-use. Compulsive behaviors, however, are already covered by existing diagnostic categories and treatment would be similar. It’s not the technology (whether it be the Internet, a book, the telephone, or the television) that is important or addicting — it’s the behavior. And behaviors are easily treatable by traditional cognitive-behavior techniques in psychotherapy.
  • Case studies, the alternative to surveys used for many conclusions drawn about online overuse, are just as problematic. How can we really draw any reasonable conclusions about millions of people online based upon one or two case studies? Yet media stories, and some researchers, covering this issue usually use a case study to help “illustrate” the problem. All a case study does is influence our emotional reactions to the issue; it does nothing to help us further understand the actual problem and the many potential explanations for it. Case studies on an issue like this are usually a red flag that help frame the issue in an emotional light, leaving hard, scientific data out of the picture. It is a common diversionary tactic.

Why Does the Research Leave Something to Be Desired?

  • Well, the obvious answer is that many of the original researchers into the phenomenon known as IAD were actually clinicians who decided to conduct a survey. Usually doctoral training is sufficient to create and test a survey, yet the psychometric properties of these surveys are never released. (Perhaps because they were never conducted in the first place? We simply do not know.)
  • The obvious confounds are never controlled for in most of these surveys. Questions about pre-existing or a history of mental disorders (e.g., depression, anxiety), health problems or disabilities, or relationship problems are absent from these surveys. Since this is one of the most obvious alternative explanations for some of the data being obtained (for example, see Storm King’s article, Is the Internet  Addictive, or Are Addicts Using the Internet? below), it is very surprising these questions are left off. It taints all the data and make the data virtually useless.
  • Other factors are simply not controlled for. The current Internet population is nearly 50/50 in terms of proportion of men to women. Yet people are still drawing conclusions about this same group of people based upon survey samples that have 70-80% men, comprised mostly of  white Americans. Researchers barely mention these discrepancies, all of which will again skew the results.
  • Research done in a particular area should also agree about certain very basic things after a time. Years have gone by and there are more than a few studies out there looking at Internet addiction. Yet none of them agree on a single definition for this problem, and all of them vary widely in their reported results of how much time an “addict” spends online. If they can’t even get these basics down, it is not surprising the research quality still suffers.
  • More research has been done since the original surveys were released in 1996. This newer research has been conducted by more independent researchers with clearer hypotheses and stronger, less biased population sets.  More about these studies will be discussed in updates to this article.

Where Did It Come From?

  • Good question. It came from, believe it or not, the criteria for pathological gambling, a single, anti-social behavior that has very little social redeeming value. Researchers in this area believe they can simply copy this criteria and apply it to the hundreds of behaviors carried out everyday on the Internet, a largely pro-social, interactive, and information-driven medium. Do these two dissimilar areas have much in common beyond their face value? I don’t see it.
  • I don’t know of any other disorder currently being researched where the researchers, showing all the originality of a trash romance novel writer, simply “borrowed” the diagnostic symptom criteria for an unrelated disorder, made a few changes, and declared the existence of a new disorder. If this sounds absurd, it’s because it is.
  • And this speaks to the larger problem these researchers grapple with… Most have no theory driving their assumptions (see Walther, 1999 for a further discussion of this issue). They see a client in pain (and in fact, I’ve sat in many presentations by these clinicians where they start it off with just such an example), and figure, “Hey, the Internet caused this pain. I’m going to go out and study what makes this possible on the Internet.” There’s no theory (well, sometimes there’s theory after-the-fact), and while some quasi-theoretical explanations are slowly emerging, it is putting the chicken far before the egg.

Do You Spend Too Much Time Online?

  • In relation to what or whom? Time alone cannot be an indicator of being addicted or engaging in compulsive behavior. Time must be taken in context with other factors, such as whether you’re a college student (who, as a whole, proportionally spend a greater amount of time online), whether it’s a part of your job, whether you have any pre-existing conditions (such as another mental disorder; a person with depression is more likely to spend more time online than someone who doesn’t, for instance, often in a virtual support group environment), whether you have problems or issues in your life which may be causing you to spend more time online (e.g., using it to “get away” from life’s problems, a bad marriage, difficult social relations), etc.  So talking about whether you spend too much time online without this important context is useless.

What Makes the Internet So Addictive?

  • Well, as I have shown above, the research is exploratory at this time, so suppositions such as what makes the Internet so “addictive” are no better than guesses.  Since other researchers online have made their guesses known, here are mine.
  • Since the aspects of the Internet where people are spending the greatest amount of time online have to do with social interactions, it would appear that socialization is what makes the Internet so “addicting.” That’s right — plain old hanging out with other people and talking with them. Whether it’s via e-mail, a discussion forum, chat, or a game online (such as a MUD), people are spending this time exchanging information, support, and chit-chat with other people like themselves.
  • Would we ever characterize any time spent in the real world with friends as “addicting?” Of course not. Teenagers talk on the phone for hours on end, with people they see everyday! Do we say they are addicted to the telephone? Of course not. People lose hours at a time, immersed in a book, ignoring friends and family, and often not even picking up the phone when it rings. Do we say they are addicted to the book? Of course not. If some clinicians and researchers are now going to start defining addiction as social interactions, then every real-world social relationship I have is an addictive one.
  • Socializing — talking — is a very “addictive” behavior, if one applies the same criteria to it as researchers looking at Internet addiction do. Does the fact that we’re now socializing with the help of some technology (can you say, “telephone”?) change the basic process of socialization? Perhaps, a bit. But not so significantly as to warrant a disorder. Checking e-mail, as Greenfield claims, is not the same as pulling a slot-machine’s handle. One is social seeking behavior, the other is reward seeking behavior. They are two very different things, as any behaviorist will tell you. It’s too bad the researchers can’t make this differentiation, because it shows a significant lack of understanding of basic behavioral theory.

What Do I Do If I Think I Have It?

  • First, don’t panic. Second, just because there is a debate about the validity of this diagnostic category amongst professionals doesn’t mean there isn’t help for it. In fact, as I mentioned earlier, help is readily available for this problem without needing to create all this hoopla about a new diagnosis.
  • If you have a life problem, or are grappling with a disorder such as depression, seek professional treatment for it. Once you admit and address the problem, other pieces of your life will fall back into place.
  • Psychologists have studied compulsive behaviors and their treatments for years now, and nearly any well-trained mental health professional will be able to help you learn to slowly curve the time spent online, and address the problems or concerns in your life that may have contributed to your online overuse, or were caused by it. No need for a specialist or an online support group.

In Conclusion…………………………….

This information was forwarded to me by my daughter who is a double Bachelors in Engineering candidate attending college as we speak. One of her elective classes offered a free writing essay for their final exam grade. A grade with is 65% of their overall grade. My daughter chose to write about the theory of Internet Addiction and chose this article by John M. Grohol, Psy.D. as her launching point for her research. Why did she send me this article to read? Probably because I tell her that she spends too damn much time on the internet and the fact the we talk about disabilities every once in a while because there is so much bullshit out there called a disability. I believe this is my daughter’s attempt to humor me, she didn’t say exactly. Funny enough is the fact that she sent it to me but I had sent her the picture below just a few days ago because eventhough she has unlimited data usage on her cell phone plan, she is always taking “Free Wi-Fi ” into consideration when heading out.

What do you, the reader on the internet right now, think about studying internet addiction?

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Is being an alcoholic a disability?

Did y’all know that being an alcoholic is a “disability” which is both covered and protected by the Americans with Disabilities Act? Included in this post will be, but not limited to, information, links, and my opinions on this little factoid. When did being an alcoholic become a disability? When did being an alcoholic become a disease? I have news for y’all, being an alcoholic is neither a disability or disease. For example, one can quit drinking, but one can not quit having MS or CF. I found that reading at the Americans with Disabilities Act website that the definitions of terms are very screwed up. In fact, I challenge y’all to to look up four words, for fun of course, and then review how they are applied in the Americans with Disabilities Act. The four words are Disability, Disease, Alcoholic, and Addiction. Meanwhile, let me continue. Consuming alcohol is a choice a person makes. Stopping the consumption of alcohol is as well a choice.

 
This seems to be a very blurred subject when it comes to employment, benifits, and a person living their life. Unfortunately, as we see everyday, we tend to pay for the mistakes made by people making bad choices. Alcoholism is an addiction, it is a choice, it is a matter of a person’s will power, and that doesn’t make it a disability or disease. Makes no sense to me that an alcolholic is considered sick, he/she is not sick, he/she has an addiction to alcohol. Let me give you an example taken from the ADA questions and answers page. Click the “ADA” for an entire list of questions and answers.
 
Q. Are alcoholics covered by the ADA?
A. Yes. While a current illegal user of drugs is not protected by the ADA if an employer acts on the basis of such use,a person who currently uses alcohol is not automatically denied protection. An alcoholic is a person with a disability and is protected by the ADA if s/he is qualified to perform the essential functions of the job. An employer may be required to provide an accommodation to an alcoholic. However,an employer can discipline,discharge or deny employment to an alcoholic whose use of alcohol adversely affects job performance or conduct. An employer also may prohibit the use of alcohol in the workplace and can require that employees not be under the influence of alcohol.

I tend to look at the choices we make in life as being similar to choices we would make while playing a game of chess. Each move in chess is a choice, each choice has a consequence, and in turn each time we make a choice, good or bad, we have determined what the outcome will be in advance. The non-chess players are now scratching their head. Just in case one or all of y’all are curious to what brought this up with me today, let me take a minute to explain. I was listening to the radio and one of the commercials boasted information in reference to lawsuits based on the discrimination of alcoholics in the workplace, either being hired or grounds for dismissal. The advertisement went on to explain it was in violation of the ADA and that lawfirm was there to help. Needless to say, it pissed me off just a tad. It pissed me off enough to do some research on my own.

In case you are wondering, yes I do have family members and friends who are “classified” as alcoholics. I have had the exact same conversation with them as well, I have explained to them they do not have a disease, they have an addiction. I can’t say much about a person’s addictions, I have my own since I make the choice every day to light just one more cigarette. Maybe they should make smoking a “disease” and then I wont have to go out in the rain to smoke. Seriously. Speaking of which, I am being very serious here, I am not making light of someone being an alcoholic. Trust me when I say I fought my own demons of self control not too many years ago. I used to be a heavy drinker, even could be considered an alcoholic, and one day I made a choice. My choice? My choice was to stop drinking. Why? Because I was tired of waking up sick every morning. I was tired of throwing money into the bottle. I was done. Hence, I wanted to quit. Therefore, I made the choice to quit and uphold my decision. Yes I know, what happens with one person is not the blanket answer to everyone’s problems. But, I do know, that making the choice to stop drinking is still just that, its a choice.