The Ghost in the Addict

by Siegel, Shepard

• ISBN13: 9780262547970
• ISBN10: 026254797X
• Format: Paperback
• Copyright: 2024-03-05
• Publisher: The MIT Press

Summary

How withdrawal distress and cravings can haunt current and former addicts, and what they can teach us about addiction and its treatments.

“The dead drug leaves a ghost behind. At certain hours it haunts the house,” Jean Cocteau once wrote. In The Ghost in the Addict, Shepard Siegel offers a Pavlovian analysis of drug use. Chronic drug use, he explains, conditions users to have an anticipatory homeostatic correction, which protects the addict from overdose. This drug-preparatory response, elicited by drug-paired cues, is often mislabeled a “withdrawal response.” The withdrawal response, however, is not due to the baneful effects of previous drug administrations; rather, it is due to the body’s preparation for the next drug administration—a preparatory response that can haunt addicts like a ghost long after they have conquered their usage.

Examining the failure of legislation, the circumstances of overdose, and the cues that promote drug use, Siegel seeks to counter the widespread belief that addiction is evidence of a pathology. Instead, he proposes that the addict has an adaptive, learned response to the physiological changes wrought by drug use. It is only through understanding so-called withdrawal symptoms as a Pavlovian response, he explains, that we can begin to understand why addicts experience cravings long after their last drug use.

Author Biography

Shepard Siegel is Distinguished University Professor of Psychology, Neuroscience, and Behavior at McMaster University. He has been a Fellow in the American Psychological Association, the Society of Experimental Psychologists, and the Royal Society of Canada. From 2003 to 2008 he was Editor of Learning & Behavior.

Table of Contents

CONTENTS
Preface and Acknowledgments ix

1 The Haunting of the Addict 1
2 The Failure of Legislation 5
3 The Heroin Overdose Mystery 11
4 Why Addicts Usually Don’t Overdose 25
5 Why Addicts Sometimes Overdose: Opiate Expectancy and Effects 31
6 Ivan P. Pavlov, Walter B. Cannon, and Homeostasis 43
7 Learning and Drug Tolerance 49
8 Alcohol Expectancy and Alcohol’s Effect 57
9 Victimized by Pavlovian Conditioning 67
10 The Geographic Cure 81
11 Expected and Unexpected Drugs 95
12 Evocative Effects of a Small Drug Dose 107
13 Images, Cognitions, and Emotions as Cues For Drugs 113
14 Problems with Treating Addiction 117
15 The Special Case of Cigarettes 127
16 Why Doesn’t Everyone Become an Addict? 131

17 Does Addiction Result in Brain Damage? 137
18 To Be Addicted 143

Notes 147
Index 175