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  1. Alfa
    Mental illness linked to cigarette addiction

    Posted: July 15, 2008

    Dr. R. Andrew Chambers is an assistant professor of psychiatry at the Indiana University School of Medicine.

    Question: Do mental illnesses and cigarette addiction go hand in hand?

    Answer: That's correct. One recent study documents that up to 50 percent of cigarettes are smoked by people with some form of mental illness. This includes schizophrenia, bipolar disorder, major depression, anxiety disorders, post-traumatic stress disorder, borderline personality disorder.

    In the general population, the smoking rate is between 20 and 25 percent, depending on where you live. In schizophrenia, the smoking rate is 75 to 90 percent. Alcoholism is about 80 percent. Bipolar disorder is 60 to 70 percent, and major depression is 40 to 50 percent.

    Q: Why is there a link between smoking and nicotine addiction?

    A: The traditional theory is that people are self-medicating and they're receiving some kind of benefit from the nicotine. There is evidence out there that nicotine in certain circumstances does have cognitive-enhancing effects or might be a modulator of mood or anxiety.

    Another theory is that people with mental illness are more susceptible to the disease of addiction. There's quite good evidence for that because you also see addictions with many other drugs, such as cannabis, cocaine and alcohol. It may be that nicotine is just a not-so-unique example of a broader picture.

    There's a third cutting-edge perspective that nicotine can change the brain, especially in adolescents. In 90 percent of smokers, smoking begins between 15 and 25, when the brain is undergoing a lot of changes. Nicotine exposure in that period can change the brain chemistry in a way that may make you more susceptible to mental illness.

    Q: So are different smoking cessation methods recommended for the mentally ill?

    A: That is being looked at. Self-medication is the most popular theory, but ironically the least validated. If you label it self-medication, the label does not acknowledge that they're addicted, and when clinicians go along with that, they're sort of rationalizing the drug use.

    The cultures of mental health care and addiction-ology are segregated. That creates huge problems. Most of our patients who need mental health care have an addiction of some kind. Yet we have an amazing inability to effectively treat those addictions.

    Chantix, the newest drug for smoking addiction, appears to be very effective. When that drug was developed, the trials excluded people with mental illness. It got approved and the drug shows efficacy, but now we're finding out this drug has all kinds of implications for people with mental illness.

    What I'm arguing for is for psychiatrists to be trained in addiction. But that's a long way off.

    http://www.indystar.com/apps/pbcs.dll/article?AID=/20080715/LIVING25/807150313/1300/LIVING25

Comments

  1. stoneinfocus
    Nicotine also induces CYP3A4 enzymatic pathways, so that butyrophenone neuroleptics are faster metabolized and I don't know of anyone who likes this sort of medication.
    Also, nicotine, as the short Dopamine-push it provides, might be used for learning and therefor by intelligent people, e.g. Wernherr von Braun or others, who where heavy smkokers, among with the widespread use of cigarettes in the general population, this is some far-fetched statement, that had to be validated, among any other thesis of psychiatry, like genetic predeposition, etc. , it's just all more assumption, than science, much more, than in any other medical field. Sounds like penis-envy from sides of the psychiatrist, imho.

    and -to add a little more to those speculation, what were the consequences of takin' this (smoking as a co-morbidity to mental illness) as a, more-or-less, valid assumption?

    I. It was just another far-fetched symptom to validate a maybe far-fetched illness, and even a very often found habit in the general public.

    II. Smoking cigarettes is something legal to do, so they don't have to rely on illegal activities, like smoking cannabis was illegal and going about an legal issue was itself a sign of mental illness, along with some mind-alterning effect.

    Conclusion: Taken together, those approaches to validify mental deseases are becoming more and more a danger to the civil rights of selfdetermination and the uniqueness of an individuum in its right to differ from the mainstream; the practice of psychiatry and psychology are such, that, already, it's very easy to diagnose nearly any human with a mental desease; and all that, on grounds of half-assed assessments of individual habits, that might fail to relate those habits to the lifestyle and forcing enviromental causes, which led the individuum take-on to those habits, to compensate for its own lifestyle in this society and the sanity's sake of its nature in it.

    What's next? -excessive sporting, which is not soccer? Being not obese? Being without a job? Not drinkiong red wine every forthnight? Selfmedication? Society is approaching the latter conclusions, thanks to psychiatry, in huge steps and it's us all to see the inevitable danger, that emerges from the "issue" psychiatry and its ways of diagnosing.

    The worst thing one can do to a human life, imho, is commanding societies' institutions to help humans, when there's absolutely nothing to "help," on basis of numerous half-validated symptoms, in the delusion the mere flood of questionable diagnostic sings were making them more valid and trustworthier, but which are all far away from the duty of very exact conventional scientific validation, which are only valid when the very same results have been achieved by any other scientific third party around the world under the same conditions.
    (Ever heard i.e. Shulgin, stating; "the meltingpoint is 15°C off, but I declare it's the correct substance, because other signs are just the same measure off, like those 15° in m.p.?)
    The line between helping and dictature becomes then non-existant.
  2. ShawnD
    Looks like another bullshit article from a doctor who sucks at being a doctor.

    Is this even a real question? Asking why smoking leads to a nicotine addiction? Come on, we're told in elementary school why smoking is addictive.

    And the sky is blue, you say? Let's check to see if random internet people already knew this. wiki - nicotine
    Fascinating.

    Oh, so when people are addicted to the dopamine from cocaine and amphetamine, that's actually the same as dopamine associated with nicotine? And you say that mentally ill people are more interested in drugs? I'm absolutely shocked. Let's check if the internet already knew this. wiki - bipolar disorder
    Damn, the internet is now 2/2. Doctor is 0/2.

    oh mah gawd, wait until I tell the internet about this! wiki - nicotine
    You mean neurotoxins damage the brain? Holy crap why doesn't med school teach this??? Oh, right, they do. He just didn't feel it was important to actually listen to what the lecturer was saying.

    Fact: No.
    wiki - bupropion (Wellbutrin)
    So not only is this widely known in the research field, but it's widely known by GP's and psychiatrists who are writing these 20 million prescriptions.

    Worst statement in the history of the world. Prescription medications that "medicate" often have a warning about drug dependence or "addiction". To say that the two are thought of as mutually exclusive is beyond stupid since drug labels themselves contradict that train of thought.

    Even a 5 year old can figure out that the addiction will not go away until the mental illness itself is treated. This is why Wellbutrin (antidepressant) is given out to overcome smoking addictions; treating the underlying depression (relating to dopamine) will ease the "drug-seeking behavior" (google that term). This is also why partial dopamine agonists are being looked at in the treatment of cocaine and amphetamine addictions.


    Terrible article: 0/10
  3. sarbanes
    You always hear those in the state loony bin are chronic smokers. Many a man doing the "Thorazine Shuffle" will have hands stained from cigarette smoke. Perhaps (because) it is one of the few vice allowed them (alcohol certainly not allowed). Just like in NA meeting, it is the one thing allowed. Maybe that factors into the association as well, but more on an environmental level.
  4. Expat98
    You know what I like about this interview? The guy makes a completely ludicrous statement at the very beginning of it. Saves me from wasting my time reading the whole thing!

    On second thought, I guess professional psychologists have defined so many types of mental illnesses and have defined them so broadly that easily 50% or more of the general population can be considered to have "some form of mental illness". So he may in fact be technically correct, but in this case, it's a meaningless statement.
  5. ShawnD
    psychtruth - are you normal?

    That asshole in the video blocked me because I kept calling him out on his bullshit, but he has a point in this one.
  6. lostmente
    anyone been to a public psyche ward here? swim has been once...upwards of 80% of patients were smokers...when they were able to that is

    lostmente added 9 Minutes and 11 Seconds later...

    having a form of mental illness requires diagnosis, this requires doing something to get a diagnosis (either forced or voluntary..)

    granted the number of people put on SSRI's is outrageous...it certainly works...but mostly in a capacity sense so its up to the patient to work with that new capacity...if they fill it with the same bullshit that got them there in the first place then yeah it becomes systemic
  7. enquirewithin
    Obviously, according to this research, if you smoke cigarettes, you are 50% more likely to become psychotic.
  8. lostmente
    when was it new news that psychoactives can cause structural changes in the key periods of neurological development.
    SWIMSSA
  9. stoneinfocus
    And it (nicotine) makes thorazine go out of your system quicker ;-)
  10. ShawnD
    Come to think of it, my friend, who was a bouncer at a night club, did say something to the effect of "all smokers are heat bags". By that he meant that people smoking outside of the club were always sketchy people that one would expect to cause trouble or be loud and obnoxious. Mental illness would sure explain his observations.
  11. ShawnD
    I stumbled across an article that was too funny not to share, and it sort of relates to this!

    Encyclopedia Dramatica - Abnormal Psychology
    It's supposed to be a joke, but it's actually somewhat true how these labels get started. Own an iPod? You might have Apple Fanboy Personality Disorder. This increases your risk of smoking addiction by over 9000% :p
  12. some_random_guy
    Interesting find/read man thanks.
  13. bcubed
    Yes, I have. I'll back up the statements about the prevalence of smoking. As someone who had zero interest in smoking anything they'd allow into a psych ward, I felt I was at an advantage...the staff (mostly RNs) had a real "hook" into the smokers, as 1. There was no smoking on ward and 2. You needed their blessing to obtian the "privleges" necessary to leave the ward.

    Note this:
    And this:
    Note the reflexive (and most likely unconscious) view of the "official" drug (i.e prescription) as begnign and an unqualified benefit, and the "unofficial" drug as a wreaker of mental havoc. I've seen this firsthand: when describing withdrawing from Seroquel (Quetiapine) in solitary in jail, I (smart-assedly) said "Sorry, doc--I meant to say 'rebound.' 'Drugs' cause 'addiction' and one 'suffers withdrawl'; 'medications' lead to 'tolerance' and one might 'experience rebound!'

    Not so much as a smirk--he truly believed what I threw out as a joke! There might be exceptions, but MDs, as a class, are almost incapable of self-critical reflection, esp. whan the person asking that they do so lacks an MD himself.
  14. Mr. Giraffe
    Makes sense to me that cig smokers are self-medicating in the same way mentally ill cannabis smokers are. Nicotine does have cognitive benefits and anecdotal evidence suggests that schizophrenics find it helpful.

    I notice that doctors and researchers seem to have become more eager to prostitute their professional reputations to sensationalist claims about drugs. I can only assume that they believe we are so stupid that we need to have the truth simplified, exaggerated and then spoon-fed to us in unequivocal headlines.
  15. stoneinfocus
    Which is a kind of flawed itself, isn't dopamine supposed to exaggerate the symptoms of mental illnesses, like shizophrenia, so actually one had to say cigarette smoking causes mental illnesses?

    *LMAO* at Mr. Giraffe, bcubed and ShawnD :D

    stoneinfocus added 11 Minutes and 14 Seconds later...

    Smoking is some form of self-hatred drug use, -you know it's damaging, your first cigarette makes your knees weak, it's bad, you get a bad breath and are coughing all the time, miore likely to get any other infections... so this could well be a metaphor for some social hate those people had to bear and are expressing it this way.
  16. cra$h
    obviously there's going to be a link. Cigarettes are used as a quick way to relax, and anyone who's going to have some kind of anxiaty, is going to be prone to the quick fix smoking gives. It's really not that scientific.
  17. Richard_smoker
    Apparently, this is the gist of what some researchers from Toronto, published in the Journal of Molecular Psychiatry:

  18. ShawnD
    Are those the most retarded researchers on the planet, or are they just not aware of how humans behave?

    Most people take drugs until they reach a certain level of satisfaction, such as me drinking 2 beers, or a friend smoking 1 cigarette. Drinking 10 beers would be too many, and smoking 5 cigarettes would be too many. People with clinical depression will need more drugs to get the same level of satisfaction, such as alcoholics, cocaine addicts, chain smokers, etc. When someone is given dopamine antagonizing drugs, it will obviously take a lot more drugs to get the same reward from a dopamine boosting activity. For a schizophrenic taking Seroquel, this means smoking 5 cigarettes at once instead of just 1.

    If you want more information about how this works, try googling things that are related to depression, drug abuse, or alcoholism; use those specific terms.
  19. msmogadon
    SWIMs a psychiatric nurse and can vouch for this, perhaps more even than 80%. SWIM has also been a patient in a psych ward and is a non-smoker. She started smoking roll ups as she wanted a joint to chill but had no access to weed at the time. There was also NOTHING to do all day so at least this was SOMETHING to do.
  20. Richard_smoker
    shawnD, that's not what they're referring to...sorry, I took the liberty to edit down the actual article, but I did so, apparently, at the expense of the article's content.

    I'll have to find the original to re-quote exactly, but what the researchers found is that cigarette smoking has both POSITIVE effects (rewards) and NEGATIVE effects, mentally...their hypothesis was, essentially, that in people who take anti-psychotics (anti-dopamine drugs), the effect with regard to cigarette smoking is that the NEGATIVE effects of nicotine were BLOCKED!!!

    See??

    I'm not sure about the validity of this conclusion...but I do know that there is definitely a known association between the looney-bin and cigarettes...

    MY APOLOGY IN ADVANCE FOR QUOTING HERESAY-->i know a nurse practitioner who SWEARS that nicotine is a self-medication tool that allows schizophrenics to regulate their own dopamine excess...i don't know the exact mechanism, but maybe it was MAGIC! no. seriously...we should look this up.
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