You know you’re an addict if…

Most smokers refuse to believe that they’re addicts. Often because they haven’t been arrested for using tobacco, have never stolen tobacco, haven’t gotten into fights over tobacco, etc.

Tobacco isn’t heroin, so you’re not “really” an “addict” if you’re addicted to it — the thinking goes.

I thought it might be interesting to post a partial list of some of the symptoms of addiction.

Go through the list and see how many you have. Any one who has three or more of these is probably addicted to the substance in question. The higher the number that they admit to, the more likely it is that they’re addicted.

how-to-make-greek-coffee

When making Greek coffee, you mix the pulverized coffee grains directly into the hot water, boil it 3 times, then serve it all together – no straining.

  • Feelings (or cravings) that you have to use the drug regularly. Need to have it first thing in the morning, after meals, when stressed, to relax.
  • You suffer symptoms if you go too long without the drug. You get jittery, have difficulty sleeping, shaking, irritability, headache.
  • You’ve failed in your attempt to stop using the substance.
  • You make certain that you maintain a supply of the drug.
  • You spend money on the drug, even though you may have difficulty affording it.
  • Feeling that you need the drug to deal with problems, stressors.
  • Continuing to use the drug in spite of negative consequences. Increased risk of many types of cancer (not just lung cancer). Mouth, throat, tracheal, bladder, pancreatic cancers and others. Increased risk of heart attack and stroke. Emphysema, chronic cough, bronchitis.
  • Continuing to use it in spite of negative consequences to family and friends. Dangers of second-hand smoke to others (cancer risk, bronchitis, etc), provoking allergies, asthma, etc.
  • Using the drug in areas where you know that it is prohibited (non-smoking areas, bathrooms, hospitals, and for some, airplanes).
  • Leaving social functions, meetings, etc. to use the drug.
  • Ignoring warnings from others that they are concerned about you, concernd about your health.
  • Minimizing scientific evidence that this behavior is addictive, and that it can have serious health consequences and other negative effects.
  • Denying that one is an addict in spite of all of the above evidence.

Obviously, the above list would be somewhat different if we were talking about, for example, alcohol. In that case, we’d ask if someone has ever driven under the influence, lost a driver’s license for a DUI, committed some other crime while under the influence, etc.  Though, some would be the same.

There are several lists available to see if someone is addicted. They vary somewhat from author to author. Some are based on studies others on personal experiences with addicts.

Speaking of alcohol, a simple list to check for alcoholism (only) is the CAGE questionnaire:

Please answer ALL the questions

1. Have you ever felt you needed to Cut down on your drinking?

2. Have people Annoyed you by criticizing your drinking?

3. Have you ever felt Guilty about drinking?

4. Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

There are several others for alcoholism, and somewhat different ones for addiction.

And here is a fairly general one that covers both addiction and alcoholism. Not all of the questions would fit in with a smoking addiction.

John reported back to me, when editing this story, that he came scored a “5″ on the addiction checklist I posted at the top (regardig “coffee”).  How about you? Any addictions on which you score a 3 or above?


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Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • ComradeRutherford

    Funny, I drink coffee almost every day, and none of that list applies to me. Unlike some, I do fine first thing in the AM without coffee. I have no ill effects if I go without it for days and days. I can drink a pint of expresso and go to sleep within an hour…

  • lucyboots

    ARGHHHH I don’t even drink coffee, but every time I see that picture I want to go buy a cup!

  • Silver_Witch

    Perfectly said Naja!!

  • Silver_Witch

    I totally understand that concept. My sister, is addicted to pain medication – simply because she has chronic illness. She needs the medication to function and is treated like an addict by her doctors – because she is really. There is no shame in taking medication that you need and being addicted to it.

    Smoking on the other hand is an addiction – pure and simple. I am an addict and have no problem saying so. Smoking for me, personally, is a medication I use to help with my mental illness. I don’t smoke a set number of smokes daily, some days just one or none, others – when stress is high and my manic behavior is amping I can smoke 5 or more cigs. It is okay with me…there is risk in any medication that you take to control an illness.

  • Jade

    “Yeah, because prohibition stops people from using all the other banned substances. LOL”

    Agreed. If we made tobacco illegal, all of the smokers who currently vote for strict drug laws and have no problem whatsoever with putting people in jail for years would begin breaking laws left and right to get their own drug of choice.

  • http://www.americablog.com/ Naja pallida

    Not unlike with mental illness, our society too often treats addiction as a weakness, and something that is shameful. Because of that, people tend to feel they’re being blamed for their inability to control an addiction – which by the very definition isn’t really something under control. When people feel ashamed, blamed and powerless, we can’t really be too surprised when they react defensively any time we question their behavior. It also discourages people from admitting they have a problem, and taking steps on their own.

  • 4th Turning

    There is something weird going on with sugar in foods and bevs. and how similarly
    it and alcohol pass directly into the bloodstream. My sense there is a metaphoric
    hunger (craving?) for some huge thing that is missing in people’s lives resulting in a need to be numbed or taken away to someplace other than this present. I think I can put myself, if not in your shoes, at least at your elbow as you (the collective you) attempt to mend so many broken hearts and souls and bodies. I have often wondered whether self-destructive behaviors are not some kind of eerie variation on suicide and how a celebration of life and purpose got denied and/or lost to so many. The stories in our cultural heritage meant to instruct and warn each succeeding generation have languished-over-ridden by hubis. etc. Have often noted our species has managed to survive all adversity except peace and prosperity. I’m grateful you feel led (a Quaker term?) to put up these pause and think topics. You will likely never receive word but I’m betting more than one out here are listening and get it.

  • docsterx

    The American Psychiatric Association is looking at the “behavioural” addictions. Especially gambling and internet addictions. These would be the first non-substance-related addictions (i.e. the person addicted would not be using a exogenous chemical to feed the addiction. Though he might be getting the same kind of stimulation from an endogenous chemical(s) from his own brain. Some of those may become listed in future editions of the Diagnostic and Statistical Manual (DSM) which outlines most recognized psychiatric disorders. The current one is DSM-V.

    I think that food “addiction” is classified under eating disorders and sex “addiction” classified as hypersexuality.

  • docsterx

    Actually, many people who smoke don’t realize that they’re addicted or won’t admit to it. “Addict” is a word that carries a ton of negative baggage with it. It implies criminal activity, no self-control, low status and other negative associations. If you tell someone he’s addicted to something (alcohol, nicotine, sleeping pills, etc.) you will probably get an angry look at the very least. “Addiction” is something that only other people have.

  • docsterx

    You’re right to a degree. But the questionnaires above are designed to see if people show evidence of being addicted to specific substances: alcohol, opioids, tranquilizers, sleeping pills, etc. If you look at the CAGE questions (above) none asks if the respondent has had any negative consequences connected to his drinking. When the CAGE test is given, the patient is asked to answer the questions with respect to alcohol.

    Three of the questions do deal with negative consequences. Two start with “Continuing to use . . .” and the other is the second from last. In addition, many people who are not substance abusers would probably view other people having concerns about their use as a red flag that something might be wrong.

  • Silver_Witch

    I guess I should say that for me – this is true. I don’t smoke pot because I can’t get it, have not access to it and am not willing to go “hunting” for it. Back in the day when Xtasy was legal – well there I was…once it became hard to obtain (or worse illegal) sadly I stopped doing it. Guess fear of jail, prison or losing my job was initially the motivator, later the “not needing” just became real.

  • http://www.rebeccamorn.com/mind BeccaM

    Yep. Already noticed it with respect to another topic Mark’s been writing about lately…

  • Yalma Cuder-Zicci

    “Have you ever felt you needed to Cut down on your drinking?”
    This question always cracks me up. Why would you be taking a “do I have a drinking problem?” survey if you had never felt that?

  • 4th Turning

    As seems to occur with many of these topics, I happen to be about 2/3 of the way through a
    Montreal doc. (on youtube) featuring a series of interviews with male sex workers-break your heart
    slow going but I feel an obligation to watch as with other impossibly difficult issues like the Holocaust.
    This is also a topic I cannot water-ski over as I’ve been personally affected like other commenters
    below. My father was a smart, left-brained “controlled” (never missed a day of work) alcoholic and my mother was a smart, right-brained (impeccable taste) unfiltered pall mall chain smoker. (Not too
    surprising I chose gay.) She was wise enough to guide me in this fraught situation to discover for
    myself cause and effect. I once promised her at 12 if she would allow me to smoke one of her cigs
    I would never smoke another. And neither parent minded me having a beer as a teen which I had
    little use for watching my smart dad stupid drunk-and knew deep down I had the liking for…
    I had a caring mom and sincere if remote father. To the man, those interviewed above had no
    chance at maternal bonding or parental love. One kid estimated he’d made 400,000 and spent
    every penny on crack… None felt themselves capable of loving or being loved. All dwell in the
    shadow of profound melancholy lost to anything we might define as happiness-even occasional joy.
    Coincidentally, have also been reading the latest on how addiction is hard-wired forever in the/our
    brain. It never dissolves and gets rinsed away. The only cure(?) rests in being able to over-lay with
    new wiring-a long and difficult process. As doc can confirm success rates are sadly very low.
    There is a definite spiritual component those who succeed come to rely on as well as therapy,
    etc.
    This was the first website I happened on while doing a little doc inspired homework-also from Canada…

    THE MECHANISM OF ADDICTION
    Addiction is a chronic, relapsing disease affecting the brain’s reward, motivation, and related systems. People struggling with addiction are unable to control their actions or make rational decisions about their behaviour, even in the face of negative consequences.
    Compounds and experiences with addictive potential activate the brain’s reward circuitry. These triggers are also called reinforcers because the pleasurable feeling we get from them makes us more likely to engage in them again. Both alcohol and illicit drugs are powerful reinforcers, and cause the release of the neurotransmitter dopamine in the brain’s reward system. Repeated activation by these compounds changes the brain’s reward system structurally and chemically, and produces behaviours like bingeing,escalating use, and symptoms of withdrawal when the drugs are taken away.
    Addiction is a process based in altered functioning of the reward and motivation systems of the brain. It can manifest in many ways, but historically addictions fall under two categories.
    SUBSTANCE-RELATED ADDICTIONS
    This includes dependence on any of the following:
    Tobacco
    Alcohol
    Street drugs
    Prescription drugs
    BEHAVIOURAL OR PROCESS ADDICTIONS
    Although less well studied, many behaviours appear to have reinforcing properties, and may involve excesses related to:
    Gambling
    Food
    Sex
    The Internet
    Video Games
    Work
    MULTIPLE ADDICTIONS AND CO-MORBID FACTORS
    Science shows that substance and behavioural addictions can occur within the same individual and that multiple variants of substance or process addiction can be expressed at the same time. Thus, people can have multiple addictions with each addition being active to differing degrees of severity. Additionally, depression and anxiety frequently accompany addiction as co-morbid factors.
    http://www.albertafamilywellness.org/brain-development-addiction/different-kinds-addiction

  • Indigo

    Exactly. That’s why Facebook profile quizzes have no validity outside of Facebook.

  • http://www.americablog.com/ Naja pallida

    I think I would just ask “are you unable to stop harming yourself”. But the problem comes when many addicts don’t recognize their self destructive behaviors, or simply don’t care, and most are completely oblivious to the impact their addiction has to the people around them. We, as a culture, have a strong streak of “I’m adult, I can do whatever I want.” without ever considering how that changes our relationships to others.

  • http://www.rebeccamorn.com/mind BeccaM

    That’s why the term ‘addiction’ can’t be defined by just three items, if in fact whatever it is you’re using or consuming is more good for you than bad. There HAS to be an element of, “…and you shouldn’t, it’s doing damage, and your doctor has advised you against it or would if they knew.”

  • Indigo

    Which raises the issue of addiction vs medication. I’d be in bad medical straights if I abandoned my blood pressure meds which I don’t exactly crave, I just need them to keep my blood pressure properly adjusted. And isn’t that okay? I mean . . . it’s not like I’m holding up the local CVS for Oxycontin or like that.

  • Indigo

    Understandable. Report the outage to your provider and request a discount. Just don’t shout at them because then they can’t figure out to to push the discount button.

  • http://www.rebeccamorn.com/mind BeccaM

    Well, there’s addiction and then there’s addiction. By the “three yes answers” standard, I’m addicted to coffee. 1. I feel I need to have it first thing in the morning. 2. I suffer symptoms if I don’t have it. 3. I seek to ensure I have a steady supply of it. I suppose I’d even seek it out if I had trouble affording it.

    On the other hand, this particular addiction is maintained upon the advice of my (now former) doctor, the one with whom I worked for many months to develop a regime of migraine headache management. We determined — via the ‘migraine journal’ I kept over the course of a full year — that being 100% caffeine free increases both the frequency and severity of my migraine attacks.

    Thing is though, I can stop if I want to, and if I use an increasing ratio of decaf/regular blend, I can manage the immediate acute physical symptoms of caffeine withdrawal. However, knowing I’ll experience more pain in the long run is kind of a disincentive.

    With respect to that addiction checklist, I’d say it’s important that at least one or more of the major negative effects needs to be included. Otherwise, by a literal reading of those checklist items, most people are ‘addicted’ to food. (Feel they need to have it 1st thing in the morning, suffer symptoms if they don’t have it, seek to have steady supply, etc.) Same deal with many prescribed medications, like insulin.

    My coffee ‘addiction’ has no particular negative measures and enough positive ones to outweigh other considerations. For instance, my coffee consumption has none of the “do you consume it even though it’s bad for you” items. On the contrary, my doctor and I determined that regular coffee consumption, in moderation (one large mug each morning, and that’s it), is actually better for me than abstaining. My quality of life is significantly improved by not having as many migraines or as severe.

    So like I said, in measuring whether something is an actual addiction — with the negative connotations and the presumption that one’s health and well-being would be significantly better off without it — there needs to be that element of using or consuming whatever it is, even though you really shouldn’t, of it being more bad for you than good.

  • dcinsider

    Remind me not to invite you to a party.

  • http://parkandbark.wordpress.com/ Houndentenor

    I hear stories of an impending coffee shortage (not verified) so if that’s true we may soon find out how bad our coffee habits really are. I only really need it on mornings when I have too early a rehearsal or class. (8 am calls suck, especially after late nights doing something else.) I’d happily substitute it for something else, especially enough sleep. Too bad that my multiple employers won’t accommodate each other’s schedules.

  • http://parkandbark.wordpress.com/ Houndentenor

    Yeah, because prohibition stops people from using all the other banned substances. LOL Now if you start making people pee in a cup to prove they haven’t been ingesting nicotine, that might work. I don’t know anyone whose reason for not using marijuana is its illegality but I know plenty who stopped because their job drug-tests and they don’t want to do it badly enough to risk getting fired.

  • http://www.americablog.com/ Naja pallida

    I don’t get anxious, I just get angry because I’m paying for something that isn’t working. :)

  • http://www.americablog.com/ Naja pallida

    “Have you ever found yourself vehemently defending the entirely untrustworthy tobacco industry on a blog, in attempt to justify your addiction?”

    I’m one of those weird people who doesn’t seem to get addicted. I smoked for years, quit cold turkey and never had another one. I used to drink a ton of coffee, doctor told me to stop, so I did – had nasty physical withdrawal symptoms, but never really felt inclined to have a coffee, of anything else, to fix them. Back in college I tried all sorts of other things, figured you had to try something to understand why people do it, and never felt inclined to keep doing any of it. Never been much of a drinker either. Hell, I just decided to stop biting my nails one day and haven’t done that since either. Even though I’m on the Internet pretty much all the time, some people would probably call it an addiction, but I’ve never had an issue dropping it if I have other things to do. But that’s about as close as I get.

  • http://www.oneutah.org Glenden Brown

    Caffeine – specifically tea. The rule in my office is “Don’t talk to Glen until he’s had his first cup of tea.” My coworkers formulated it in the interest of their own safety.

  • http://www.americablog.com/ Naja pallida

    Same diff, all around the Balkans many places prepare coffee in the Turkish way, some with a few variations, but call it something local to them. Turkey isn’t known historically for having good relations with most of its neighbors, so they don’t want the association, but they want the coffee. :)

  • Buford2k11

    thanks, I have my “sources”…I been addicted a long time…

  • emjayay

    Teach yourself to enjoy lower sugar/higher cocoa varieties and you can imagine it’s healthy too.
    http://well.blogs.nytimes.com/2014/04/24/why-chocolate-is-good-for-us/?_php=true&_type=blogs&ref=magazine&_r=0
    Trader Joe’s Pound Plus bars from Belgium – I think you can get a 72% type – are the best deal, although there must be higher quality stuff out there for much more money. They have a 50 something per cent variety if that’s too much for you.

  • Silver_Witch

    One objection – anyone who smokes knows they are an addict. This article is only pointing out what we smokers already know. Quitting would be great – but the access is easy and the pay-off wonderful.

    We are using a legal drug and we know it. Since tobacco is so harmful why is it legal. Make it illegal and most users will stop – because they will not want to be on the wrong side of the law. It is why I quit doing drugs – the risk was too intense for the return. I would quit smoking the moment they become illegal…while it is a legal drug I will continue to smoke.

  • Yalma Cuder-Zicci

    I am too. I get really anxious when my connection goes out.

  • Buford2k11

    Nicotine was the worst to kick…Heroin was bad, but not even close to nicotine…I will never give up coffee…at least until I can’t afford it anymore…chocolate, can’t get enough chocolate…

  • goulo

    (The description of Greek coffee sounds just like Turkish coffee! Apparently they are indeed the same: https://en.wikipedia.org/wiki/Turkish_coffee )

    Like many of us, probably my main addiction is the internet…

  • TheOriginalLiz

    coffee and Ben&Jerry’s ice cream

  • Indigo

    I’m addicted to the Internets. I feared as much.

  • Indigo

    Add a teaspoon of Swiss Miss and suddenly, it’s Mocha!

  • Mike_in_the_Tundra

    I didn’t score well as far as coffee is concerned, but I feel no need to do anything about it. Well maybe I’ll have a cup of coffee and think about it.

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