Quitting nicotine

[colker]

My PhD was all done on the underlying neurobiology of a phenomenon that is termed "incubation of craving" which has been found with opiates, alcohol, nicotine and stimulants like cocaine. It follows the great saying, "getting people off of drugs is easy - keeping people off of drugs is hard." Essentially, our brains create deep associations between the pleasurable stimuli (drug) and various otherwise neutral stimuli. Your brain created a relationship between finishing a meal and having a smoke, just like a dope addict who buys his gear in the bathroom of a McDonald's might get a little burst of "ooh ahh" every time he sees the golden arches. When one quits a drug there are two phases: acute withdrawal (the shakes, tremors, sweats, nausea..etc.) and incubated withdrawal, which actually increases the potency of this association for years. While it might be easy to get through the acute withdrawal given the right conditions (a lush rehab clinic away from all those associated triggers), back in the real world it gets much harder while the incubated withdrawal gets stronger over time.

On a related note, there is a still un-sussed-out factor where the brain is able to hit a "reset" button (there are good theories and evidence for what this button is, if anyone is interested in the boring nitty-gritty of it all). I watched this happen in college to a number of people, mostly under the influence of potent psychedelics. A two pack-a-day smoker friend of mine and I were out at a desert rave known as Moon Tribe back in 2008 somewhere in the badlands outside of LA, swimming in the weirdness of a handful of magic little pieces of paper, when she went to get a cigarette out. She paused, totally overcome with the visceral reaction of disgust at the thought of lighting up and inhaling that noxious smoke. She handed me the pack and said "find someone who wants these" and never mentioned it again. 12 years later she hasn't had another cigarette.

Brains are weird.

LSD gives you a succession of epiphanies. Hers was the grotesque nature of tobacco. Most of the LSD epiphany (love, peace, nature) won´t resist daily life... but it can be manipulated into cultdom: Manson used lsd to indoctrinate his family. Otoh lsd is not addictive: you do it and you don´t do it. You don´t crave for it like cocaine and opium.

[rwsaunders]

My Dad started smoking at 14 and quit cold turkey when he was 52 as a result of a health awakening. He commented once, that for a few years, he would wake up in the middle of the night imagining a cigarette in one hand and cup of coffee in the other. When I was 12, three of us snuck into the woods with a pack of Salem Menthol cigarettes that we stole from someone’s Mother. I smoked 3 cigarettes in a row and that was it for me...I guess that I owe Salem for shielding me from being fully exposed to nicotine, as it’s a tough drug to shake.

[Mabouya]

If you really need something for your hands to fiddle around with, I've thought that my Kaweco Sport pen could pass for a vape device.

They come in pencil, fountain and rollerball pen models, and just about every metal known to man, and plastic too:

Search Results for "kaweco sport" | JetPens

[Peter Polack]

...He commented once, that for a few years, he would wake up in the middle of the night imagining a cigarette in one hand and cup of coffee in the other.

Perhaps someone can explain to me the common practice of having BOTH the cigarette AND the coffee at the same time. Is this some sort of drug stacking? Do the two drugs have complementary effects?

[Mabouya]

Perhaps someone can explain to me the common practice of having BOTH the cigarette AND the coffee at the same time. Is this some sort of drug stacking? Do the two drugs have complementary effects?

Cigs and booze are also well known, but don't forget the most famous pair of all - cigarettes and sex (or vice versa...).

[Octave]

Add smartphone addiction to the list.

What list?

LSD gives you a succession of epiphanies. Hers was the grotesque nature of tobacco. Most of the LSD epiphany (love, peace, nature) won´t resist daily life... but it can be manipulated into cultdom: Manson used lsd to indoctrinate his family. Otoh lsd is not addictive: you do it and you don´t do it. You don´t crave for it like cocaine and opium.

LSD also enhanced serotonergic transmission which increases the likelihood that learning experiences will be solidified through long-term forms of synaptic plasticity. This is one of the reasons why psychedelic-assisted therapy is so effective. MDMA is a serotonergic agent as well, as mentioned above used for therapy for individuals with treatment-resistant PTSD. Psychedelic experiences are what you make of them, and the "love, peace, nature" stuff is all about expectations (aka "set" in the "set & setting" concept). If you do not have these preconceived ideas of what LSD (or other psychedelic drugs) is (are) "supposed" to show you, it's not going to do the work for you and instill some specific feelings/ideas.

Perhaps someone can explain to me the common practice of having BOTH the cigarette AND the coffee at the same time. Is this some sort of drug stacking? Do the two drugs have complementary effects?

Without getting into the neuroscience of it: yes, they have nice complementary effects. I spent much of my high-school years, back before the indoor cigarette bans, playing scrabble in the back of a skeezy café in Evanston, IL smoking hand-rolleds and crappy coffee under a yellowed Breakfast at Tiffany's poster. Good years.

Plus, coffee and tobacco (interestingly, not caffeine and nicotine) can stave off Parkinson's Disease.

[vertical_doug]

Since a vaping company is there to make money, you can only expect them to try to formulate the most addictive potion possible.

And for marijuana, give big Ag a few crop cycles to 'improve' yields. The marijuana which is legalized now will not be the marijuana sold in a 10 to 15 years from now.

[colker]

LSD also enhanced serotonergic transmission which increases the likelihood that learning experiences will be solidified through long-term forms of synaptic plasticity. This is one of the reasons why psychedelic-assisted therapy is so effective. MDMA is a serotonergic agent as well, as mentioned above used for therapy for individuals with treatment-resistant PTSD. Psychedelic experiences are what you make of them, and the "love, peace, nature" stuff is all about expectations (aka "set" in the "set & setting" concept). If you do not have these preconceived ideas of what LSD (or other psychedelic drugs) is (are) "supposed" to show you, it's not going to do the work for you and instill some specific feelings/ideas.

That´s a loaded issue. Almost a theological debate: lsd epiphanies like any epiphany.. are an illusion? If so does any truth reveals to us other than enagaged in science practice? Isn´t love a given to all species as described by budhism and experienced by mothers w/ their newborns? I think so.

[Peter Polack]

What list?

The list of "substances" by which people get addicted. Coffee, booze, cigarettes, smartphones; in my eyes there's no difference.

[Octave]

The list of "substances" by which people get addicted. Coffee, booze, cigarettes, smartphones; in my eyes there's no difference.

I see. I started this thread about nicotine in particular, but we can discuss addiction in general, sure.

There is most definitely a difference. Similar substrates in the brain, sure, but very different mechanisms. The means by which our brains and bodies become habituated and addicted to caffeine, alcohol, nicotine and non-chemicals like smartphones (or sex, or cycling) are not identical and to lump them in together is a discredit to their respective natures, in my opinion as someone who has been working in the field of addiction for the past decade+.

Motivations and associations are also key to the instigation, escalation, maintenance, withdrawal and relapse to all of those addictive "substance" which you listed. Nicotine has very little, if any, real-world tangible application or benefit aside from pleasure (ignoring the offshoot sciences of nicotine as a nootropic cognitive enhancer, or mild and hyperspecific medical uses). Smartphones have a very tangible real-world application. I for instance am able to work a job which does not require me to fly, commute, or even live on the same continent as my employer thanks in part to smartphone technology; while the smartphone itself has a nasty carbon footprint and requires toxic mining and exploitation, it pales in comparison to the things it helps offset in my case. This is a separate conversation entirely, but I personally don't think phone technology falls into the same category as addictive drugs, for a lot of reasons. Just my two cents.

[lumpy]

LSD also enhanced serotonergic transmission which increases the likelihood that learning experiences will be solidified through long-term forms of synaptic plasticity. This is one of the reasons why psychedelic-assisted therapy is so effective. MDMA is a serotonergic agent as well, as mentioned above used for therapy for individuals with treatment-resistant PTSD. Psychedelic experiences are what you make of them, and the "love, peace, nature" stuff is all about expectations (aka "set" in the "set & setting" concept). If you do not have these preconceived ideas of what LSD (or other psychedelic drugs) is (are) "supposed" to show you, it's not going to do the work for you and instill some specific feelings/ideas.

That's really interesting. I took some psychedelic drugs when I was a teenager; I really enjoyed the feelings of enhanced perception and connection that I experienced, but I tapered off quickly after concluding that those feelings of perception and insight were only feelings, and that I wasn't really enhancing my consciousness or perception - compared to the focused outdoor athletic stuff that I was into, and even academics. Fascinating to see the current research about the real effects of those substances.

As far as nicotine, I started smoking in college and loved it. Also smoked Chesterfield Kings like a poster above, and Larks (because our beer store owner said they were good; the people I took advice from, it's a wonder I survived). Pretty much quit after driving an old convertible across the country after college, I was bored and kept chain smoking, and by the time I got back to Massachusetts I was really all smoked out. I dabbled after that, but never really got back on the train. I liked chewing tobacco, too. One thing I do miss is the sensory pleasure of rolling up a nice tight tailor-made with Drum tobacco.

[colker]

Coffee has a benign aspect. Listing coffee along nicotine is not right. Alcohol (and cocaine) otoh is much more of a personality than physical disorder that is nicotine. Heroin/opium is way more addictive than alcohol or cocaine. Treating addiction from a morality pov leads to weak results: cycling/ physical exercise is more addictive than smart phones.

[jerk]

if you control for folks who are voluntarily trying to quit opiods and the time and money spent on it- ibogaine therapy is no more successful in treating opiode addiction than any other technique that is voluntary and involves a similar commitment in terms of time and finance. ibogaine therapy "works" because it is expensive, last resort, and is generally done by people who have tried other forms of rehab and have a history of relapse and are likely in a place where they have the tools to finally quit both in terms of privilege, wealth, time, and a desperation that's made them willing to go to a kinda crazy extreme and expensive potential solution.

here's the thing- all the methods to get people off dope work about the same when you actually control for the variables. the consistent thing is that the person has to want to quit, and be in an environment where he or she can be healthy and happy enough to quit. just look at the GIs coming home from Vietnam. Over 99% of those that were addicted to heroin got clean within the first year of coming home. drug addiction has very little to do with the drug. it has to do with the world the addict lives in.

(i say this as an addict)

[e-RICHIE]

drug addiction has very little to do with the drug. it has to do with the world the addict lives in.

amen ^

[mjbabcock]

amen ^

I’m agreeing with Jerk on addiction issues and bike geometry.

[bking]

drug addiction has very little to do with the drug. it has to do with the world the addict lives in.

(i say this as an addict)

You aren't saying the world is causing the addict, or preventing him or her from "getting out" are you? There is more to it on the addicts side, than simply the world around them, no? Otherwise, we'd all be addicts, or most of us. In my case, a change of geography--which I initiated, with all that means, helped me move out from under my beast. But that same geography was fine for my siblings, and others around me. No question I get that we are powerfully influenced by the environment we are found it, but we are still the central character in our plays.
As was said above, you have to want to first and last, and be willing, and I guess I would add, be able to pay that price.


On nicotine though, I'd read some time ago that it's particularly tough (this one was never one of mine) as it literally becomes part of our cellular make up. Is that true of most other chemical addictions or is nicotine particularly tenacious that way?

[Octave]

You aren't saying the world is causing the addict, or preventing him or her from "getting out" are you? There is more to it on the addicts side, than simply the world around them, no? Otherwise, we'd all be addicts, or most of us. In my case, a change of geography--which I initiated, with all that means, helped me move out from under my beast. But that same geography was fine for my siblings, and others around me. No question I get that we are powerfully influenced by the environment we are found it, but we are still the central character in our plays.
As was said above, you have to want to first and last, and be willing, and I guess I would add, be able to pay that price.

Jerk can correct me if I'm off base here, but I do not think he was referring to "the world" so much in a literal sense as in a figurative one; the world, meaning the environment, social, economic, personal, inter/intra, the everything...

There's a very famous series of experiments, not without some controversy of course, that illustrate this point quite well: Rat Park. In essence, animal modeling of drug addiction hsa been very useful for us as neuroscientists, but there is a major caveat: rats or mice are generally housed in laboratories in what could be best-described as prison-like conditions. They generally live in small groups or in isolation, depending on the experimental conditions. Small cages with very little "environmental enrichment" for them to play, hide, be entertained, explore...etc. They eat the same thing every day and drink only plain water. There are reasons for all of this, of course, but it does not mimic the human condition very well. Thus, some researchers built a giant, multi-story housing arena with a plethora of toys, places to hide and play, explore and be entertained..etc. and found that the rats who lived in this "Rat Park" were far less likely to self-administer morphine than their prison-housed counterparts. This experiment, in some capacity, has been reproduced many times. Environmental enrichment reduces cue-induced and stress-induced relapse to cocaine. Conversely, the loss of this environmental enrichment may actually make cocaine addiction more likely. Being exposed to positive, enriched environments early in life develops a complex reward system in the brain which thereby devalues other external sources of pleasure like drugs. Draw whatever parallels you would like, there is much debate to be had about the relevance of rodent data to humans, but I for one find these data to be quite telling and, if I'm not mistaken, relevant to Jerk's point above. We are all products of our complex environments, and assuming that we have the internal willpower to simply change an extremely rewarding, engrained behavior (like drug addiction) without changing any of the factors that shape our reality/environment is naive at best, egotistical self-aggrandizing more likely.

On nicotine though, I'd read some time ago that it's particularly tough (this one was never one of mine) as it literally becomes part of our cellular make up. Is that true of most other chemical addictions or is nicotine particularly tenacious that way?

No, it certainly doesn't "become part of our cellular make up" but it is particularly difficult to quit for a number of other reasons.

First, until very recently it was quite socially acceptable to smoke worldwide. Here in France, it remains so. If there is no social stigma, that is one less reason to quit. Think about alcohol: I haven't had a drink in a long time, but the response I get when this comes up (usually when I turn down wine at a dinner or celebration) is one of consternation, concern or ridicule. Those are factors working against my sobriety due to the social acceptability of alcohol. Cigarettes aren't as "cool" as they once were, but vaping is in certain circles, and it certainly doesn't carry the shame and stigma of other drugs. This lack of stigma also permits near constant use. It is not until an addict to alcohol, cocaine or opiates really gets their head around a drug that they can do it all day, every day. But nicotine? Right off the bat you're basically able to self-administer anytime, anywhere.

Second, the consequences are very protracted. Cancer, emphysema, blah blah blah right? Opioid withdrawals are the pits, cocaine too. Alcohol has hangovers, sickness, carries the weight of drunk driving and horrible errors made under the influence. When was the last time you heard about "driving under the influence of nicotine" or a "wicked bad cigarette hangover"? It's also relatively cheap compared to most drugs of abuse (although it's getting less-so due to intensification of "sin taxes"). There are of course many motivations to quit, but they are not nearly as apparent as with many other drugs.

Third, and this is the biological one, nicotinic receptors underly the very-most basic reward circuitry in our brains. They are ancient components of biology compared to some other evolutionary advances in the brain, and play a major role in nearly every rewarding behavior you can name. People in my field like to use the term "hijacking the brain's reward circuitry" when referring to how drugs of abuse induce addiction. This is accurate, in my opinion, and no drug does this at a more brute and basic level than nicotine. Consider the fact that, unlike opioids or cocaine or even alcohol, the first exposure to nicotine is almost 100% across-the-board unpleasant. Yet people continue to do it. There is really nothing inherently rewarding about smoking, especially when compared to literally any other drug. To me, that says it all: it is addictive without even making you feel good. Anyone who has done opiates/opioids can attest to the ineffable "goodness" that they instill in your body/brain. Burroughs and others spent their whole lives trying to explain and capture that, and still only did it well enough that other drug-users got the picture. There is something intensely pleasant, aggressively rewarding, about some drugs. Nicotine? Nah. But damn does it get its hooks in you nonetheless.

[prcrstn8]

Smoked for 20 years, quit 34 years ago and still feel like I could be back to a pack a day by the end of the week. Sometimes the smell when someone lights up is a “damn, that smells good” reaction.

Luckily, what I found to do with my hands were fake plastic cigarettes that I “smoked” until I no longer needed them.