Pharmacological Crutches

Pharmacological Crutches

Joel
Joined: 18 Dec 2008, 23:57

10 Nov 2000, 20:01 #1

Joel's Reinforcement Library
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Pharmacological Crutches


Due to the recent release of NicoretteĀ®, a chewing gum containing nicotine, I feel it is necessary to issue a special warning to all clinic participants who may be considering experimenting with this product. The gum is intended to be used by smokers to ease the severity of symptoms encountered during initial smoking cessation.

But the ex-smoker occasionally desires a cigarette months and even years after quitting. He may feel that the urge is due to a physiological residual effect of withdrawal. This thought may lead to the idea that trying the gum may help get rid of the desire. But, the actual cause of the thought for a cigarette is due to a psychologically triggered response. Some situation, person or event is causing the thought for a cigarette. While these occasional triggers may be annoying, they pass in seconds and may not occur again for hours, days or even weeks.

If the ex-smoker tries the gum, the end result will be tragic. For once he takes the first piece, his addiction to nicotine will be established. Once again he will be in nicotine withdrawal. Then he will have to make a choice--either relapsing into full fledged smoking or once again encountering the two week nicotine withdrawal. All this because he wanted to ease a thought for a cigarette which would have only lasted seconds.

Even the intended use of nicotine gum presents certain problems. Many hope the gum will be a panacea for the truly addicted smoker. But caution must be given to the non discriminate use by any smoker who feels that this new aide will help him break free from cigarettes. For while the gum may reduce the severity of initial withdrawal, it does so at a cost.

Normally, when a smoker quits, physical discomfort will peak within 72 hours and totally subside within two weeks. While the first three days may be traumatic, with proper support any smoker can successfully get through this period.

Use of the gum may reduce the initial severity of withdrawal when quitting. The ex-smoker may continue chewing the gum for months, never reaching peak withdrawal. But because blood nicotine never reaches the levels maintained by cigarettes, nor totally leaves the body, he feels minor withdrawal symptoms on a chronic basis. When he finally quits using the gum, he will probably experience the same withdrawal he would have originally encountered when quitting cigarettes.

The gum may help an addicted smoker break some of the psychological dependence and conditioned responses before experiencing potential difficult withdrawal. But the cost for this easing of initial symptoms is a prolonged chronic withdrawal followed by peak symptoms when giving up the gum. This is a lot of long term discomfort which could be avoided by simply ridding the body of all nicotine by quitting cold turkey.

When you quit smoking, you broke free from the addiction to nicotine. As long as you keep all nicotine out of your body you will never again have to worry about the health consequences of smoking or deal with the withdrawal of quitting. If you wish to stay free, don't try the gum, and as for cigarettes, cigars or pipes - NEVER TAKE ANOTHER PUFF!

NOTE: I originally wrote this in 1984. Since then, a number or similar products, (e.g., patches, gums, other devices are currently under development), have been introduced as over the counter cessation aids. The same principal applies to them all - they are transferring the delivery system of the drug nicotine. If the smoker simply stops, withdrawal will peak and start to subside within 72 hours. Use of the agents will unnecessarily prolong the cessation process as well as add to the expense.
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Joel
Joined: 18 Dec 2008, 23:57

10 Nov 2000, 20:02 #2

For Anne
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LindaO
Joined: 19 Dec 2008, 00:02

12 Nov 2000, 22:19 #3

HI Joel

It's funny, I know that all the time I was talking about buying some nicotine chewing gum, patches ("will have to cover my whole body with them! ha ha!") etc I wasn't serious about giving up smoking. My excuse for not buying them was that it worked out pretty expensive if they didn't work, but deep down I knew they were not going to work, because I wasn't serious or even that inteested in quitting. It is only when I first found this site that I began to think well maybe it can be done? I'm glad now I didn't waste my time and money pretending to be serious about quitting, and my first serious quit/and my only quit was here at Freedom.
Thanks
Linda x
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Joel
Joined: 18 Dec 2008, 23:57

12 Nov 2000, 22:31 #4

Hello Linda:

I just want to point out one real important fact. You can quit your first time. You will hear lots of material to the contrary, that you have to quit over and over until it finally takes. This is absolutely wrong. The only reason it takes most people multiple attempts to quit is that they don't understand the addiction to nicotine. How could they, no one really teaches it. People had to learn by screwing up one attempt after another until it finally dawns on them how each time they lost it, it happened by taking a puff. If you understand this concept from the get go, you don't have to go through chronic quitting and smoking. So learn from other people's mistakes, not your own. Going through a quit once is bad enough, going through it over and over again is horrible and should be avoided at all costs. The way to avoid it is to always remember to never take another puff!.

Joel
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GrumpyOMrsS (Gold)
Joined: 19 Dec 2008, 00:00

28 Nov 2000, 23:53 #5

ImageImagefor petey
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Suzanne T Gold
Joined: 07 Jan 2009, 19:08

21 Mar 2001, 08:24 #6

For Ray
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Joel
Joined: 18 Dec 2008, 23:57

20 Aug 2001, 19:36 #7

For Joyce
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Joel
Joined: 18 Dec 2008, 23:57

25 Sep 2001, 19:05 #8

I know most of our member don't need to read this one, they are here because they have already realized the pitfalls of NRT usage. But at times you can find yourself tempted by the well meaning friend or acquaintance who, when you are under times of stress and feeling "stress," will try to convince you that while they understand why you don't want to take a cigarette and relapse back to smoking, why not just take a piece of gum or a patch to "get the edge off."

You must understand that these people don't understand drug addiction. They see cigarettes as the dangerous addiction and not the true culprit--nicotine. It would be like telling an alcoholic who has only drank whisky or scotch that he should take a beer or a glass of wine to calm his nerves. The person giving this advice does not understand nicotine addiction.

Don't be tempted by other people's lack of real understanding. Nicotine in any form cannot take the edge off anything for an ex-smoker. For a smoker it can end withdrawal, for a few minutes. For an ex-smoker it can cause chronic withdrawal that can last a lifetime. For the newly relapsed smoker may never be able to muster the strength or even the desire to quit again before it is too late. The addiction may cost the smoker his or her life.

The only way to avoid relapse is to never administer nicotine in any form. To stay free of your addiction make sure that it is clear to yourself that your task is to stay nicotine free--not just cigarette free. This means that you need to realize that the way to stay in control is to follow the next sentence and interpreting each statement with equal significance. The way to stay nicotine free is to never take a chew of nicotine laced gum, never take another dose from a nicotine laced patch, never take another whiff of a nicotine laced inhaler, never take another drink of a nicotine laced fluid, never take an injection from a nicotine laced needle, and, never take another puff!

Joel
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John (Gold)
Joined: 18 Dec 2008, 23:57

25 Sep 2001, 22:33 #9

Thanks Joel! This thread reminds me of a long conversation I had last night with a friend from Chicago : )))))

I do want to encourage all of our newbies to be very careful when surfing tobacco/smoking sites on the internet. There are new tobacco sites springing up across the internet that peddle nicotine to every smoker who arrives seeking help and guidance. Also be aware that their list of quitting tips offer some of the worst quitting advice that you'll ever see, and it's truly nothing more than a recipe for perpetual relapse. I sometimes wonder if the people putting these sites together are really sincere about wanting smokers to quit. I pray they are!

I reviewed a brand new site yesterday and this is what they were telling smokers -

1. Wait to quit during a period of low stress in your life.

2. When you are ready, buy and use nicotine products like the patch, gum, spray or inhaler. If you don't buy them you're twice as likely to fail !

3. If you do fail and smoke a few, don't be hard on yourself. It's normal to slip and cheat.

These three statements are contrary to Freedom's basic core teachings. If we're going to tell smokers to wait at all (which is totally unnecessary), we should tell them to wait until they're experiencing the most stress that they've ever felt because they CAN break free during such times and in doing so they increase the likelihood that stress will never again be used as their mind's junkie excuse for relapse.

As for not being hard on cheating and slipping, these statements either show that person making them has absolutely zero understanding of the law of addiction or that they don't understand how the nicotine addict's junkie mind operates. During withdrawal we're searching for legitimate excuses to immediately bring our early quit anxieties to an end.

Imagine coming across a list of online quitting tips on day three that reassure a quitter in the heat of battle not to worry about a little cheating here or there! WRONG! Just one puff and it's back to square one with your determination and energy spent, while far weaker emotionally than you were the day you started. Yes, one puff of new nicotine and this quit is over! We hope that you've got another quit left in you but there is never any guarantee!!

The key to learning to live life with normal dopamine levels is not by taking drugs that will elevate them for an extra 2,160 hours (the recommended 90 days for NRT programs) when you can begin to do so within just 72 hours. As Table 40 of the USDHHS Guidelines so clearly tells us, the over-the-counter nicotine patch produces an 88.2% failure rate within six months (just three months after the user stopped using NRT ).

The "doubles your odds of quitting" assertions being made in association with the sale and promotion of NRT is based upon how the placebo (or no nicotine in my patch quitters) did at 6 months. Yes, the nicotine fed quitters who got to use nicotine three months longer than the placebo group did better than the placeo group, but not by much!

True, only 6.7% of the placebo group remained quit at 6 months, as compared to 11.8% who wore the O.T.C. patch, but Freedom educated, counseled and supported quitters are not placebos - we're the real deal! One more way to look at these results is to subtract from the 11.8% those who would have quit anyway (6.7%). When you do, you're left with just 5.1% of all quitters receiving any benefit whatsoever from the nicotine patch. Imagine a T.V. commercial for nicotine products that is honest enough to tell smokers that 95% of all our customers fail at quitting within six months. It's crazy!

What's most important in my mind is that the simple fact that we here at Freedom are not the ignorant placebo in some medical study. The Guidelines themselves repeatedly declare and recommend that quitters quit by the following method but sadly you will NEVER read any of the below at any online site engaged in selling nicotine products to nicotine addicts:
USDHHS Guidelines Recommendation Number 5:

"There is a strong dose-response relation between the intensity of tobacco dependence counseling and its effectiveness. Treatments involving person-to-person contact (via individual, group, or proactive telephone counseling) are consistently effective, and their effectiveness increases with treatment intensity (e.g., minutes of contact).

With only a couple of two week clinics under my belt I'm still pretty green at delivering live educational clinic programs but even so, 50% of those attending my first clinic are still nicotine clean six months later. Joel is far more skilled at this and over 50% of his clinic students remain free at one year! Although it sounds a bit drastic, I understand that the Mayo Clinic has an eight day inpatient program where over 60% of their abrupt nicotine cessation participants have remained nicotine clean for one year while their NRT quitters only did about half as well.

The key is in getting quitters through the first 72 hours so that they can begin to feel true healing begin. Once you begin to actually feel the withdrawal anxieties begin to subside, your confidence begins to build! The key to victory during those first 72 hours is to only fight and focus on that battle that is occurring RIGHT NOW, this very moment!

Prepare to give your all, should the need arise (which it may not), but stay focused on only today! If you were going to walk across your entire country (from end to end, or coast to coast) would you be more likely to succeed if you continued to picture and think about how far you actually have to walk, or would your chances of success be greater if you only focused on continuing to put one foot in front of the other? Think about it! Don't breed defeat in your mind, simply take it one step at a time, and glory will be yours! You can do this!

Breathe deep, hug hard, live long! John Image
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John (Gold)
Joined: 18 Dec 2008, 23:57

02 Apr 2002, 08:28 #10

The Times of India Online

Nicotine patches can do more harm than good
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ANI [ MONDAY, APRIL 01, 2002 5:03:08 PM ] Image ImageASHINGTON: Nicotine patches and gum may be hazardous to health. Nornicotine, a component of nicotine, can interfere with chemical reactions in the body, triggering adverse health effects, according to a report published in the Science Daily.

The Daily quoted a study published in the Journal of the American Chemical Society. The study was conducted at the Scripps Research Institute, California.

The study suggests that smokers who are under medication or use nicotine patches are at a greater risk. Nornicotine could modify these drugs, possibly reducing drug potency and cause side effects, according to the report. While patches and gum can vary in nicotine content, those who continue to smoke while using these products expose themselves to higher health risks by getting extra nicotine, they said.

The study also says that nornicotine adds to the health dangers of smoking itself. Although nicotine has been shown to be a dangerous chemical in addition to its known addictive properties, this is the first demonstration of the chemical potential of a nicotine metabolite, they said. "This represents another potentially adverse chemical found in tobacco that's coming from nicotine itself," said the study's lead author, Kim D Janda. "We've got to be more aware of this."

The addictive effects of nicotine have been known for some time. Nornicotine, also a natural constituent of tobacco, was thought to be a minor player in addiction. While investigating ways to treat nicotine addiction, Janda and graduate student Tobin Dickerson conducted a detailed chemical analysis of nicotine.

They found that nornicotine is not just an innocent bystander. It catalyses certain reactions that play major roles in processing chemicals that circulate in the body, whereas nicotine itself has no effect on these chemical reactions.

The finding was surprising because it was believed that, under conditions found in the body, only certain enzymes were able to catalyse these reactions, and nornicotine is not an enzyme. The compound, which differs from nicotine by a single carbon atom, is the first example of a metabolite that acts as a catalyst for chemical reactions, the researchers said.

The researchers demonstrated that nornicotine could interact with many important chemical reactions, including the conversion of glucose into energy.

They also identified certain medicines, including steroids and antibiotics, which are likely to interact with nornicotine. This drug interaction could trigger potentially adverse health effects. Tests are currently underway to determine specific drugs that may put smokers and other users of nicotine products at increased health risks.

Those who want to quit smoking may wish to consider treatments that don't involve nicotine, he added. "Unfortunately, although some nicotine-free treatments are currently undergoing testing, to our knowledge there are no nicotine-free treatments for smoking cessation therapies currently available over-the-counter," Janda said.
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