This paper examines addiction from a biobehavioral perspective, defining it as repeated use of a substance and/or a compelling involvement in a behavior that directly or indirectly modifies the internal milieu in such a way as to produce immediate reinforcement, but with harmful long-term effects. Using cigarette smoking as an exemplary addiction, we attempt to develop a comprehensive analysis of substance abuse that incorporates both pharmacological and social learning factors. Such a formulation suggests that research strategies involving multivariate analyses will be required if the complexities of addiction are to be satisfactorily addressed. It also has implications for treatment, in suggesting that interventions with both pharmacological and behavioral components are more likely to produce successful outcomes.
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References
1.
AbramsD. B.MontiP. M.PintoR. P.ElderJ. P.BrownR. A.JacobusS. I. in press Psychosocial Stress and Coping in Smokers who Relapse or Quit. Health Psychology.
2.
BakerL. H.CooneyN. L.PomerleauO. F.1987Craving for Alcohol: Theoretical Considerations and Treatment Procedures. In CoxW. M. (ed.), Treatment and Prevention of Alcohol Problems: Resource Manual. New York: Academic Press.
3.
BakerT. B.TiffanyS. T.1985Morphine Tolerance as Habituation. Psychological Review92:78–108.
4.
BensonH.1975The Relaxation Response. New York: William Morrow.
5.
BestJ. A.HakstianA. R.1978A Situation Specific Model of Smoking Behavior. Addictive Behaviors3:79–82.
6.
BozarthM. A.1983Opiate Reward Mechanisms Mapped by Intracranial Self-Administration. In SmithJ. E.LaneJ. D. (eds.), New York: Elsevier Biomedical Press.
CarrD. B.FishmanJ. M.1985Exercise and the Endogenous Opioids. In FotherbyK.PalS. (eds.), Exercise Endocrinology. New York: De Gruyter.
10.
CherekD. R.1982Schedule-Induced Cigarette Self-Administration. Pharmacology, Biochemistry, and Behavior17:523–527.
11.
EpsteinL.CollinsF.1977The Measurement of Situational Influences of Smoking. Addictive Behaviors2:47–54.
12.
FertigJ. B.PomerleauO. F.SandersB.1986Nicotine-Produced Antinociception in Minimally Deprived Smokers and Ex-Smokers. Addictive Behaviors11:239–248.
13.
FalkJ. L.DewsB.SchusterC. R.1983Commonalities in the Environmental Control of Behavior. In LevisonP. K.GersteinD. R.MaloffD. R. (eds.), Commonalities in Substance Abuse and Addictive Behavior. Lexington, MA: D.C. Heath.
14.
GoldbergS. R.StolermanI. P. (eds.) 1986Behavioral Analysis of Drug Dependence. New York: Academic Press.
15.
GritzE.1980Smoking Behavior and Tobacco Abuse. In MelloN. (ed.), Advances in Substance Abuse. Greenwich, CT: JAI Press.
16.
HallS. M.TunstallC.RuggD.JonesR. T.BenowitzN.1985Nicotine Gum and Behavioral Treatment in Smoking Cessation. Journal of Consulting and Clinical Psychology532:256–258.
17.
HatsukamiD. K.HughesJ. R.PickensR.1984Tobacco Withdrawal Symptoms: An Experimental Analysis. Psychopharmacology84:231–236.
18.
HatsukamiD. K.1985Characterization of Tobacco Withdrawal: Physiological and Subjective Effects. In GrabowskiJ.HallS. M. (eds.), Pharmacological Adjuncts in Smoking Cessation (NIDA Monograph 53). Rockville, MD: National Institute on Drug Abuse.
19.
HenningfieldJ. E.LukasS. E.BigelowG. E.1986Human Studies of Drugs as Reinforcers. In GoldbergJ. R.StolermanI. P. (eds.), Behavioral Analysis of Drug Dependence. New York: Academic Press.
20.
HenningfieldJ. E.MiyasatoK.JasinskiD. R.1985Abuse Liability and Pharmacodynamic Characteristics of Intravenous and Inhaled Nicotine. Journal of Pharmacology and Experimental Therapeutics234:1–12.
21.
HodgsonR. S.RankinH. J.1976Modification of Excessive Drinking by Cue Exposure. Behaviour Research and Therapy14:305–307.
22.
HoffmanJ. W.BensonH.ArnsP. A.StainbrookB. L.LandsbergL.YoungJ. B.GillA.1982Reduced Sympathetic Nervous System Responsivity associated with the Relaxation Response. Science251:190–192.
23.
HughesJ. R.1984Psychological Effects of Habitual Aerobic Exercise: A Critical Review. Preventive Medicine13:66–78.
24.
HughesJ. R.MillerS.1984Nicotine Gum to Help Stop Smoking. Journal of the American Medical Association. 252:2855–2858.
25.
HughesJ. R.HatsukamiD. K.PickensR. W.SvikisD. S.1984Consistency of the Tobacco Withdrawal Syndrome. Addictive Behaviors9:409–412.
26.
IversenS. D.IversenL. L.1981Behavioral Pharmacology (2nd ed.). New York: Oxford University Press.
27.
JacobsonE.1938Progressive Relaxation. Chicago: University of Chicago Press.
28.
JarvikM.1977Biological Factors Underlying the Smoking Habit. In JarvikM.CullenJ.GritzE.VogtT.WestL. (eds.), Research on Smoking Behavior (NIDA Research Monograph 17). Rockville, MD: National Institute on Drug Abuse.
29.
JeffreysD.OeiT. P. S.SingerG.1979A Reconstruction of the Concept of Drug Dependence. Neuroscience and Biobehavioral Reviews3:149–153.
30.
JellinekE. M.1960The Disease Concept of Alcoholism. Highland Park, NJ: Hillhouse Press.
31.
KalantH.1973Biological Models of Alcohol Tolerance and Physical Dependence. In GrossM. M. (ed.), Alcohol Intoxication and Withdrawal: Experimental Studies. New York: Plenum Press.
32.
KamerlingS. G.WettsteinJ. W.SloanJ. W.SuF. P.MartinW. R.1982Interaction Between Nicotine and Endogenous Opioid Mechanisms in the Unanesthetized Dog. Pharmacology, Biochemistry, and Behavior17:733–740.
33.
KaplanR. F.CooneyN. L.BakerL. H.GillespieR. A.MeyerR. E.PomerleauO. F.1985Reactivity to Alcohol-Related Cues: Physiological and Subjective Responses in Alcoholics and Nonproblem Drinkers. Journal of Studies on Alcohol46:267–272.
34.
KoopC. E. (ed.) 1986The Health Consequences of Using Smokeless Tobacco: A Report of the Advisory Committee to the Surgeon General. Bethesda, MD: U.S. Public Health Service.
35.
KornetskyC.BainG.1983Effects of Opiates on Rewarding Brain Stimulation. In SmithJ. E.LaneJ. D. (eds.), The Neurobiology of Opiate Reward Processes. New York: Elsevier Biomedical Press.
36.
KozlowskiL. T.HarfordM. A.1976On the Significance of Never Using a Drug: An Example from Cigarette Smoking. Journal of Abnormal Psychology85:433–434.
37.
LeBlancA. E.KalantH.GibbonsR. J.1976Acquisition and Loss of Behaviorally Augmented Tolerance to Ethanol in the Rat. Psychopharmacology48:153–158.
38.
MarlattG. A.GordonJ. R.1985Relapse Prevention. New York: Guilford Press.
39.
MausnerB.PlattE. S.1971Smoking: A Behavioral Analysis. New York: Pergamon Press.
40.
MeyerR. E.MirinJ. M.1979The Heroin Stimulus. New York: Plenum Press.
41.
MontiP. M.BinkoffJ. A.AbramsD. B.ZwickW. R.NirenbergT.LiepmanM. R. in press Psychosocial Stress and Coping in Smokers who Relapse or Quit. Journal of Abnormal Psychology.
42.
MorleyJ. E.LevineA. S.YimG. K.LowyM. T.1983Opioid Modulation of Appetite. Neuroscience and Biobehavioral Reviews7:281–305.
43.
MorrellE. M.HollandsworthJ. G.1986Norepinephrine Alterations under Stress Conditions Following the Regular Practice of Meditation. Psychosomatic Medicine48:270–276.
44.
MyrstenA. L.ElgerotA.EdgrenB.1977Effects of Abstinence from Tobacco Smoking on Physiological and Psychological Arousal Levels in Habitual Smokers. Psychosomatic Medicine39:25–38.
45.
O'BrienC. P.EhrmanR. N.TernesJ. W.1986Classical Conditioning in Human Opioid Dependence. In GoldbergS. R.StolermanI. P. (eds.), Behavioral Analysis of Drug Dependence. New York: Academic Press.
46.
O'BrienC. P.GreensteinR.1976Naltrexone in a Behavioral Treatment Program. In JuliusD.RenaultP. (eds.), Narcotic Antagonists: Naltrexone (NIDA Monograph 9). Rockville, MD: National Institute on Drug Abuse.
47.
PeeleS.1985The Meaning of Addiction: Compulsive Experience and Its Interpretation. Lexington, MA: D.C. Heath.
48.
PechacekT.1986Specialized Treatment for Highly Anxious Smokers. Paper presented at the Annual Meeting of the Association for the Advancement of Behavior Therapy, New York City.
49.
PomerleauO. F.1980Why People Smoke: Current Psychobiological Theories. In DavidsonP. (ed.), Behavioral Medicine: Changing Health Lifestyles. New York: Brunner/Mazel.
50.
PomerleauO. F.1981Underlying Mechanisms in Substance Abuse; Examples from Research on Smoking. Addictive Behaviors6:187–196.
51.
PomerleauO. F.1986Nicotine as a Psychoactive Drug: Anxiety and Pain Reduction. Psychopharmacology Bulletin22:865–869.
52.
PomerleauO. F.AdkinsD.PertschukM.1978Predictors of Outcome and Recidivism in Smoking Cessation Treatment. Addictive Behaviors3:65–70.
53.
PomerleauO. F.FertigJ. B.BakerL.CooneyN.1983aReactivity to Alcohol Cues in Alcoholics and Non-Alcoholics: Implications for a Stimulus Control Analysis of Drinking. Addictive Behaviors8:1–10.
54.
PomerleauO. F.FertigJ. B.ShanahanS. O.1983bNicotine Dependence in Cigarette Smoking: An Empirically-based, Multivariate Model. Pharmacology, Biochemistry, and Behavior19:291–299.
55.
PomerleauO. F.PertschukM.StinnettJ.1976A Critical Examination of Some Current Assumptions in the Treatment of Alcoholism. Journal of Studies on Alcohol37:849–867.
56.
PomerleauO. F.PomerleauC. S.1984Neuroregulators and the Reinforcement of Smoking: Towards a Biobehavioral Explanation. Neuroscience and Biobehavioral Reviews8:503–513.
57.
PomerleauO. F. in press A Biobehavioral Perspective on Smoking. In NeyT.GaleA. (eds.), Smoking and Human Behaviour. Chichester, England: John Wiley & Sons.
58.
PomerleauO. F.ScherzerH. H.GrunbergN. E.PomerleauC. S.JudgeJ.FertigJ. B.BurlesonJ. in press The Effects of Acute Exercise on Subsequent Cigarette Smoking. Journal of Behavioral Medicine.
59.
PomerleauO. F.TurkD. C.FertigJ. B.1984The Effects of Smoking on Pain and Anxiety. Addictive Behaviors9:91–94.
60.
RussellM. A. H.1977Smoking Problems: An Overview. In JarvikM. J.CullenJ.GritzE.VogtT.WestL. (eds.), Research on Smoking Behavior (NIDA Research Monograph 17). Rockville, MD: National Institute on Drug Abuse.
61.
SangerD. J.1986Drug Taking as Adjunctive Behavior. In GoldbergJ. R.StolermanI. P. (eds.), Behavioral Analysis of Drug Dependence. New York: Academic Press.
62.
SchachterS.1978Pharmacological and Psychological Determinants of Smoking. Annals of Internal Medicine88:104–114.
63.
SchusterC. R.1986Implications of Laboratory Research for the Treatment of Drug Dependence. In GoldbergS. R.StolermanI. P. (eds.), Behavioral Analysis of Drug Dependence. New York: Academic Press.
64.
ShiffmanS.1982Relapse following Smoking Cessation: A Situational Analysis. Journal of Consulting and Clinical Psychology50:71–86.
65.
SiegelS.1983Classical Conditioning, Drug Tolerance, and Drug Dependence. In SmartR.GlaserF.IsraelY.KalantH.PophamR.SchmidtR. (eds.), Research Advances in Alcohol and Drug Problems. New York: Plenum Publishing.
66.
SingerG.OeiT. P. S.WallaceM.1982Schedule-Induced Self-Injection of Drugs. Neuroscience and Biobehavioral Reviews6:77–83.
67.
SkinnerB. F.1953Science and Human Behavior. New York: Macmillan.
68.
SliferB. L.1983Schedule-Induction of Nicotine Self-Administration. Pharmacology, Biochemistry, and Behavior19:1005–1009.
69.
SmithJ. E.LaneD. (eds.) 1983The Neurobiology of Opiate Reward Processes. New York: Elsevier Biomedical Press.
70.
SpitzerR. L.1980Diagnostic and Statistical Manual (3rd ed.). Washington, DC: American Psychiatric Association.
71.
SternM. J.ClearyP.1982The National Exercise and Heart Disease Project: Long Term Psychosocial Outcome. Archives of Internal Medicine142:1093–1097.
72.
StitzerM. L.BigelowG. E.LiebsonI.1979Reinforcement of Drug Abstinence: A Behavioral Approach to Drug Abuse Treatment. In KrasnegorN. (ed.), Behavioral Analysis and Treatment of Substance Abuse (NIDA Research Monograph 25). Rockville, MD: National Institute on Drug Abuse.
73.
TiffanyS. T.BakerT. B.1986Tolerance to Alcohol: Psychological Models and their Application to Alcoholism. Annals of Behavioral Medicine8:7–12.
74.
WallaceM.SingerG.1976Adjunctive Behavior and Smoking induced by a Maze Solving Schedule in Humans. Physiology and Behavior. 17:849–852.
75.
WallaceR. K.1970The Physiological Effects of Transcendental Meditation. Los Angeles: Herbert Herz Co.
76.
WetheringtonC. L.1982Is Adjunctive Behavior a Third Class of Behavior. Neuroscience and Biobehavioral Reviews6:329–350.
77.
WeiszD. J.ThompsonR. F.1983Endogenous Opioids: Brain Behavior Relations. In LevisonP. K.GersteinD. R.MaloffD. R. (eds.), Commonalities in Substance Abuse and Addictive Behavior. Lexington, MA: D.C. Heath.
78.
WiklerA.1965Conditioning Factors in Opiate Addiction and Relapse. In WilnerD.KassenbaumG. (eds.), Narcotics. New York: McGraw Hill.
79.
WiklerA.1975Opioid Antagonists and Deconditioning in Addiction Treatment. In BostromH.LarssonT.LjungstedtN. (eds.), Drug Dependence Treatment and Treatment Evaluation. Stockholm: Almqvist & Wiksell.
80.
WiklerA.1976The Theoretical Basis of Narcotic Addiction Treatment with Narcotic Antagonists. In JuliusO.RenaultP. (eds.), Narcotic Antagonists: Naltrexone (NIDA Monograph 9). Rockville, MD: National Institute of Drug Abuse.
81.
WilliamsR. B.LaneJ. D.KuhnC. M.MeloshW.WhiteA. D.SchanebergS. M.1982Type A Behavior and Elevated Physiological and Neuroendocrine Responses to Cognitive Tasks. Science218:483–485.
82.
WolkowitzO. W.RoyA.DoranA. R.1985Pathologic Gambling and Other Risk-Taking Pursuits. Psychiatric Clinics of North America8:311–322.
83.
World Health Organization1969Technical Report Series, No. 407. Geneva, Switzerland.
84.
WrayI.DickersonM. G.1981Cessation of High Frequency Gambling and ‘Withdrawal’ Symptoms. British Journal of Addiction76:401–405.
85.
WuK. M.MartinW. R.1983An Analysis of Nicotinic and Opioid Processes in the Medulla Oblongata and Nucleus Ambiguus of the Dog. Journal of Pharmacology and Experimental Therapeutics227:302–307.
