That is an interesting statistic. I had not heard it before, but it makes sense. I feel that a tendency toward addictions tends to go along with the tendency to have mental illnesses. The only reason I never tried smoking/alcohol/drugs, etc. was because my religious beliefs prevented me. Still, those things have their appeal and I am positive that if I ever did get started with them it would be extremely difficult for me to stop. I have addictive behaviors instead, like SI, and I am addicted to chocolate. I think I would get addicted to antidepressants also if I started using them.

DocJohn wrote a blog entry about an article (<A target="_blank" HREF=http://www.reason.com/0404/fe.jj.emotional.shtml>http://www.reason.com/0404/fe.jj.emotional.shtml</A>) that makes a point for mood medications being similar to unprescribed mood altering substances. I can see the author's point. I sent that article to my T, and he disagreed on the basis that he has seen an improvement in the lives of people who use antidepressants, as opposed to also having seen alcohol and illegal drugs ruin people's lives. I wrote back to him further arguing the point of the article and that I think that the context of use and intent of the user accounts for the difference in results. That didn't make him happy at all. He just said he didn't know what point I was trying to make with that (I guess since he stopped pushing antidepressants to me a few months ago, albeit reluctantly).

For what it's worth, here's my argument:

<font color=blue>There are some definite similarities between the way that prescription mood altering drugs and the other kind operate. From Richard O. Straub (2002). Health Psychology. New York: Worth Publishers, p. 316: "Once in the brain, drugs affect behavior by influencing the activity of neurons at their synapses. Drugs can achieve their effects in one of three ways: by mimicking or enhancing the action of a naturally occurring neurotransmitter, by blocking its action, or by affecting its reuptake." No distinction is made between prescibed vs. other drugs. Antidepressants generally work by inhibiting the reuptake of neurotransmitters - particularly serotonin, norepinephrine, and/or dopamine. Cocaine blocks the reuptake of norepinephrine and dopamine. Amphetamines stimulate the release of dopamine. LSD is similar in structure to serotonin, and mimicks its action. Caffeine blocks the effects of adenosine, which normally inhibits release of transmitters that excite postsynaptic cells, so the effect of caffeine is that excitatory cells keep firing. Librium and Valium are still used to treat anxiety and insomnia, but I think maybe they are not used as much now as they once were. They are depressants, as are alcohol and barbituates - they stimulate the release of dopamine. Barbituates also were used to treat anxiety and insomnia, but are not anymore because they are too addictive. Alcohol is very effective in regulating mood swings, as in bipolar disorder, and is used in that manner by quite a few people who have diagnosed or undiagnosed bipolar disorder. Doctors don't prescribe alcohol for that because the side effects are bad. Heroin was developed for medical use but was found to be too addictive.

Much of the effect of drugs and alcohol is related to the expectations of the user. If you give a group of people in a social setting like a party a drink that they think is alcoholic, but actually contains no alcohol, they will act drunk. In cultures where it is customary to drink wine or beer with meals, children also drink wine or beer as a beverage, and used in that context, those people do not get drunk. If people were abusing prescription antidepressants in order to get high, wouldn't the effect be the same as if they were using cocaine? How powerful each drug is would also be a factor, besides the context of using it.

Prescription antidepressants are associated with the effects of tolerance as well as withdrawal. Physical dependence is defined as "a state in which the use of a drug is required for a person to function normally." I'm finding that with SJW. I got by without anything for most of my life, but now if I skip it for 3 days in a row I don't function very normally. Maybe I never did before either - I don't know.

The only real differences I can see between prescription and other drugs is the quantity and/or power of the drug (or how regulated its use is), and sometimes the reason for using it. And I think that those differences are what account for the differences in their effects.
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Way more than you wanted to know, but I'm curious what everyone thinks about this topic. I do think that people with mental illnesses probably are more susceptible to addictions also. And in treatment settings there has been a tendency to capitolize on that. How often do we hear about cigarettes being used as a reinforcer in behavior modification programs, especially in an inpatient mental health treatment setting?

If you have made it this far, here's my short answer - no, I do not smoke and I consider myself lucky to be among that 8%. And I would like to encourage you to try to quit. Tobacco use is still the single biggest preventable cause of death, illness, and disability in the U.S. and I'm not sure but probably worldwide also.

<font color=orange>"If we are going to insist that people pull themselves up by their own bootstraps, we must ensure that they have boots."</font color=orange>