Recovery Messages & News

Are you Smoking… Or being Smoked?

By Dr. Raju Hajela, Addictionist 

 

People often consider smoking cigarettes to be their comfort, choice and the “lesser of evils” in recovery from addiction related to alcohol and other drugs. In reality, research has demonstrated, unequivocally, that the same brain circuits that are affected by alcohol and other drugs are involved with nicotine. It has also been noted that relapse rates are higher among smokers than amongst those who quit smoking as part of their recovery.

 

Tobacco, in the form of cigarettes, is often the first drug that children or youth try when they begin experimenting with substances and wanting to do what adults do to relax! The “relaxing effect” of smoking is driven more by relief than reward. This is true for all aspects of addiction – the reward that one may get initially increasingly turns into a chase to seek relief as addiction-related changes take place in the brain. Nicotine is the ingredient in tobacco that is highly addictive, as it acts directly on the acetylcholine receptors, which are vital for healthy functioning of the brain and body. Further, there is stimulation of the endo-opioids, such as endorphins, and endo-cannabinoids, such as anandamide, which activate the reward circuitry, making it quickly dependent on that outside stimulation rather than maintaining self-sufficiency through natural mechanisms, such as healthy eating, exercise, yoga and meditation. A disordered endo-opioid and endo-cannabinoid system has serious implications for mental health  and pain problems, in addition to addiction-related problems, which result from problems in the brain reward, motivation, memory and related circuits.

 

From a treatment and recovery perspective, the psycho-social-spiritual components for tobacco (nicotine) addiction are the same, hence, attention is needed for clarifying feelings and challenging addictive thinking. The biological base of addiction requires consideration for nicotine replacement therapy (NRT), to deal with withdrawal symptoms, while changes are made behaviourally to develop a smoke-free lifestyle. Naltrexone, which is an opioid antagonist, can be useful to decrease cravings too, while the endo-opioid system recovers its more natural function. Bupropion and Varenicline are agonist medications that can be helpful as well. Ongoing research may lead to medications that are useful in covering off the cannabinoid circuitry in time to come.

 

On the other hand, those that smoke cannabis (marijuana) are in a double jeopardy situation, as the endo-cannabinoid system becomes directly impaired due to the marijuana being ingested, in addition to the addiction-related brain circuitry effects. It is helpful to use Steps 1, 2 and 3 from 12 Step Programs such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) as a starting point to address recovery from tobacco addiction.

 

From a practical standpoint, it is essential that someone who is a smoker makes smoking a solitary, outdoor activity, even before quitting, in order to break the associations (environmental cues) that drive addict thinking and addict behaviours. Best results with smoking cessation are achieved when all the bases – biological, psychological, social and spiritual – are covered.

 

For more information on Tobacco Cessation, please consult the National Institute on Drug Abuse (NIDA) website. In addition to articles about tobacco, this website is a wealth of information for other substances of choice and has a subsite specifically designed for Teens.

 

At HUM we approach addiction as addiction so if you are struggling wtih tobacco cessation or any other type of substance or process addiction, please contact us at 403-536-2480 to schedule an assessment or get more information.