384 



But what is it about truly addicting drugs that differentiates them from habitual behaviors such 

 as cigarette smoidng, coffee drinking, eating or exercise? 



The differences are present in all phases of these behaviors. First is the effect produced by 

 ingestion. A person on hard drugs is intoxicated. Intoxication is fundamentally an organic brain 

 syndrome whereby the person's state of consciousness is altered, reasoning is impaired, coordination 

 is affected and memory and concentration are substantially altered. Further, mood is visibly 

 changed, judgment is warped, delusions and/or hallucinations may occur, and unconsciousness or 

 sudden death will result from substantial overdose. 



Intoxication does not occur with cigarette smoking. Measured and observed effects on mood 

 and mental functioning of cigarette smoking reveal that it is similar to the effect produced by 

 drinking a cup of coffee and very dissimilar from the effects produced by hard drugs. People who 

 smoke think clearly and make reasoned decisions. Smokers perform with competence at the highest 

 levels in their personal and professional lives. They make complex and difficult decisions without 

 any interference from their cigarette smoking. 



The second difference occurs upon cessation of drug use. Abrupt cessation of a hard drug 

 following regular use will inevitably and predictably result in a "classic" withdrawal syndrome. This 

 generally requires medical hospitalization for clinical management because drug withdrawal can be 

 a life-threatening situation. The symptoms of withdrawal due to physiologic dependence include 

 severe vasomotor instability (rapid blood pressure changes), muscle cramps and nausea, 

 hallucinations and/or delusions (in alcohol withdrawal they are called delirium tremens or "DT's"), 



