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A 33-year-old female asked:

Some cultures use drugs for centuries (like khat) is "addiction" just a modern phenomenon? can addictive substances be used safely in other cultures?

4 doctor answers8 doctors weighed in
Dr. Mark Fisher
Neurology 30 years experience
Complex issue: There's nothing cultural about physiological addiction. It's real. What are considered "licit" vs "illicit" substances or practices varies widely by period & culture. Ditto for whether an addiction is accepted & accommodated by a society or condemned & persecuted. There is a very rich literature on this subject which is really more sociology than medicine. Check your library & bookstore.
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Dr. Mark Fisher
Dr. Mark Fisher commented
Neurology 35 years experience
Provided original answer
A number of years ago the History Channel - back when it WAS a history channel and hadn't yet been turned into a travesty by that monster Rupert Murdoch - aired a series of programs called "Hooked: Illegal Drugs and How They Got That Way" which is available on DVD through Amazon and can also be found on line to view for free. I recommend it.
Sep 28, 2014
Dr. Lois A Freisleben-Cook
Pediatrics 36 years experience
Universal: Addiction occurs in every culture and every country. There is no safe place to use addictive substances. If you have a genetic predisposition to addiction, refrain completely. Remember, "No matter where you go, there you are." the image here is khat teeth. A detailed review of consequences of KHAT is available here http://apt.rcpsych.org/content/9/6/456.full
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Dr. Randy Baker
Holistic Medicine 41 years experience
Varies with the drug: Addiction is not modern & occurs in all cultures, but the addictive potential of drugs varies widely. For example, tobacco & opiates are highly addictive for almost anyone who uses them, whereas most can use alcohol periodically without becoming addicted, but a moderate percentage have a genetic tendency to addiction. Others like marijuana & peyote have relatively low addiction rates. See comment:
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Dr. Randy Baker
Dr. Randy Baker commented
Holistic Medicine 41 years experience
Provided original answer
Any psychoactive substance can be addictive but some are more addictive than others.There are also variations in how cultures use them.For example,ayahuasca & peyote are used in religious ceremonies & don't seem addictive.Coca leaves chewed in the Andes help people adapt to high altitude & don't seem addictive unless processed into cocaine. So cultural constructs can influence addictive potential.
Sep 27, 2014
Dr. Alan Wartenberg
A Verified Doctoranswered
Addiction Medicine 50 years experience
No, it's not modern: Ancient medical texts from both the East and West have described problems with people with alcoholism and opioid dependency many thousands of years ago. Certain issues in modern culture, such as fragmented families, increasing stress, poverty, war, increased discretionary income in young people and other factors may increase the incidence/prevalence. But it has always been around.
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Dr. Philip Miller
A Verified Doctor commented
A US doctor answered Learn more
addiction: is a brain disease with physiologic ramifications and a certain mortality
Nov 24, 2015
Dr. Johanna Fricke
Pediatrics - Developmental and Behavioral 51 years experience
Agree on all counts. Ramifications are also socio- familial, social & legal. Half of U.S. pregnancies are unplanned. The structure that becomes the fetal brain & spinal cord starts to form 3 weeks after conception, which is 1 week gestational age. Damage from maternal alcoholism & from either parents' use of smokable drugs, including tobacco, often occurs before pregnancy is diagnosed.
Nov 24, 2015
Dr. Johanna Fricke
Pediatrics - Developmental and Behavioral 51 years experience
Damage also occurs when alterations in methylation of certain genes in the sperm of fathers with chronic alcoholism. are encoded in a male fetus' genetic complement.
Nov 24, 2015

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