Nicotine is an interesting drug and nicotine dependence is an even more fascinating subject.

Nicotine differs from other drugs. Nicotine is usually a gateway drug for most smokers, that is, it is the first drug used. Often, it is also the last drug that a person puts down. In other words, we begin with nicotine, may later use or abuse or become dependent on other drugs. Then, in recovery, stop using or abusing other drugs, maybe all at once, maybe one at a time, except nicotine. The final drug from which one recovers is often nicotine.

We now know that simultaneous recovery from all mood and mind altering substances, including nicotine, enhances recovery. Years ago, we believed that it was best to simply focus on alcohol or other drugs on which one was dependent, but that it was ok to continue to use nicotine. Now we have additional information that informs us that continued nicotine use while recovering from other drugs can jeopardize that recovery.

Nicotine is a very reinforcing drug. When we inhale cigarette smoke, the nicotine reaches our brain in seven to ten seconds. Yes, that’s right, seven to ten seconds. Lightning speed! We usually take about 10 drags from each cigarette. So let’s see……..if I smoke one pack per day (10 drags times 20 cigarettes per pack) that gives me 200 drags per day…..or 73,000 drags per year! Oh, no wonder it’s so reinforcing!

Nicotine dependence is part physical and part psychological. First, nicotine is the most addictive drug in the world. On a milligram by milligram basis, it is more addictive than heroin or cocaine.

We experience physical dependence with nicotine. We experience:

• Tolerance (needing higher doses to achieve the same effect)
• Continued use despite adverse consequences
• Withdrawal (when we stop or decrease use)
• Cravings
• Relapse is very common

With psychological dependence, we notice:

• Most smokers smoke at regular times of day
• Their use follows a definite pattern, with many smoking more in the morning to make up for the lack of nicotine intake during the night
• Companion habits and cues (smoking with coffee, with alcohol, while driving, when starting a new task, etc) and it is difficult to break the association of smoking with these activities
• Smoking when others smoke (hey let’s go outside for a quick smoke…)
• Use of nicotine to control mood and performance (smoking to give a boost, smoking to relax).

As a result of the physical AND the psychological dependence, we become addicted to nicotine (the drug) and to smoking (the behavior). Although this makes it more difficult to become nicotine-free, we have interesting information about our first two weeks in nicotine recovery. If we stay nicotine-free during our first two weeks after quitting, we have a 40% chance of being nicotine-free after 6 months. However, if we smoke during our first two weeks after quitting, even a puff, we have only a 5% chance of being nicotine-free after 6 months.

MESSAGE: When we become nicotine-free, the first two weeks of recovery is crucial. Make recovery your priority, plan in advance, and have a solid, detailed relapse prevention plan in place.

Until next time, this is Cory the Counselor from the Chicago area signing off, wishing you well on your journey, and reminding you to keep at it because you are worth it! I welcome your comments and thoughts about this article at crkalat@aol.com or 630.263.8888…….Take care!

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