March 05, 2004

Cause and Affect

(Now, before y'all start in on the Confidence Man's spelling with this-here header, please hold on, keep reading, and your patience shall be rewarded. Have Confidence. This shall all make sense in good time.)

Hm. This is an odd and intriguing article in the LAT. Apparently, nicotine is the new Magick Redemptive Patent Liniment, Salve and Cure-All. Brought to you, of course, by Big Terbacky. Which, in turn, means -- more Space Pork for Nawth Cahwlayna and Kaintuck!

But, the Confidence Man doth digress. The topic here that interests him is Science! or the lack of principled thought therein.

Note in the article the innocuous discussion in the second nut graf of certain scientists' belief that "nicotine holds promise as a powerful treatment for a variety of illnesses, from Alzheimer's disease to depression to schizophrenia."

Now, reading further, we find the reasoning for studying the effects of nicotine on schizophrenics:

Why do almost 90% of schizophrenics smoke — three times the rate of the general population? Why do teens with attention deficit hyperactivity disorder, or ADHD, smoke at higher rates than their peers?

[...]

Doctors have long suspected that people with schizophrenia and ADHD are self-medicating — that is, they try to alleviate their symptoms by smoking.


So, ok, sure, perhaps there is potentially something to this discussion of acetylcholine receptors.

The Confidence Man, however, has grave reservations.

Schizophrenia research from the days of Bleuler and Krapelin has been plagued by confusion between affect and effect, and between behavioral symptoms and molecular/chemical/biologic symptoms and pharmacokinetic symptoms.

Not to mention the fact that schizophrenia presents with "symptoms" that are impossibly bound up with linguistic and social structures to be merely biologic in nature. The altered affect so notable in schizophrenia is very likely as much a sociological phenomenon as it is a biological phenomenon.

(A-ha! And now the cute "mis"-spelling in our header becomes apparent as a clever little pun. Aren't we adorable?)

So, back to the nic-fit issue at hand. Apparently, "scientists" have determined that persons with schizophrenia and ADHD -- which are both characterized by altered affect, twitches, mood swings, and nervous, restless energy -- are "self-medicating" with cigarettes.

Uh-huh.

Well, first of all, ANYone who smokes is "self-medicating" per se.

But, more importantly, smoking gives you something to do with your hands and mouth. To calm you down and keep you from tweaking out in other less socially acceptable ways. It's an oral-digital affect and a behavioral/attitudinal affect and a peer-induced behavioral gesture, especially when first adopted and reinforced as a habit.

This "self-medicating" stuff is utter nonsense.

But understandable: research physicians are not trained in sociology or anthropology or linguistics. As evidenced further by this priceless nonsense.

Now, don't get the Confidence Man wrong: he is not saying that nicotine has no effect or no potential as a treatment for these conditions; nor is he denying the molecular/biological evidence of nicotine's effect on the acetylcholine receptors.

No, our point here is that these researchers have Confidence. That is, though they claim to toe the line of Science!, they tread the path of the True Believers.

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