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How Is Nicotine Addiction Treated?


August 2nd, 2011 – Posted by James W. West M.D. F.A.C.S. in Counseling

      


Question:  If – as you say – “nicotine is just as addictive, more deadly, than cocaine,” where are the centers that treat these nicotine addicts?  Does this mean that chomping on gum and sticking on adhering (nicotine) patches will alleviate the mental and physical distress that accompanies the withdrawal from tobacco?

 Answer:  Most inpatient alcohol and other drug treatment centers have a protocol for the treatment of nicotine dependence.  Treatment of nicotine dependence does not require inpatient treatment.  The protocol for dealing with this addiction can be accomplished effectively as an outpatient.

 Any physician is capable of providing the medication and the support to help a patient get off the drug and stay off.  First of all, the Fagerstrom Questionnaire is administered to assess the degree of nicotine dependence.  On the basis of this simple assessment the strength (megs/day) of the transdermal nicotine patch can be determined.

 The dose of nicotine can be adjusted over a protocol lasting up to 21 days.  The transdermal nicotine patch will greatly relieve the physical symptoms of nicotine withdrawal.

During this time the patient must pick a “quit date” at which time his smoking days are over.  Nicotine withdrawal signs and symptoms include irritability, headache, insomnia, anxiety, difficulty concentrating, nausea and diarrhea.  A substitute for the nicotine patch could be a gum, which supplies an amount of nicotine sufficient to allay symptoms of withdrawal.  There is supportive literature to encourage the person who is going through the quitting process.

Most inpatient alcohol and other drug programs, which treat nicotine dependence, are treating alcohol or some other drug dependence as the reason the person is in an inpatient setting.

 Nicotine dependence does not require inpatient care.  Motivation to quit must go beyond the generally known statistical information about lung cancer and other issues that are associated with cigarette use.

At the core of beating this addiction has to be the image of one’s self as a nonsmoker and the willingness to go to any length and to bear any discomfort to get there.

In my opinion, quitting “cold turkey” is the most direct and effective way to become a nonsmoker.


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11 Responses to “How is nicotine addiction treated?”

  1. Len B says:

    I beg to differ with your opinion regarding the effectiveness of quitting smoking “cold turkey.” All the statistics I’ve read indicate that no more than 5% of those who try to quit on their own and without assistance are ever successful. As a recovering ex-smoker who was addicted to cigarettes for more than 40 years, I was finally able to stop smoking only after participating in a comprehensive smoking cessation program at my local Veterans Administration Medical Center. It took weeks of classroom training, one-on-one counseling, Nicotine Replacement Therapies (patches and inhalers), and medicine (Bupropion)for me to finally quit. It has now been more than 2 years since I crushed out my last cigarette and I must continue to work hard to remain smoke free.

    Please rethink your opinion about the effectiveness of quitting “cold turkey” as all it does is minimize the complexity of nicotine addiction when, in fact, it is at least as difficult to treat as the addictions to cocaine, heroine, or other deadly drugs.

    Finally, please check out my web site. It has lots of information to help those who would like to quit, or for those who would like to help someone else quit. http://www.smokefreevets.org

  2. Sabrina H. says:

    I agree with Len B that smoking addiction is as serious and as difficult to quit as alcohol, prescription drug or other drug addiction. I also agree with the initial question of why there are no treatment centers for this addiction. The patch, inhalers, medicines, etc. only treat one aspect (the physical) of nicotine addiction which helps only those who have this one type of addiction to the drug (for that is exactly what cigarettes are), but they do not help those of us who are addicted to nicotine on two – or worse – all three of the levels of addiction. There are those, like me, who have a serious psychological addiction to the drug which is based on a traumatic past (as in my case), severe depression, or other such conditions. Quitting cold turkey, or use of one (or even a combination) of the other medications or replacement therapies out there do not work. In my case, when I even think about quitting smoking or having to go without cigarettes for a lengthy period of time, I get shaky, extremely angry (borderlining on pure rage), severely anxious and even physically sick. While heroine or cocaine withdrawal symptoms may be more intense, nicotine withdrawal symptoms follow a similar pattern. Where is the help for people like me? In short, nicotine addiction is just as serious as addiction to any other drug.

  3. Betty Ford Center says:

    There are Nicotine Anonymous support meetings in many communities, and that group approach would cover more than just one aspect of the addiction. A good place to start would be to contact your local AA Central Office; they would probably know of other types of 12 Step support meetings in your area. http://www.nicotine-anonymous.org/

  4. Kerry B/ says:

    I like smoking and can’t quit. I did everything: hospital group programs, nicotine patches. I need more than my free will to quit, and I won’t make it as an outpatient. I need to be prevented from smoking while the poison leaves my system. When I start to withdraw, I will light up a cigarette.
    I am willing to go to any length and to bear any discomfort to get there. Do state hospitals treat cigarette smoking addiction? I am willing to lose my freedom for a while to stop smoking. If any do this near new York City, email me and let me know, ok?
    I live at the Connecticut NY border line near Rye, NY.

  5. kerry says:

    i want to be a inpatient on a addiction ward for at least a month and restrained as well
    as not being able to leave the ward. the only way to beat a smoking addiction is by forced cold turkey … i felt the effects of not getting enough air for the first time today and i am pretty
    much afraid of this. i have to be stopped i want to but i cant.

  6. Michelle T says:

    I’ve had my share of addictions, and I have successfully kicked all of them “cold turkey” except for cigarettes. The nicotine is the least of the problem. Once the nicotine has left my system (three days), the psychological addiction hits and I fail. Wellbutrin worked for about a month, but I couldn’t shake the “desire” or “need” to smoke a cigarette.

    Having been treated within the past 18 months for two smoking related cancers, in all honesty, I’m committing suicide with each puff. I need a supportive environment which will keep me away from cigarettes for at least 30 to 60 days.

  7. Jerry says:

    Would it not make sense for every state to take some of the billions of dollars from their settlement with the tobacco companies and establish free nicotine rehab clinics across the country? They could also use some of the tax on tobacco products to support these centers.

  8. Susan B. says:

    Kerry, I totally agree with you. For many of us, outpatient does not work. There are many alcoholics and drug addicts where outpatient doesn’t work. It’s the same with some nicotine addicts. Actually, there are a few inpatient facilities in the country – I remember reading about it once. Google it and see what you come up with. But, insurance won’t pay, presumably because nicotine is the largest abused drug and in-patient treatment would be too enormously expensive for insurance carriers due to all of the addicts out there. Have you tried electronic cigs? They have nicotine but NONE of the other crap that makes cigarettes so deadly.

  9. Amy says:

    I’m thankful to all of you for your genuine comments. I believe my fiance is in the same boat as all of you. I have been searching everywhere for help for him, for a smoking cessation program that really works and is affordable; and, no one at any medical facility I have talked to seems to have a clue the gravity of this addiction and how much help people need to overcome it. It’s shocking, the lack of true help avalable. I understand the Mayo Clinic (and perhaps the Cleveland Clinic) have inpatient programs. We need affordable, individualized care for this.

  10. EMY says:

    This article angers me. For Betty Ford Clinic to say nicotine addicts do not need inpatient treatment may be true for some, but not for all. I am one of those in the latter category. Desire is not enough. I have 26 – almost 27 – years of continuous sobriety from other drugs (besides nicotine) and alcohol. I have tried many various ways to quit smoking and had actually maintained sobriety for 7 months (from nicotine). It was the lack of support that made me unsuccessful and lack of suitable treatment, unresolved issues. Nicotine has been my drug of choice since I was 10 years old. I am now 54. Quitting drugs and alcohol was easy compared to nicotine addiction. I had inpatient treatment, AA support and sponsorship. Finding support for this addiction is nil to impossible.
    So please Betty Ford Clinic, do not say inpatient treatment is not needed for nicotine addiction. I hope this article isn’t written as a result of monies from Phillip Morris. I do wish you well…

  11. Ashley says:

    I have been confused by all the new “Vapor” products now and how beneficial they really are or aren’t. They are not real smokes to me and neither is gum or a patch (which I am allergic to). I have researched and found that not only is nicotine addiction not taken seriously as an inpatient thing, but marijuana is not either! I could not believe that everywhere I searched, people said that cigarettes and pot don’t require rehab? AND JUST WHY NOT? Mind-boggling to me. You can try http://www.quitnet.com and its an online way to find your own path, set things yur way, and talk to other smokers etc..I have had some success with them, but Im just not ready to give it up yet.

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