Page 75 - PhD GT

3.4.5 Drug dependence and the Severity of Opiate Dependence Scale (SODQ)
Writing in 1981 for the World Health Organisation, Edwards et al. proposed a convergence between theorising on the nature of alcohol dependence and drug dependence which, until that point had been conducted by separate expert committees albeit that they were beginning to reach similar conclusions (World Health Organisation 1981). Theorising on the nature of drug dependence had focused on the addiction forming properties of drugs to a much greater extent than had theorising on the nature of alcohol dependence (where deliberations had been centred to a greater degree on questions of whether it was the person who drinks rather than the properties of alcohol, which determines the patterns of use). This was implicit in the very names the ‘WHO Expert Committee on Drugs Liable to Produce Addiction’ (World Health Organisation 1952) and the ‘Expert Committee on Addiction Producing Drugs’ (World Health Organisation 1957). In 1964 this Expert Committee proposed that the term ‘drug dependence’ replace the previously proposed terms ‘drug addiction’ and ‘drug habituation’ which had been based in a recognition of the different patterns of use that might be produced by the drug itself (World Health Organisation 1964). While the term dependence substituted the idea of discrete categories with the idea of a continuum, the idea that drug dependence was substance specific was retained in the definition of dependence and in the description of it which made a distinction between ‘psychic dependence’ and ‘physical dependence’. Psychic dependence referred to the reinforcing potential of the drug which resulted in a drive to use the drug in order to be rewarded by the pleasurable effects and the avoidance of pain. Physical dependence referred to the adaptive state that resulted from continual or episodic use. Early definition of the psychological components of alcohol dependence (for example Jellinek 1964) contained this recognition of the reinforcement potential of the drug ethyl alcohol in their focus on use for the purpose of reducing anxiety and producing relaxation.
From this background, Edwards et al. (1982) proposed a generic term ‘dependence’ that was a psychological phenomenon separated from the physical phenomena which, the authors proposed were renamed under the heading ‘neuroadaptation’. In spite of this proposal, the dualism of physical and psychological dependence has been retained in much research and in the measurement of dependence. Arguing that an instrument equivalent to the SADQ or other measures of alcohol dependence syndrome had not been developed and that this was impeding research into the nature of drug dependence, its career and natural history and implications for treatment planning, Sutherland and her colleagues developed an instrument that:
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