Tony: Well, I knew one coke addict who specifically told me that was exactly the case for her. I don't know if she was exaggerating or not. I don't have any medical references to back up the statement, though, so I will defer to the CW on that subject. My point was that there are some people who have tendencies towards either end of the spectrum, and from what I've heard, those tendencies are often genetically determined.

I used to pay more attention to the biological literature and politics of addiction than I have recently, so I stand ready to be corrected and informed by someone with more information. I don't really disagree re: genetic determination, although I probably think of it more in terms of predisposition -- stroner or weaker -- that interracts with other factors.

Paul: It also depends on the substance. I have very little experience in the matter, but I have never heard of anyone "trying" herione or crack without addiction soon following.

Some drugs, I think, are generally acknowledged to have much greater addictive characteristics than others, heroin and crack ranking right up there. I can tell you, though, that there are people who have tried one or both of those and who did not become addicted (I've met a few of them).

It is hard to control for "genetic predisposition" when what constitutes that is so poorly understood, but allow me to offer this (admittedly artificial, ginned-up) example:

Two 21 year-old women, each with "comparable" genetic predisposition to crack cocaine addiction are each given an identical dose of crack -- their first -- on a single Saturday evening. "Sue" is one of two children from a middle class suburb of Gotham, has never taken drugs before, has a steady boyfriend, and is scheduled to attend her college graduation on Sunday; the dose is administered by her "wild" college roomate. "Jane" is one of 8 children of a drug-addicted mother raised in foster homes, has two children of her own, is essentially unemployed, but is now becoming acquainted with the neighborhood pimp, who administers the dose.

I can't predict who will become addicted, but, of these two women, I have to guess that one is more likely to become addicted than the other.

So, my view of biological determinants in addiction is a mixed one. I accept the concepts of genetic predispositions in general, but I am a little wary of the tendency to "medicalize" everything to the exclusion of multi-factor causation. Also, with respect to addicts' attitudes toward addiction and statements like being addicted at the first whiff, it is my sense that there is a whole secondary culture of addiction that revolves around prevalent addiction theory and treatment (lately more medicalized) that influences the world view of recovering addicts. There are times I could almost believe that treatment and recovery are substitute addictions.