[HN Gopher] It's not the chemicals that cause addiction (2017)
       ___________________________________________________________________
        
       It's not the chemicals that cause addiction (2017)
        
       Author : worez
       Score  : 139 points
       Date   : 2023-06-11 16:55 UTC (6 hours ago)
        
 (HTM) web link (dancesafe.org)
 (TXT) w3m dump (dancesafe.org)
        
       | benreesman wrote:
       | It's obviously better when there's good data. People like myself
       | who frequent HN often do because they want to hear an expert cut
       | through the propaganda with the inside baseball on the real
       | science.
       | 
       | And I hope someone does on this thread.
       | 
       | But in the absence of a qualified expert interpreting the inside
       | data laypeople are as always thrown back on the thoughtfulness
       | arbitrary creative force gave a rock and anecdata.
       | 
       | And this rings insanely true. My life never changed back from
       | COVID lockdown, maybe that says more about me than the biggest
       | natural experiment in arbitrary and sweeping human confinement
       | probably ever: but I use more of everything from nicotine to
       | caffeine to adderall now than when I was partying with a purpose
       | ten years ago.
       | 
       | More substances more screen time more all of it. Being trapped on
       | an island with 100 people sounds like a vacation from either the
       | glass box I live and work in or the empty-seeming bars and coffee
       | shops and comedy clubs in the half dozen cities I've traveled to
       | this past year.
       | 
       | Lockdown was boom time for screen companies. Anyone got a vested
       | interest in leaning on the delicate pressure points of really
       | resuming IRL life?
        
         | htag wrote:
         | All of the things you loved about life before COVID are still
         | out there. Caffeine, nicotine, and adderall shouldn't prevent
         | you from being able to experience the world.
        
         | SoftTalker wrote:
         | It sounds trite but just do it. Go out. Go to bars, go to the
         | gym, go to the coffee shop, go to wherever people are
         | congregating. Living cooped up in a box is no way to live.
         | Unsurprising that the study in TFA found that creatures living
         | in unhappy circumstances seek mood-altering substances more
         | than those living more freely and naturally.
        
           | benreesman wrote:
           | As I said: maybe I'm an outlier and my N=1 study is one of
           | those dots in the corner.
           | 
           | But historically I'm a rabid extrovert on paper in terms of
           | coffee shops and bars and comedy clubs and music shows.
           | Before the risk was that I'd meet some cool people and talk
           | until I had to race to the morning's first meeting.
           | 
           | And when I say "empty-seeming" I don't mean there are no
           | people exactly, but rather that walking up to someone and
           | introducing yourself seems to go over about as well
           | everywhere as it historically has in Paris.
           | 
           | Now one random guy having a bad time socially isn't data, but
           | I thought it was worthwhile to throw out in case I wasn't the
           | only one.
        
             | cstejerean wrote:
             | Try traveling to other parts of the world if you can. For
             | example I was just in one of the greek islands for a week
             | and everyone was incredibly friendly. Meeting cool people
             | and chatting late into the night is precisely how I'd
             | describe my time there.
        
             | ethanbond wrote:
             | Another consideration is that you've gotten older during
             | the pandemic.
             | 
             | Especially given many people's description of "time
             | distortion" through lockdown, it's easy to forget you got
             | 2-3 years older, so did all of your friends, and 2-3 years
             | is plenty for some formative changes depending on how old
             | you were.
             | 
             | I left New York for the pandemic and came back after a few
             | years just to realize that I'm too old for this shit now,
             | or at least for what I loved about NYC previously.
        
               | yieldcrv wrote:
               | and the 21 year olds completely missed being 18, 19 and
               | 20
               | 
               | really all the teenagers missed 2-3 years of social
               | development in line with what the older crowds they
               | coexist with experienced
               | 
               | I'm down to play, but just something to be aware of
        
         | captainkrtek wrote:
         | Think COVID has caused many of us to reflect on life, and how
         | choose to resume it now that the situation has improved.
         | 
         | Working from home for so long definitely removed a social
         | element from my life, but I've replaced the time I would be
         | commuting with exercise and time outdoors, which has been a
         | massive life improvement.
        
       | reliablereason wrote:
       | You have to use a very strange definition of "cause" for the
       | articles title to be true.
       | 
       | If there was no chemical the addiction to the chemical would not
       | be there. It is obvious.
       | 
       | The existence of the chemical is part of a hugely complicated
       | causal tree that leads to addiction. The argument laid out in the
       | article is a false dichotomy, which is denying one part of the
       | causal tree(the existence of the drug) by pointing to one part of
       | another part of the causal tree(social factors).
       | 
       | Real change (the end of the war on drugs) should come from facts
       | not poorly laid out rhetorics.
        
         | mordae wrote:
         | > If there was no chemical the addiction to the chemical would
         | not be there. It is obvious.
         | 
         | From my experience, users would find another way to compensate.
         | Maybe gambling. Maybe self harm. Maybe hurting others.
        
       | zephrx1111 wrote:
       | I disagree with this article, not because of it's correctness,
       | which I don't care. It is more about the perspective. This kind
       | of "explanation", has nothing good to solve the problem. It is
       | just yet another aftermath "excuse research".
       | 
       | In east Asia, we had an infamous example: Chang Hsueh-liang
       | https://en.wikipedia.org/wiki/Chang%20Hsueh-liang . The problem
       | is clear here: if we could find an excuse for him, then we could
       | for anybody.
       | 
       | Let's ask ourselves this question: do we want our kids addicting
       | to drugs, or do we want ourselves addicting to drugs? If the
       | answers are no, still the question will be, going forward what we
       | can do, which this article has little advice.
        
         | criddell wrote:
         | > this article has little advice
         | 
         | What about this part:
         | 
         | > The war on drugs we have been fighting for almost a century
         | now has made everything worse. Instead of helping people heal
         | and getting their life together, we have cast them out from
         | society. We have made it harder for them to get jobs and become
         | stable. We take benefits and support away from them if we catch
         | them with drugs. We throw them in prison cells which are
         | literally cages. We put people who are not well in a situation
         | that makes them worse and then hate them for not recovering.
         | [...] We have to build a society that looks a lot more like Rat
         | Park and a lot less like those isolated cages. The opposite of
         | addiction is not sobriety; the opposite of addiction is
         | connection."
         | 
         | That seems like pretty solid advice to me.
        
       | stan_kirdey wrote:
       | I strongly disagree with the article. I work in the space and
       | been involved in this topic for the last 20 years.
       | 
       | While the article claims that jails only worsen addiction,
       | correctional facilities in the U.S. provide medically-supervised
       | drug rehabilitation programs that have high success rates. Folks
       | with substance use disorder are given medication for withdrawal
       | and co-occurring mental health issues. There are withdrawal
       | monitoring and detox programs at every facility. Some facilities
       | started to offer MAT, which is currently gold standard of
       | treatment.
       | 
       | The article fails to consider how addictive substances
       | themselves, especially opioids, undermine one's autonomy and
       | ability to connect with others. Opioids activate reward centers
       | in the brain, inducing a sense of euphoria and pleasure that is
       | difficult to resist (Volkow et al. 2014). Even a small dose of
       | fentanyl, for example, can trigger an addiction with continued
       | use (Kounang 2018); it is disingenuous to blame the "cage" alone
       | when the substance itself chemically hijacks the brain. Genetics
       | also predispose certain individuals to higher addiction risk, as
       | addiction correlates highly with hereditary factors (Ducci et al.
       | 2012).
       | 
       | The rise of fentanyl and other synthetic drugs has made "escaping
       | the cage" of addiction nearly impossible for some. In some cities
       | int he U.S. in 2023, a pill of fentanyl would cost as little as
       | 50c. Counterfeit opioid pills containing fentanyl are extremely
       | cheap, potent, and deadly, yet addictive to a point when a single
       | pill can completely change direction of one's life.
        
         | johnea wrote:
         | And if every addict had good opportunity for a prosperous life,
         | do you think the number of overdoses would increase or
         | descrease?
         | 
         | The brain highjakcking still occurrs in a context.
         | 
         | While some people simply use for kicks, many others are trying
         | to escape some intractable situtaion.
         | 
         | Improving life opportunities would only help reduce extreme
         | addiction and overdose...
        
           | stan_kirdey wrote:
           | I think opportunities might help people avoid taking the drug
           | in the first place, but from observations, even folks with
           | seemingly great jobs and families often fall to opioids once
           | they try them.
        
             | pas wrote:
             | obviously (!) it means that the more things look like
             | everything should be fine the less people find ways to be,
             | to feel, to act as they actually are - non-fine, and due to
             | this the more they can end up using more and more.
        
         | pstuart wrote:
         | We should not treat drug addiction as a crime -- it's a medical
         | condition and should be addressed in that context.
         | 
         | That said, we need to find a way to institutionalize and treat
         | those that have become non-functional from their addiction(s).
         | And that power needs to be wielded with extreme transparency
         | and accountability.
        
           | stan_kirdey wrote:
           | "we should not treat drug addiction as a crime" - I don't
           | think anyone is saying otherwise
        
             | xigency wrote:
             | Placing the blame on the substance rather than society is
             | an on-ramp to criminalization.
        
             | standardUser wrote:
             | Everyone is saying that, unless you think drugs materialize
             | out of thin air? Because in reality, a drug user, drug
             | seller and drug producer are all part of the exact same
             | system, completely inseparable and entirely co-dependent on
             | one another. Any differentiation we make is a fantasy we
             | have devised to make ourselves feel better, like we're
             | going after the "real" criminal, not the poor victim/user.
             | 
             | The only way to stop criminalizing drug use is to end the
             | black market for drugs. Half measures like
             | "decriminalization" simply leads to more and problems and
             | solves nothing.
        
               | 8note wrote:
               | Decriminalization is the thing you're looking for --
               | making people free to sell whatever drugs they want,
               | rather than something like legalizing, which keeps the
               | black markets intact
        
       | loeg wrote:
       | Another rehashing of Rat Park, a dubious study which has never
       | replicated. I'm pro legalization, but this isn't a good angle for
       | arguing that case.
       | 
       | https://en.wikipedia.org/wiki/Rat_Park
        
         | lowbloodsugar wrote:
         | Your link doesn't provide any evidence that the study was
         | dubious. If anything the counter arguments seem dubious.
        
           | loeg wrote:
           | I was providing the link as context and a jumping off point
           | for further reading, if you were curious (which is encouraged
           | here). If you're looking for criticisms of Rat Park, I
           | suggest starting with the "Criticisms" section on the
           | Wikipedia article.
        
         | kevinmchugh wrote:
         | The strongest conclusions from Rat Park should be that rodent
         | studies are complicated by lab conditions. This probably
         | doesn't sound too controversial (by now anyway). But because of
         | the ideological or personal issues at play, it's easy to draw
         | conclusions about humans from Rat Park.
         | 
         | Put another way, placebo studies show that attention and
         | treatment alone get some level of result and that science is
         | hard, not that sugar pills are a panacea.
        
         | Kalium wrote:
         | Rat Park is an excellent example of how people pick studies
         | that show the things they're looking for. When people point to
         | it uncritically, it says more about them than about the world.
        
       | bionhoward wrote:
       | If not for the drug, you cannot be addicted to the drug. QED
       | drugs "cause" addiction.
        
         | daseiner1 wrote:
         | Necessary but not sufficient.
         | 
         | If not for alcohol, there would be no alcoholics but the vast
         | majority of drinkers are not alcoholics.
         | 
         | Drug + ?? ==> Addiction
        
       | davelondon wrote:
       | It's a nice story but it's actually a load of rubbish...
       | 
       | https://theoutline.com/post/2205/this-38-year-old-study-is-s...
       | 
       | "Despite his claims of a revolutionary breakthrough, Alexander
       | had trouble finding a journal to publish his results. Both
       | Science and Nature rejected the study for publication, likely due
       | to significant problems with the methodology and results.
       | Pharmacology Biochemistry and Behavior published the results in
       | 1981 with little response and the funding for Rat Park was
       | canceled shortly thereafter."
       | 
       | "When scientists tried to replicate the Rat Park study, they got
       | mixed results. In 1996, a study attempted to precisely replicate
       | the conditions in Alexander's Rat Park, down to the breed of rat.
       | The researchers conducted two experiments to see if they could
       | replicate the Rat Park study's results. In the first experiment,
       | the happy, social rats consumed slightly more of the morphine
       | liquid, in the second experiment, the isolated rats drank
       | slightly more. Neither experiment reflected the Rat Park's
       | results, which had the isolated rats drinking up to seven times
       | the amount of the morphine liquid as the social rats."
        
         | pas wrote:
         | why is it a load of rubbish?
         | 
         | it's inconclusive. it seems there's no strong independent
         | evidence either for or against the strong addiction model.
        
           | aeternum wrote:
           | Whenever a large group of people really want something to be
           | true, your Bayesian evidence threshold should increase
           | significantly.
           | 
           | IE cigarettes not causing cancer, glass of red wine a day,
           | unleaded gasoline, caffeine has no negative effects, drugs
           | are not addictive, you can eat as much as you want as long as
           | no carbs.
        
             | AnimalMuppet wrote:
             | What about unleaded gasoline puts it on this list? What
             | about it do people really want to be true?
        
           | stillbourne wrote:
           | Science operates on a system of checks and balances, not a
           | free speech model. If your paper can't pass peer review then
           | your paper is what is clinically referred to as bullshit. Now
           | there are people who bypass the system of checks and balances
           | by publishing on pay to play journals but scientist came up
           | with a solution to that too, Impact Factor. They took all the
           | journals and rated them by how much of the content that they
           | publish has an high impact on science and how much of it is
           | bullshit. If you can't get your paper to publish in a journal
           | with an impact factor higher than say 3.5 then you're
           | probably bullshit.
        
           | pyrophane wrote:
           | I assume it is more the author's response to the headline of
           | this article, which treats the conclusions of the experiment
           | as robustly proven fact.
        
       | petermcneeley wrote:
       | Some articles express a confused position with such clarity that
       | I cannot help but to upvote.
        
       | golemiprague wrote:
       | [dead]
        
       | belorn wrote:
       | There are an alternative interpretation of the same data. The rat
       | park may provide protection against addition, while the rat cage
       | makes the rats more vulnerable to addition.
       | 
       | This model is often use with illnesses such as chronic stress,
       | depression and ptsd. A "rat park" has many major health benefits,
       | and aspect of it is measured with organ donations in order to
       | determine which patients has the highest probability of
       | surviving.
       | 
       | A way to see it is that in order for a negative outcome you need
       | three things to be true. Be exposed to a trigger, while being
       | vulnerable, and lacking protection.
        
       | hyperific wrote:
       | The title should have (2017) at the end
        
       | philothrow wrote:
       | _Capitalist Society and Its Consequences_?
       | 
       | The drive for ever more productivity and efficiency causes us to
       | eschew things which -- on the surface and by measurable metrics
       | -- are inefficient, unproductive, and "not good," but serve
       | incorporeal purposes, like keeping us sane.
        
       | photochemsyn wrote:
       | Relevant quote:
       | 
       | > "Imagine a society that subjects people to conditions that make
       | them terribly unhappy then gives them the drugs to take away
       | their unhappiness." - TK
        
       | dang wrote:
       | Related threads. I know there have been others - anybody have
       | time to find them?
       | 
       |  _Rat Park_ - https://news.ycombinator.com/item?id=19928803 - May
       | 2019 (2 comments)
       | 
       |  _Addiction: The View from the Rat Park (2010)_ -
       | https://news.ycombinator.com/item?id=10605524 - Nov 2015 (1
       | comment)
       | 
       |  _Rat Park_ - https://news.ycombinator.com/item?id=9039039 - Feb
       | 2015 (70 comments)
       | 
       |  _Rat Park drug experiment cartoon_ -
       | https://news.ycombinator.com/item?id=7742950 - May 2014 (22
       | comments)
       | 
       |  _Rat Park experiment upturns conventional wisdom about
       | addiction_ - https://news.ycombinator.com/item?id=6565426 - Oct
       | 2013 (10 comments)
       | 
       |  _Rat Park Experiment: A New Theory of Addiction_ -
       | https://news.ycombinator.com/item?id=6391701 - Sept 2013 (42
       | comments)
        
       | xrd wrote:
       | I've got a friend who recently was hospitalized for fentanyl
       | addiction.
       | 
       | Twenty years ago he was my first investor in my first startup. He
       | was the guy that taught me about mediation. He was the first
       | vegetarian I knew.
       | 
       | He owned four cab licenses in Portland. Then Uber came in and
       | shredded his retirement plan. The cab company forced him out so
       | he wouldn't even capitalize on the partial ownership of the land
       | they owned. He lost everything. He has nothing left.
       | 
       | He discovered some awful things about his father. His brother
       | died in a gruesome car crash at 25.
       | 
       | I remember him telling me about oxycotin (edited: I misremembered
       | it as oxycodone), this "miracle drug" without the addiction of
       | morphine. He got on that.
       | 
       | Ten years later he was using heroin. Then fentanyl more recently.
       | 
       | I'm pretty angry at the Sakler family. I'm mad at the drug
       | cartels. I'm not mad at my friend. He's a generous and loving
       | person.
       | 
       | Everyone has a story. I'm sure some are full of awful actions
       | that led them to where they are, but I don't see my friend in
       | that way.
        
         | 2-718-281-828 wrote:
         | of course you shouldn't be mad at your friend. he is suffering
         | and seeking relief. the sacklers and the cartels for sure are
         | despicable. but they aren't responsible for your friend either.
         | they didn't force him to take drugs. it sounds petty but i
         | firmly believe for a number of reasons that it is very
         | important to keep this in mind.
        
         | xrd wrote:
         | Also, my friend is in the hospital and apparently will be there
         | for a week or two. So he will leave with several hundred
         | thousand dollars of debt, which will probably be shackled
         | around his mom's neck.
         | 
         | This is a medical crisis that will never get solved because our
         | medical system doesn't want to handle people with these
         | addictions. No one does of course. But that's the only way to
         | solve it in my opinion.
        
           | daniel-cussen wrote:
           | [dead]
        
           | ThePhantom wrote:
           | Sorry to hear about your friend. What was he hospitalized
           | for? Several hundred thousand dollars is an exorbitant amount
           | of money even with how high the cost of healthcare is in the
           | US.
        
             | xrd wrote:
             | From a mutual friend, apparently the withdrawals were
             | severe. He was actually admitted to a recovery place with
             | his mom's help (that was $45k for a month!). Fentanyl is
             | stored in fat cells apparently. It takes a long time to
             | leave the system. So he was hospitalized because his
             | potassium levels dropped to a dangerous place.
             | 
             | I'm not sure of the price tag. But i had another friend who
             | was told to go to another hospital when his wife's
             | pregnancy took a bad turn. They spent two weeks and it was
             | several hundred thousand. The insurance said, just beg the
             | hospital to reduce it? It was ridiculous. I'm just sure my
             | friend won't leave with that covered. Not the hospitals
             | responsibility for sure but it's outrageous the cost and
             | prevents people from seeking help.
        
         | throw-4e451c8 wrote:
         | > He owned four cab licenses in Portland. Then Uber came in and
         | shredded his retirement plan.
         | 
         | I am sorry for your friend, but not for him losing out on his
         | rent seeker plans.
        
           | euiq wrote:
           | this exchange is _so_ hacker news
        
           | nick_ wrote:
           | The folks flagging your post would hunt the poor for sport if
           | it was legally and socially acceptable.
        
             | p0pcult wrote:
             | [dead]
        
         | mobilefriendly wrote:
         | My family member died from his addiction and I'm still angry at
         | him. He made several decades of selfish, disastrous choices. He
         | had every advantage in the world and squandered it all. I'm
         | angry we don't do more to fight these drugs. Drug dealing is
         | very much a violent crime, it killed my cousin. The popular
         | culture that celebrates drugs and dealers.
         | 
         | Plenty of blame all around but central is the person who
         | decides to use.
        
           | brightball wrote:
           | There are a growing number of people who think that drug
           | dealers should be charged with murder in these circumstances.
           | 
           | It's difficult to argue with the logic. The worse the problem
           | gets, the more it seems like correct path.
        
             | civilitty wrote:
             | Dealers who sell drugs laced with Fentanyl are increasingly
             | facing manslaughter charges (homicide has a higher
             | premeditation bar to clear)
        
           | mordae wrote:
           | > Plenty of blame all around but central is the person who
           | decides to use.
           | 
           | Oh get off your high horse.
           | 
           | I've had two uncles die from alcoholism. In reality, it was
           | the divorces and way more complex circumstances that really
           | did them in. It really is the cage.
        
             | lo_zamoyski wrote:
             | Wow, that's rude. He said something wrong.
             | 
             | It's important that we avoid the twin extremes of, on the
             | one hand, categorically blaming circumstance for
             | everything, and on the other hand, categorically assuming
             | 100% culpability. The proper view is that human beings
             | operate at a nexus between circumstance and decision.
             | Circumstances can create good or bad incentives, and
             | statistically, people will follow incentives (hence the
             | need to legislate properly, for example). These incentives
             | can be strong or weak. They can create more or less
             | pressure to follow through with the incentive. But we must
             | ultimately make a choice and that rests with us (in the
             | extreme case, something like extreme pain can blind a
             | person and effectively rob him of the freedom to choose
             | intentionally which is to say with the capacity to use
             | reason). So how culpable we are for a decision varies on a
             | variety of factors, but there is almost always some
             | culpability.
             | 
             | In the case of your parent comment, it _sounds_ like the
             | person in question is very culpable, that he had the
             | capacity to reason, to know he should have chosen
             | otherwise, but did not. There 's nothing wrong with the
             | content of that claim as such.
        
           | mikub wrote:
           | I mostly agree with you. But when your doctor is telling you
           | to take some 'medicine', and that is what makes you addicted
           | it's not completly in your hands anymore.
        
             | brightball wrote:
             | After I had surgery on my ankle in college, my dad took
             | away the pain medicine the moment it was no longer
             | necessary (1 day later) and just gave me Advil after that.
             | 
             | I didn't fully appreciate why until I saw somebody go
             | through it.
             | 
             | But then I got the entire picture. This man struggled. Hid
             | it from his family. Finally confessed it to his wife who
             | stuck by him and sent him to a rehab program to get clean.
             | He was gone for about 4 months and got clean. Got his life
             | back. Got his family back and got back to work.
             | 
             | And then his old dealer came back around. It took another
             | family member telling the dealer he'd shoot him on sight if
             | he ever came around again to get that predator to leave.
        
           | civilitty wrote:
           | _> The popular culture that celebrates drugs and dealers._
           | 
           | You mean modern medicine? That's what makes this problem so
           | pernicious - so much of it was created by the people
           | fictionalized in shows like House MD and Grey's Anatomy not
           | The Wire and Breaking Bad.
        
             | [deleted]
        
             | quacked wrote:
             | Obviously he doesn't mean that, there's an enormous body of
             | media and art that glamorizes drug dealing and using. It
             | stretches across ethnicity and class. It begins with
             | alcohol and weed, stretches into cocaine and hallucinogens,
             | and from there gets into the heavy drugs.
             | 
             | If the _only_ input into drug addiction was the modern
             | medical industry over-prescribing opioids, the landscape of
             | modern drug use would look very different.
        
               | civilitty wrote:
               | Does any recent media actually glorify the drugs that are
               | causing the worst problems right now? I watch a lot of TV
               | but have less exposure to popular music so I'm genuinely
               | unsure.
               | 
               | There's plenty of alcohol, weed, cocaine, and
               | hallucinogens, I'll give you that, but they're not
               | gateways to opioid addiction. Breaking Bad glorifying the
               | manufacture and sale of meth is the only except I can
               | think of - Oxy, fentanyl, and p2p meth aren't exactly the
               | drugs musicians and Hollywood turn to as a lyrical/plot
               | device.
               | 
               | There's also a fine line between glorifying and
               | entertaining. I struggle to find any such glorification
               | in shows like Snowfall, for example, which mostly shows
               | the _very_ negative impacts of crack cocaine in cities.
               | There 's only a single character in the entire run that
               | manages to overcome the drug and the main character is a
               | tragic anti-hero at best.
               | 
               | Any time heroin or another opioid comes up in pop culture
               | it's almost always in the context of horrifying drug
               | dens.
        
               | norir wrote:
               | I would argue that if one watches Breaking Bad to its
               | conclusion that it's hard to say that it glorified the
               | manufacture and sale of meth. Everyone involved has huge
               | negative consequences in their lives as a result. The
               | collateral damage is staggering. By the end, Walt seems
               | as addicted to the sense of power that making meth gives
               | him as the user of meth desperately seeking their next
               | hit. He sabotages himself and ultimately gets himself
               | shot (probably killed -- though I think this is open to
               | interpretation) chasing his last hit.
        
               | benatkin wrote:
               | It does the antihero bit pretty well. It shows life going
               | on after Walt's brother in-law is killed. In real life
               | people would be a lot more torn apart by it, and not just
               | sad.
               | 
               | The main thing it glorifies I think is that boys will be
               | boys, not drugs per se.
        
               | civilitty wrote:
               | I think "high school chem teacher builds a drug empire
               | that rivals Mexican cartels" is definitely a glorified
               | macho-suburban fantasy elevated to an art form. In
               | reality season 1 would have ended with Bryan Cranston's
               | character dissolving in a vat of drain cleaner or buried
               | out in the New Mexican desert missing his head and
               | fingers. I mean, look at the drug addict that gets the
               | most screen time in the show: he's the cofounder of the
               | drug empire guiding the main character through the drug
               | game like a methed out Master Miyagi.
               | 
               | Compare it with Snowfall: the main character's family has
               | at least _some_ history of drug dealing and he only
               | succeeds because he discovers a cheap and ultra-addictive
               | recipe for crack cocaine and because the CI-freaking-A is
               | using him to fund the global war on communism. Recurring
               | characters get killed off in dumb gang skirmishes all the
               | time and the drug addict with the most screen time is
               | literally a shell of her former self that can barely get
               | through the day up until the latest season.
               | 
               | Or compare it with The Wire: all the people involved in
               | the drug game are only in it because they have literally
               | _nothing_ else to live for except the glory of the game.
               | Basically no one survives except the cops and Bubbles
               | never really gets fully clean.
        
               | quacked wrote:
               | > There's plenty of alcohol, weed, cocaine, and
               | hallucinogens, I'll give you that, but they're not
               | gateways to opioid addiction.
               | 
               | This is only partially accurate. There are two primary
               | "pipelines" to opioid addiction; one of them is
               | overreliance on painkillers, but the other one is fairly
               | standard risk-seeking escalation through a socially
               | deleterious lifestyle, often culminating in an OD or a
               | prison sentence after a predictable years-long risk
               | escalation path through social drug use.
               | 
               | I will agree that I don't think there's a lot of media
               | showing meth or fentanyl use as cool and attractive, but
               | my overall point is less that a specific drug needs to be
               | shown to be cool, and more that the artistic construction
               | of the drug lifestyle as alternative, exciting,
               | rebellious etc. wears down the emotional barriers of a
               | lot of people when they're young and malleable. I've done
               | a good number of drugs in my day and I can assure you
               | that in the case of most of the people I did drugs with,
               | early exposure to "drugs are cool" art and music played a
               | part in their ready acceptance of the lifestyle.
               | 
               | As one example, if you go to a high school party, often
               | the riskiest, coolest kids will go off in private and do
               | drugs. There's no feedback loop in the media to make this
               | look pathetic or sketchy--on the contrary, most drug use
               | is played for laughs, or it's added as another dimension
               | to a lifestyle that's _supposed_ to be tragic but instead
               | looks awesome.  "Oh my god, look at this guy's life, he's
               | a mess, his apartment is so dirty, he's doing lines off
               | the mirror... with a smoking hot supermodel-actress while
               | we do a B-plot story about how his small-town parents are
               | boring and stodgy... and he's a rock star..."
               | 
               | I don't really know whether or not you could seriously
               | reduce drug use by _not_ showing it in the media, but I
               | do believe that showing it as positively as it is now
               | increases drug use. And I haven 't even mentioned the
               | music surrounding drugs.
        
               | benatkin wrote:
               | If you want to see a sincere take on it, read the
               | writings of Thich Nhat Hanh.
               | 
               | https://www.lionsroar.com/food-for-
               | thought/#:~:text=I%20hear...
               | 
               | I still tend to disagree because I have a hard time
               | finding balance and not going too far in restricting the
               | media I consume, but it's a nice vision.
               | 
               | A lot of the religious right in the US, especially the
               | part that is led by televangelists like the late Pat
               | Robertson, just wants to suppress it out of ignorance and
               | they have no plan except to throw more and more people in
               | jail, creating more X to prison pipelines.
        
               | quacked wrote:
               | After reading this article, I agree with the words of
               | Thich Nhat Hanh, thank you for the recommendation.
               | 
               | > The religious right in the US just wants to suppress it
               | out of ignorance
               | 
               | I tend to agree that the religious right in the US is a
               | legislative force that does more harm than good, and that
               | many people who campaign against drugs don't have a solid
               | understanding of drugs or drug culture. However, I don't
               | think that it's ignorant to want to suppress drug culture
               | (either in the media or in real life), and I think more
               | religious conservatives have experience with addict
               | family members than you think.
        
               | benatkin wrote:
               | Good point, I ninja edited just before you posted to say
               | that a chunk of them have been mislead by televangelists
               | and such.
               | 
               | I can tell Thich Nhat Hanh appreciated the people you're
               | talking about, having read about him traveling all around
               | the world and meeting people from the US (where he lived
               | for quite some time) and countless other countries.
        
               | quacked wrote:
               | Ah, there's the edit, right.
               | 
               | One of the principles that I hold to pretty strongly is
               | that the more performatively famous someone is
               | surrounding a certain idea, the more likely it is that
               | they don't have any real principles, and they're just
               | beating whatever drum allows them to continue to hold
               | influence over people. So someone like Pat Robertson
               | doesn't actually believe what he's saying in private, but
               | if he kept banging that drum he kept his lifestyle and
               | acolytes. I think the majority of US politicians that
               | people recognize by name are like that, and certainly
               | most religious leaders like Pat or Joel Osteen.
        
               | tudorw wrote:
               | nice reccomendation.
        
               | benatkin wrote:
               | There's a longer piece that I found as a PDF by searching
               | for words of an excerpt I happened upon. I can't find a
               | page linking to it, but it seems legit. https://static1.s
               | quarespace.com/static/5c03ced75ffd204418037...
               | 
               | Edit: I searched a phrase in the PDF and found this:
               | https://thubtenchodron.org/2017/11/non-harmful-
               | consumption-n...
        
         | xrd wrote:
         | Fifteen years ago there was a guy outside my apartment selling
         | the homeless newspaper. He admitted he was addicted to heroin.
         | So I paid for him to go to a halfway house. That was because my
         | friend told me that even though it was unlikely to work, every
         | chance is an extra chance.
         | 
         | That's what I'm hoping for here. I want a story that addiction
         | from these horrible drugs isn't always the end. It would be
         | amazing if he can recover from this. I'm scared but it's all I
         | have for him right now.
        
         | zoklet-enjoyer wrote:
         | That sucks about your friend. But how did anyone think there
         | was no abuse potential? I was in highschool in the early to mid
         | 2000s and even I knew there was massive abuse potential.
         | There's a reason it was called hillbilly heroin
        
           | SV_BubbleTime wrote:
           | I was at a party in 2001 and they were getting Oxy delivered
           | and figuring out how much and who wanted it. I knew then it
           | wasn't harmless recreational.
           | 
           | Two party from that party are now dead of overdoses.
        
           | antonvs wrote:
           | Yeah. Oxycodone was always known to be addictive, like any
           | other opiate.
           | 
           | The claim from the company was that _Oxycontin_ , which was a
           | slow release form of oxycodone, was less addictive because of
           | the slow release.
           | 
           | That turned out to be largely BS, but it wasn't helped by the
           | fact that addicts would crush the tablets, eliminating the
           | slow release aspect.
        
             | fires10 wrote:
             | I had this told to me and had family members told this by
             | doctors. A large number of addicts started from medical
             | prescriptions for legitimate pain. I have been scolded for
             | not taking pain meds.
        
             | retrac wrote:
             | > The claim from the company was that Oxycontin, which was
             | a slow release form of oxycodone, was less addictive
             | because of the slow release.
             | 
             | A similar claim is now made about Vyvanse, a pro-drug for
             | amphetamine. Like a slow release formulation, but needs to
             | be metabolized first. The slower onset, less sharp peak,
             | makes it less euphoric for a similar effective dose, which
             | is supposedly one of the mechanisms involved with the
             | reward-feedback addiction cycle. Less likely to experience
             | (intentionally or accidentally) the intense euphoria of a
             | bit too much instant-release amphetamine on an empty
             | stomach, and so less likely to seek out the experience
             | again. It also frustrates injection, since it needs to be
             | metabolized first so injecting it doesn't make it work any
             | faster. I'm not sure the premise is wrong, and it is
             | probably fairly similar with opioids. But slightly less
             | abuse risk is certainly not the same as non-addictive.
        
               | pault wrote:
               | That's interesting, I've been on vyvanse for five years
               | now and never felt any of the telltale signs of
               | dependency (which I am familiar with). I had to stop
               | taking it for a month once and it just made me very
               | drowsy for a week.
        
             | xrd wrote:
             | Ah, I corrected my original post. That's what he was on.
             | It's confusing even now to me. Anyone in this thread
             | suggesting that anyone with half a brain should be intimate
             | with the difference can tell me I've only got half a brain.
        
         | refurb wrote:
         | Oxycodone was _always_ known to be addictive. It's right on the
         | label from day one.
         | 
         | "Also at the time of OxyContin's approval, FDA product labeling
         | warned of the danger of abuse of the drug and that crushing a
         | controlled-release tablet followed by intravenous injection
         | could result in a lethal overdose. There was no evidence to
         | suggest at the time that crushing the controlled-release
         | capsule followed by oral ingestion or snorting would become
         | widespread and lead to a high level of abuse."
         | 
         | https://www.fda.gov/drugs/information-drug-class/timeline-se...
        
           | arcanemachiner wrote:
           | People are often taken in by the Big New Thing. That's why I
           | have a default policy of skepticism towards pretty much
           | everything.
        
             | SV_BubbleTime wrote:
             | > That's why I have a default policy of skepticism towards
             | pretty much everything.
             | 
             | I'm convinced anyone who doesn't do this is either too
             | young to know better or too dumb to have been paying
             | attention.
        
             | bufio wrote:
             | The Big New Thing at the moment seems to be a moral panic
             | about oxycodone.
        
           | daniel-cussen wrote:
           | Yeah that was saying if you crushed n injected it would be
           | addictive. No. It was addictive in literally any form. They
           | knew that too, n it wasn't on the packaging.
           | 
           | You kind of have to be a monster to say something that
           | callous.
        
             | fweimer wrote:
             | As far as I understand it, crushing/injecting it makes it
             | more likely to induce pronounced euphoria and other side
             | effects that encourage abuse. But it was known from the
             | start that it was addictive (causing a physical dependency)
             | even if used as intended, simply because it is an opioid.
             | Here's an older package insert:
             | 
             | https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/0
             | 2...
             | 
             | Among other things, it says "Physical dependence and
             | tolerance are not unusual during chronic opioid therapy."
             | I'm no expert, but I think that explains why warnings about
             | dependence weren't more pronounced. The drug was supposed
             | to be distributed in a tightly controlled fashion due to
             | these risks, after all.
             | 
             | In retrospect, the warnings at the start, and the
             | information for patients read like recipes for abuse,
             | though.
        
           | xrd wrote:
           | I remember with distinct anger that my friend told me
           | information to the contrary. He probably got that phrasing
           | from that doctor who got a free trip to Barbados to push it.
           | I wasn't there but i remember him telling me that and it
           | makes my blood boil.
           | 
           | I do share other people's skepticism of the medical industry
           | as you might be able to tell. He should have done more
           | research, agreed.
        
             | fires10 wrote:
             | We license doctors to do the research for us. We can not be
             | expected to experts in all fields. It's why we license
             | professionals.
        
         | lo_zamoyski wrote:
         | Indeed, the idea that we shouldn't criminalize drugs because of
         | some ludicrous personal autonomy argument is silly. It rests on
         | a kind of extreme, libertarian view of human beings and human
         | society in which human beings are construed as atomic, self-
         | sufficient beings shouldering the entire burden of
         | responsibility for their actions (we ARE responsible, but those
         | who encourage or enable bad behavior share responsibility) and
         | society is construed as some kind of purely voluntary
         | association of atomic beings for transactional exchanges.
         | Classical liberal view, extremely anti-social and anti-human.
         | Human beings are social animals. Harming oneself harms society,
         | and harming society harms its members. Society exists for the
         | sake of the common good, and it isn't good to enable or allow
         | drug use.
        
         | [deleted]
        
       | MavisBacon wrote:
       | These are interesting studies mentioned, no doubt, but the
       | assertions made feel very heavy-handed to me. We have to take
       | into consideration things like bipolar disorder, depression,
       | obsessive compulsive disorder when dealing with humans. Also a
       | bit skeptical of their conclusion based on the Vietnam vet
       | studies, where we need to consider access to heroin in Vietnam vs
       | wherever soldiers went home to.
       | 
       | Worth keeping in mind that this is a non-profit organization that
       | sold fentanyl test strips at ridiculous markup for years (they
       | have some novel strip now that i'm unsure of bulk pricing on).
       | These were the same exact BTNX strips most fellow harm
       | reductionists were handing out for free or at low cost. I was
       | paying 75 cents per strip as a fairly small harm reduction
       | organization, DanceSafe sold them for $2 (their novel strips are
       | same price) and I can only imagine they got significantly better
       | pricing through the biotech company we all were going through due
       | to how many strips they must move.
        
       | version_five wrote:
       | Just want to mention my experience quitting smoking (which is
       | notably hard, but I have no point of reference having not used
       | other drugs).
       | 
       | Physical addition is easy. With nicotine there are not really
       | strong symptoms anyway, irritability mainly and inability to
       | focus. I know other drugs are worse but in principle, battling
       | withdrawl is not that tough, people are good at physical
       | hardships. For nicotine it's a few days.
       | 
       | It's the rest of your life that's the problem, because you know
       | that something that has an effect you enjoy immensely (and you
       | tend to view use nostalgically though rose colored glasses) and
       | you could do it any time if you wanted to. You need to deal with
       | that forever. And if you slip you're back on the thick of things
       | - like why alcoholics can't have a social drink.
       | 
       | So anyway, I sort of agree with the article, because it's easier
       | to quit when you have something going on (I started walking and
       | then running, which is what I attribute to success). Though I
       | also think humans are complex enough that making a "rat paradise"
       | for someone is not at all tenable.
       | 
       | Edit: and just to conclude, I smoked for 15 years and quit 12
       | years ago. I still want to smoke, I still dream about it, I still
       | know I would enjoy it. I will never do it and I've learned to
       | cope, but wanting to is something I'll live with forever. That's
       | what makes addiction hard. If it was just a couple sweaty nights
       | tied to a bed, things would be very different.
        
         | scoofy wrote:
         | I quit smoking well over a decade ago. It was very hard.
         | 
         | I use the crass metaphor of a gorgeous ex-girlfriend who is
         | terrible for you and you know it, as a way to describe the
         | mindset I came to with the difficulty of quitting. The idea
         | being, when you're lonely, you know you could call her up and
         | she would come over and you'd get what felt good, but not what
         | you wanted. Only when you get to the point where you know it's
         | a waste of time can you quit. That took me years.
        
         | jl2718 wrote:
         | Reminds me of this: https://youtu.be/z3kF9S0h_7A
         | 
         | Not even once, kids.
        
         | VeninVidiaVicii wrote:
         | I used to smoke and chew tobacco quite infrequently once a day
         | or so, but for about ten years, but decided to stop about three
         | years ago.
         | 
         | During the past several years I've come back to realize I was
         | using tobacco therapeutically -- specifically to actually focus
         | and as a relief from constipation.
         | 
         | And, since then I've been "trying to get healthy" - especially
         | mentally. But just feel endlessly stuck trying to get some kind
         | of ADHD diagnosis -- having seen 4 separate mental health
         | professionals for problems I never had on tobacco.
         | 
         | Sadly I've relapsed and for the first time in those three years
         | since I quit I actually don't feel constipated when I chew in
         | the evenings. Also, I've found the ability to sit down and
         | finish my manuscript.
         | 
         | Meh, I feel much healthier chewing once a day.
        
         | generalizations wrote:
         | > because you know that something that has an effect you enjoy
         | immensely
         | 
         | > And if you slip you're back on the thick of things - like why
         | alcoholics can't have a social drink.
         | 
         | I know someone who prescribes naltrexone for alcohol addiction,
         | which has the specific purpose of blocking the positive effect
         | of the alcohol. So you can have the drink, and you won't enjoy
         | it, and it's easier to live with.
        
           | daseiner1 wrote:
           | The Sinclair Method does have impressive results, and I've
           | have some success with it in the past.
           | 
           | For alcoholics at a certain level (thinking of myself here -
           | yes, anecdotal), there is the necessary accountability to
           | take the naltrexone tablet and "deprive" one of the euphoria,
           | which can be difficult to maintain over a long period of
           | time.
           | 
           | With Vivitrol (an injectable form of Naltrexone that lasts ~1
           | month per injection), it is not difficult to simply "drink
           | through it". Results in an absolute horrible hangover - sure
           | - but that's not necessarily enough to stop the motivated
           | alcoholic.
           | 
           | Overall though, MAT is a valuable tool in the toolbox.
        
         | zytron3 wrote:
         | Running is also used successfully by heroin addicts to help
         | quit. It's actually one of the best ways to help with many
         | addictions. Not discounting your achievement in quitting
         | smoking in any way, but the easiest way to quit an addiction is
         | to slot in a replacement habit that is also pleasurable, and
         | running is deeply satisfying
        
           | version_five wrote:
           | Personally I think what's great about running is that it's
           | also addictive, and so the same personality quirks that make
           | you susceptible to other addictions, at least in my case,
           | make you susceptible to becoming a regular runner.
        
           | convolvatron wrote:
           | creating art can work for some people
        
       | denton-scratch wrote:
       | The author's contention is that "addiction" is a result of
       | circumstances, not of substances. He cites a rat study, and
       | that's about it.
       | 
       | I don't think that's correct. I _do_ think that addiction results
       | from circumstances, and it 's impossible to quit if the
       | circumstances are wrong; but depending on the substance,
       | withdrawal can mean life-threatening seizures.
       | 
       | Suggesting that the primary (author implies "sole") cause of
       | addiction is circumstances enables all these claims of sex
       | addiction, chocolate addiction, sugar addiction and so on.
       | 
       | Author says at the end that the word "addiction" is outdated; I
       | agree, because it's been hijacked to refer to any kind of
       | obsessive or repetitive behaviour. We need a new word for a
       | chemical dependency that threatens withdrawal symptoms more
       | serious than feeling rather down.
        
       | cyberax wrote:
       | 2017. That was before fentanyl and meth onslaught.
        
         | denimnerd42 wrote:
         | don't think meth or fentanyl changes his hypothesis. if you see
         | the interviews of those in bandos in Baltimore or on the street
         | in Kensington, they have endured trauma their entire lives.
         | Whether it's societal induced trauma like racism, poverty,
         | family trauma, violence, or whatever else. These people are
         | choosing to escape their "cages" with these drugs.
        
           | nerdponx wrote:
           | And yet plenty of people without major life trauma have
           | succumbed to addiction as well.
           | 
           | I have no doubt that traumatic life experiences can
           | exacerbate addiction, make it harder to quit, and/or increase
           | propensity to becoming addicted (maybe even increasing
           | propensity to try hard drugs in the first place). But the
           | notion that the addictiveness of heroin, cocaine, alcohol,
           | nicotine, etc. is purely a psychosocial phenomenon is at best
           | a fairy tale.
        
             | ethanbond wrote:
             | Trauma + extremely high availability.
             | 
             | My understanding is that highly addictive substances will
             | be consumed [?] to their availability. Makes sense, given
             | the social dynamics of addicts. It's useful to find people
             | who you can drag into your despair with you, so there's an
             | inherent virality alongside the high "retention rate"
             | powered by the chemical itself.
        
           | niemandhier wrote:
           | There are drugs that cause neural rewireing in animals after
           | a single use e.g. cocaine. If you have a stable social group
           | and a fulfilled life you will probably not become dependant
           | on thc, you should still avoid crack.
        
             | Nowado wrote:
             | Everything causes neural rewiring in animals after a single
             | use. That's what experience is. This sentence says nothing.
        
               | beebeepka wrote:
               | I'd argue that the entire post is just preachy gibberish.
        
         | readthenotes1 wrote:
         | That was well after both, meth by decades, fentanyl by years
        
           | sokoloff wrote:
           | Indeed. Breaking Bad launched in 2008 and the meth problem
           | was long-established before that.
        
         | refurb wrote:
         | Meth was a problem in the 70's.
         | 
         | Heroin was a problem then too.
         | 
         | Not much has changed.
        
       | skilled wrote:
       | Indeed, it's not the chemicals. It's that one innocent friend of
       | yours who has you wrapped you around his finger. ;-)
       | 
       | --
       | 
       | Downvotes? How about learning to ask some questions on such a
       | "controversial" topic? What do you think, the chemicals just fall
       | into your lap from the sky?
       | 
       | And yes, I have firsthand experience with addiction, for many
       | years actually.
       | 
       | I am sorry for being so intelligent that I am able to narrow it
       | down to the actual root problem in a single sentence.
        
       | SV_BubbleTime wrote:
       | I'm not sure why it can't be both.
       | 
       | Also, I'm not really sure that giving rats all the cocaine or
       | heroin water they can drink is the same as a down on his luck
       | homeless guy or a manager of a club or a good time college
       | student... if you want to say it's the cage, then you should
       | probably theorize about how the deeper you get into drugs,
       | typically the stronger the cage gets.
       | 
       | I like the idea that it's not the addict's fault for feel good
       | reasons, but I've known enough addicts to know that the cage or
       | the drug it isn't kept at bay without hard work and discipline
       | and the latter was typically already lacking to become an addict
       | in the first place.
        
         | daseiner1 wrote:
         | I've met many, many incredibly successful, intelligent,
         | disciplined, kind, impressive people with incredibly serious
         | addiction issues. 10s-100s of millions in net worth. These
         | aren't lazy people.
         | 
         | Recovery does take an immense amount of hard work and
         | discipline, albeit in a very different way than, say, reading
         | legal briefs, writing code, performing surgery.
        
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