[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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