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What Science Says to Do If Your Loved One Has an Opioid Addiction

183 pointsby anythingnonidinover 7 years ago

22 comments

anythingnonidinover 7 years ago
OP here.<p>An interesting takeaway I had was the importance of community. Does anyone know any non-profits or startups working to increase people&#x27;s sense of community at a mass scale? It seems this is missing from large parts of the western world and has many consequences.
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emodendroketover 7 years ago
&gt; Consequently, do not try to use legal consequences as a way to help people you love, and if possible, bail them out if they get arrested for drug crimes. This doesn’t mean you shouldn’t hold them accountable, but do so in ways that are less likely to lead to lifelong problems. Meaningful employment is an important factor in recovery — and few things are more harmful to the chances of getting a good job than having a criminal record.<p>This is one area that&#x27;s crying out for some kind of reform.
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sharpercoderover 7 years ago
An addiction tries to replace a void in someone&#x27;s life. Chances are big the environment of the addicted played a role in cerating the void.
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taylorswift_over 7 years ago
I read this, as a recovering addict that went through my own hell mostly from alcoholism, and wondered where the &quot;science&quot; part was?<p>For instance this sentence &quot;More than 13 percent of its participants died after treatment,1 mainly of overdoses that could potentially have been prevented with evidence-based care.&quot; The argument is that they &quot;could&quot; have been prevented but how do they really know that? How many people in general die of an overdose after X number of stays in a rehab? Through my own experiences going to rehab, I have known of many people who die. The fact is you can&#x27;t predict which people will &quot;get&quot; it any better than you can predict if it will rain next month.<p>I also disagree with this notion that being on suboxone or methadone indefinitely is a legitimate solution. Like what? You&#x27;re advocating to stay on a drug the rest of your life? That isn&#x27;t recovery at all, it&#x27;s a band-aid that will likely lead to relapse and promotes a perpetual notion of being sick.<p>I also disagree that their supposed evidence that CRAFT gets twice as many people into rehab has much relevance. How many of those people relapsed? How many of the people that didn&#x27;t go to rehab ended up overdosing OR recovering? We don&#x27;t get the whole picture so the &quot;evidence&quot; is mute.<p>They knock 12-step which is fine but it turns out that it works for millions of people.<p>There is no silver bullet here.<p>While I have mixed feeling about the &quot;tough love&quot; approach, I can tell you from personal experience that the only reason I&#x27;m not buried right now is because at a certain point the floor dropped out too low, my family and friends abandoned me, I lost everything for a moment, and the pain and horror reached a level that finally I had a change of psyche on my OWN and realized I wanted to get better.<p>In my own humble opinion the only &quot;science&quot; that matters on this subject are the opinions of those whom have lived it and recovered. Go survey the opiate addicts that didn&#x27;t end up dead and find out what worked for them.
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biggerfischover 7 years ago
I think the saddest part of this article is perhaps the glancing statement it makes about how prison isn&#x27;t a place of recovery and rehabilitation. The prison system here really is too focused on punishment and locking people up forever rather than helping them get back on their feet and being productive members of society
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anythingnonidinover 7 years ago
Also interesting and related: <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=15241874" rel="nofollow">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=15241874</a><p>&quot;Psychedelics Help Reduce Opioid Addiction, According to New Study&quot;
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kchoudhuover 7 years ago
Now that the opioid crisis is a problem for white people, science makes an appearance in the policy discussion.<p>Contrast to the crack epidemic in the 80s: fuck&#x27;em, throw them all in prison.<p>Edit to add: I wish the best of luck to those who have been caught up in this crisis: I&#x27;m rooting for you, and I hope every last one of you find the treatment you need. For those of us who aren&#x27;t affected, it&#x27;s time for some deep introspection about what we allow our politicians and (yes) our neighbors to get away with.
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intopiecesover 7 years ago
If there were one article this year I could force my family to process adequately, it&#x27;s this one. Addiction is still seen in our group as a failure of character -- not raised right, not religious enough, not following the right path. This kind of advice is seen as &#x27;soft&#x27;, and that&#x27;s a shame.
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wjosseyover 7 years ago
I do not agree with much of what is stated in this article, nor do I feel that this article represents &quot;what science says&quot; should be done if a loved one has opioid addiction (although it really goes into addiction as a general topic). Treating someone with addiction is a remarkably nuanced and challenging situation, and the author tries to present certain treatment options as not worth doing based on science, when their own citations do not back up those claims.<p>As someone who has had a loved one go through addiction, and ultimately die from that addiction, I find the binary nature of a lot of this self-described &quot;evidence based guide&quot; dangerously black and white. Proclaiming that abstinence based programs &quot;have not been found to be effective&quot; is total nonsense. What the study found in GB was that psychological only based treatment is less effective at preventing death than replacement therapy, on average. For many, replacement therapy may very well be the best option. For other, abstinence programs may give them an opportunity to fully reclaim their life. How about we empower medical professionals with the ability to treat the disease with a number of weapons, rather than creating this false dichotomy, which is <i>not</i> represented in the data. This guide would potentially discourage someone, or a family member, from choosing a very viable option for treatment, by overstating results.<p>While I&#x27;m not a medical professional, the best example I can think of is with how we treat depression. For some people, active psychotherapy is the best treatment option. For others, a regime of anti-depressants is sufficient treatment. For others, a combination of both is the optimum treatment option. What we don&#x27;t do, as scientists, is say, &quot;Option 2 has a 30% better outcome, thus we <i>only</i> will treat depression with option 2.&quot; That&#x27;s just absolute junk. What it means is that we will look at what cohorts tend to respond best to option 1, 2, and 3, and understand <i>why</i>, so we can choose a treatment option that makes sense for that individual, without having to try 1, 2, and 3. It doesn&#x27;t mean that we just toss out the other options wholesale.<p>The 538 politics podcast does a, &quot;Good use of polling&quot; and &quot;bad use of polling&quot; intro during many of their podcasts. This article would clearly fall under the category of &quot;bad use of polling&quot;. I hope to see better out of 538 in the future on these topics.
logfromblammoover 7 years ago
In short, the published science says to addict the patient to methadone or suboxone instead of whatever they are on, for a lifetime of perpetual treatment.<p>Actual drug users are likely to recommend using kratom to alleviate withdrawal symptoms and ibogaine (or another powerful hallucinogen) to permanently remove the addiction.<p>&quot;Science&quot; does not recommend this, because politics has made the hallucinogens--and research into their therapeutic uses--at least as illegal as the opioids that cause all the problems. As someone with an opioid addiction is likely already routinely breaking some rather serious laws, and frequently courting sudden death by overdoses or adulterants, it may be worth trying the single dose of ibogaine before choosing the lifelong maintenance therapy.
Justsignedupover 7 years ago
Interesting question: The replacing opioid addiction with maintenance drugs... I could understand that drug being an okay interim solution, but in the end the person still needs to go through withdrawal, the drug just replaces withdrawal with another drug.<p>Withdrawal is hard. Yes. But at least the person is in the right mindset to go through it once they are off the compulsory addiction, even if it takes a year to get to that point.<p>As kchoudhu points out and many have pointed out to me before this article, certainly once a bunch of white kids have this problem, suddenly they are &quot;victims&quot; not &quot;criminals&quot;. Yet we have destroyed so many lives between the 80s and now, especially with the mandatory minimums and such.
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dogruckover 7 years ago
Annoying how this 538 article immediately bemoans the lack of regulation -- as if the only solution is to grow the government and pass more laws.
btmorexover 7 years ago
What science says nothing about because of the DEA&#x27;s inane scheduling: hallucinogens.
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sizzleover 7 years ago
Hands down, Naltrexone is the only thing that helped my loved ones with alcohol addiction. Please look into it and watch &quot;one pill&quot; documentary. You have a choice other than AA meetings.
otakucodeover 7 years ago
Great article, but if your loved one has an opioid addiction and wants to quit without suffering the devastating withdrawal, I would strongly recommend investigating kratom. It is a non-opiate tree which grows primarily in Thailand and similar regions. It contains an alkaloid called mitragynine. This alkaloid is a selective opioid receptor agonist. Specifically, research shows that it is an agonist to several opioid receptors but particularly an antagonist of the receptor which causes respiratory system depression, and is thought responsible for the primary addictive nature of most opiates and synthetic opioids.<p>It is legal in most of the US (I believe there are 1 or 2 states which have banned it, it has a long history by now in US law. A year or so ago the DEA announced to Congress the intention to schedule it (ban it) under their &#x27;emergency&#x27; powers (which is bullshit since there are no deaths from it, and it remains mostly unknown, those &#x27;emergency&#x27; powers are simply abused). After that announcement, they were required to consult research and doctors, along with opening a public comment period. Afterward they withdrew their intent to schedule it. So, for now, it remains legal.<p>Its effect upon a person with no opioid dependence is at low doses similar to caffeine without the &#x27;jittery&#x27; part and without the crash afterward. In larger doses it has mild analgesic and sedative properties. I&#x27;ve taken Vicodin after I had my wisdom teeth removed, and have also tried kratom, and not even in large amounts have I ever experienced it giving any sort of similar &#x27;high&#x27;. It is mildly habit-forming of itself, but very mildly compared to opiates. Withdrawal after extensive use might consist of having the sniffles and feeling a bit restless for a day or two. With tapering dosages down rather than sudden cessation, nothing is likely to be noticed.<p>Reportedly, kratom ameliorates most, if not all, withdrawal symptoms from things like Oxycontin, heroin, etc. Expecting people to go through withdrawal is inhumane and stupid. We can deal with it without the suffering. Kratom can be gotten online from multitudes of vendors. Please steer clear of the &quot;legal high&quot; and &#x27;weed shop&#x27; variety of places. In addition to being radically overpriced, their association does active harm to the community of people who use kratom reasonably. Stay away from extracts and concentrated forms (although those seem to have mostly gone away from most outlets, they were big for awhile and were bordering on dangerous) and just get simple crushed leaves. If you or a loved one wants to quit, kratom will let you do so without ruining your life.<p>If your loved one does not want to quit, because doing so would expose them to the full pain (emotional, physical, OR psychological) of a life they hate and which they feel traps them... your problem and theirs is not the drug.
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ringaroundthetxover 7 years ago
&gt; evidence-based medicine<p>non-evidence based medicine that uses the made-up-on-the-spot holistic approach is upheld by the idea that there is no scientific method available because it is about the body as a whole.<p>I think that rebuttal is reductionist and that there could be a method that is applicable to that form of treatment.<p>does anybody have thoughts on that?
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stmfreakover 7 years ago
Sympathetic support I&#x27;d fine for people interested in kicking a habit. But when the addict doesn&#x27;t want to quit? What then?
narratorover 7 years ago
Nothing about NAD therapy? Sadly, it&#x27;s an underutilized treatment for opioid addiction.
CodeWriter23over 7 years ago
&quot;Science&quot;&#x27;s answer to opioid addiction: prescribe opioids, declare addict cured.<p>PS I&#x27;m not an advocate of treatment because they also employ shortcuts to &quot;recovery&quot;.
grzmover 7 years ago
(2016)
warcherover 7 years ago
Fun fact: The current standard within the US is AA&#x2F;NA.<p>AA and NA are not only wholly unscientific, being invented of whole cloth by a layperson in the early 20th century (for context, lobotomy was a <i>totally accepted psychological treatment</i> for decades after 1935). There was no science whatsoever involved in AA, and indeed Alcoholics Anonymous <i>actively resists any data collection about the efficacy of its techniques whatsoever</i>.<p>It&#x27;s main advantages from a US perspective are a) it&#x27;s free. The costs are borne mostly in the form of churches providing basements and meeting rooms. and b) it&#x27;s super churchy. We love churchy stuff around here.<p>So basically we kicked addiction under the rug for the entire 20th century in favor of religious hokum that refuses any objective evaluation of its efficacy, or changing its methods.<p>I should say, for the record, that there&#x27;s a lot of people that have been helped by AA and NA, and there&#x27;s indisputably good work being done there. But it&#x27;s not perfect and categorically refuses to get better, and its longevity is IMHO more a result of our collective refusal to take the problem of addiction seriously in the US than anything else.
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mirimirover 7 years ago
&gt; When a family member, spouse or other loved one develops an opioid addiction — whether to pain relievers like Vicodin or to heroin — few people know what to do. Faced with someone who appears to be driving heedlessly into the abyss, families often fight, freeze or flee, unable to figure out how to help.<p>OK, if someone wants to be an opioid addict, why not just let them? The &quot;driving heedlessly into the abyss&quot; aspect seems mainly due to opioids being illegal and expensive. I mean, do we use such language about diabetics? Do we expect them to manage their diabetes through diet alone?<p>I&#x27;m not aware of solid evidence for health risks associated with chronic opioid use alone. Excluding opioid addiction, I mean. But please do share.
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