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Drug addiction: The complex truth

231 pointsby careyover 11 years ago

18 comments

ArbitraryLimitsover 11 years ago
I remember from college my Econ 101 textbook had a sidebar on heroin use by military personnel in Vietnam - apparently (according to my memory of an unattributed source) 90% of personnel stationed in Vietnam tried heroin at least once, and then 89% of them stopped when they left.<p>Why an economics textbook? The authors were trying to illustrate 1) the role of substitutes on consumption of a particular good - there was no TV, no bridge club, no women except prostitutes to go out with, so heroin &quot;cornered the market&quot; on recreational activities, and 2) the fact that people will adjust consumption of almost any good in response to its changing price - heroin was incredibly cheap, so people took more of it.<p>Anyway, I always looked skeptically at claims that trying it once guarantees addiction after that.
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netcanover 11 years ago
Anything that has to be spread to &quot;The Masses&quot; through marketing, propaganda or public education campaigns need a simple message to work. Simple, clear, strong messages with no room for debate. Just say no. Just Do it. The Real Thing.<p>Exaggeration is absolutely essential if you want to get people to react. You cannot rely on reality to provide the necessary frightening statistics.<p>So for example, almost everyone (including smokers) overestimates the risk of lung cancer caused by smoking by an order of magnitude. The danger of second hand smoke by even more. Cigarettes are unhealthy, but people are too irrational to react to that. In order to get a reaction, the dangers must be multiplied.<p>Another good example is HIV transmission. Most people assume the transmission rate is close to 100%. Someone who has had sex with a HIV+ partner and survives dodged a bullet. In reality, transmission rates after a single exposure are very low. It depends on the sex act and viral load but even for high risk activities like anal sex, infection rates are in the low single digits. They are estimated around 0.1% per exposure for vaginal penetrative sex.<p>Campaigns that made you think of how many people are 5 shags removed from you (your ex &amp; her exes &amp; his exes..) implied that infection rates were near 1%. People bought it. They started using condoms. The spread slowed or stopped. A 0.1% risk would not have done that.<p>So yeah. Marketers lie. So do propagandists. The layman public simplify. It&#x27;s how shoes get sold. it&#x27;s how public opinions are changes.
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oneofthoseover 11 years ago
One aspect to the &quot;instantly hook a user&quot; theory that I have not seen mentioned here is the following:<p>Taking a potent drug like heroine or cocaine for the first time is described by some users as &quot;pushing open a door to a very enjoyable place you did not know existed&quot;. Once this door is open, you will always know that this place exists, you can not &quot;unknow&quot; the experience.<p>While some people might be able to handle the knowledge of this enjoyable place and are able to choose when and if to go back, some might not be able to. Therefore I believe it makes sense to tell people not to open the door at all.<p>I also can imagine that the first time with these potent drugs is a positive experience for many, unlike the first cigarette or the first beer a person ever tries. The second cigarette is not smoked because the first was so good.
robbiepover 11 years ago
I have previously commented on this topic on HN, but since it&#x27;s back i&#x27;ll go again.<p>As a medical student I was taught that addiction is a spectrum. Each drug falls somewhere on that spectrum in terms of addiction potential, (And as GotAnyMegadeth comments, Nicotine is more addictive than Heroin) and every person has some prior probability of becoming addicted, due to the complex interplay of social&#x2F;biological factors that go into the nature of an addiction).<p>Okay - so Heroin is less addictive than Nicotine. We know this. People understand this if they think about the nature of addiction. Doctors are taught this at medical school. Community mental health, nurses and doctors talk to lots of people who have tried hard drugs and never got into them.<p>But what is the destructive potential of trying heroin and becoming addicted? Obviously much greater than with nicotine (Although nicotine products may well result in your death one day too).<p>This information isn&#x27;t particularly new, and certainly hasn&#x27;t been buried by the powers that be in an attempt to strengthen anti-drugs arguments (at least in Australia)
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baneover 11 years ago
Like lots of folks I drink a bit, and I smoke the occasional celebratory cigar. I&#x27;m fortunate to not have found myself addicted to anything though (that I&#x27;m aware of at least).<p>However, I have family members who have deep addiction problems. Life affecting. One thing that I&#x27;ve noticed is that even when they get off of the substance, the addictive personality traits are still there -- years later.<p>One of my relatives, for example, managed to get herself off of drinking and smoking completely and was in counseling. The addictions, and the kinds of behaviors that come with maintaining addictions (all kinds of dissociative, anti-social, manipulative weirdness) were ruining her life. Strange thing was, after removing the substance, the behaviors persisted.<p>Many months later, after quitting drinking and smoking, we found that she was latching onto other activities in an addictive way. For example, she found a puzzle game on her phone that she would play obsessively* -- forgetting to eat, sleep, show up for work, having basic human interaction and even requiring physical therapy at one point for the muscle strain of sitting in the position to play the game for hours on end. Crippling physical pain wasn&#x27;t even enough to get her to stop -- it was what was providing her &quot;fix&quot;. She would sit, literally for days straight and play it. Counseling eventually got her to recognize this addiction, but it was harder for her to stop since she had her phone on her at all times.<p>Then one day she stopped and we all breathed a sigh of relief -- she started sending emails again and generally became more communicative. A few weeks later the behaviors started again, but it wasn&#x27;t with her phone. Turned out she had just found a computer game she liked more and switched off the phone game.<p>Today she manages a bit better, but she went through a smoking binge for a while. She&#x27;s &quot;quit&quot; again, but now just habitually chews nicotine gum. Apparently the nicotine helps keep her off of other more destructive behaviors (like playing phone games obsessively). When she feels stressed, she just chews some nicotine gum and that seems to get her through the craving. She&#x27;s back working a regular job now and doing okay, but the idea that she&#x27;ll find some other, better, satisfier, scares everybody.<p>* - obsession is outright scary when you see it in another human for real. It makes a mood swing look like a flat affect. A person who&#x27;s addictively <i>obsessed</i> with something is almost feral, operating on instinct -- except with human level brain power to alter their environment to maintain the obsession.
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AznHisokaover 11 years ago
We should not look towards drugs to satisfy the void in our lives.<p>We should not look to eating for pleasure, just for health.<p>We should not look to our career as a source of fulfillment - it&#x27;s just a means to an end.<p>We should not look to our mates as a source of salvation - we should focus on giving.<p>We should not look to our kids as objects to make us whole - we should focus on giving...<p>Ok, so if we&#x27;re gonna take away all these things as &quot;drugs&quot;, what&#x27;s left?
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rwmjover 11 years ago
Does anyone really think &quot;one try ... is enough to get us hooked&quot;? They can&#x27;t know any overt functional drug users if that&#x27;s the case. Cocaine in particular isn&#x27;t instantly addictive. If anything on the few occasions I&#x27;ve used it, it actively put me off.
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GotAnyMegadethover 11 years ago
Kind of on topic: I was surprised to find out that Nicotine is thought to be more addictive that Heroine...<p><a href="http://en.wikipedia.org/wiki/Nicotine#Dependence_and_withdrawal" rel="nofollow">http:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Nicotine#Dependence_and_withdra...</a>
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jmcgoughover 11 years ago
I worked in a neuroscience lab for years - our rats were housed in pairs, in extremely small cages. They were required to have &quot;environmental enrichment&quot; by LAR (Lab Animal Resources), which for us meant a small stick for it to chew on. So yes, a lot of research is done on animals that are not exactly what I&#x27;d consider healthy or normal.
pcvarmintover 11 years ago
&quot;Drug, Set and Setting&quot; by Norman Zinberg is another classic. Andrew Weil has talked about it (search YouTube). His thesis was on nutmeg as an addictive drug. Almost anything can be addictive given the right setting.<p>&quot;Addiction is a Choice&quot; by Jeffrey Schaler. Saying it is a choice is not at all meant to cast blame, but to emphasize that to use drugs is a choice given one&#x27;s life circumstances, and is influenced by many variables. To focus on the drug use itself is to neglect real &quot;problems of living&quot; (as Thomas S. Szasz called them). By viewing it as a choice, one is also empowered to end their addiction, but it must be voluntary and not coerced by family members or the state.<p>I sometimes think of unhealthy addiction as being trapped in a local minimum of pain -- given limited resources, including limited personal strength to change the circumstances or environment one is in (e.g., job, marriage, housing), then addiction to a substance, or even a non-drug activity, can become a local minimum of pain, all avenues out of which produce, short-term, more pain than the status quo.<p>So it can be philosophically argued that addiction is a rational decision given the circumstances and the resources available. The key to successful addiction treatment is not behavior modification or &quot;education&quot;, but providing resources so that one may escape local minima, and without punishing them for any behavior which does not harm others (hurt feelings doesn&#x27;t count).<p>If the drug use is focused on and punished, even criminally, it never addresses the underlying issues which led to drug use being an escape from pain in the first place.<p>In the current system, harsh punishment for drug use, or paternalism over one&#x27;s life in the name of &quot;protecting one from himself&quot;, becomes more important than the principles of improving happiness or avoiding coercion against fellow humans.
gtr32xover 11 years ago
We acknowledge that the drug addiction is a complex issue and with our current understanding of human psychology it&#x27;s hard to generalize the rationals behind the addition.<p>With regard to the law system, it basically boiled down to this: if such a behavior or activity does have the potential to threaten recipients in their well-being and the others around them, then it&#x27;s probably better to ban it to allow a more harmonic society. Such as jay-walking, it is also illegal.<p>However, do people still jay-walk? Of course they do, because it provides convenience, a sense of accomplishment -&gt; dopamine. So is it similar to drug use? Of course. The difference is that jaywalking laws are enforced way less than hard core drug uses.<p>Now laws aren&#x27;t always black and white, judgment is often involved. Outside of law, mentally should we be more accepting and acknowledge drug use instead simply putting it down? Sure why not. As long as you can safely understand that it won&#x27;t cause harm to you or your surrounding. But can anyone be absolutely certain of that? Afraid not.
tallesover 11 years ago
&quot;when stories about the effects of drugs on the brain are promoted to the neglect of the discussion of the personal and social contexts of addiction, science is servicing our collective anxieties rather than informing us.&quot; This.<p>Also, for who missed the link in the article: <a href="http://www.stuartmcmillen.com/comics_en/rat-park/" rel="nofollow">http:&#x2F;&#x2F;www.stuartmcmillen.com&#x2F;comics_en&#x2F;rat-park&#x2F;</a>
jmngomesover 11 years ago
&quot;When Alexander’s rats were given something better to do than sit in a bare cage they turned their noses up at morphine because they preferred playing with their friends and exploring their surroundings to getting high.&quot;<p>Well, AFAIK, this doesn&#x27;t happen with most humans struggling with addiction to hard drugs. Addicts will neglect everything, namely social activities, in order to get what they need.
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cwarriorover 11 years ago
Addiction is not just about the substance (alcohol, cocaine, heroine) or the behavior (Sex, gambling, video games).<p>A person is an addict even before that person has that first try. There are many other factors that condition someone to become an addict. There are genetic factors, environmental factors, other underlying mental issues, etc.
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FollowSteph3over 11 years ago
Imagine what it must be like in North Korea then?
blueblobover 11 years ago
This was very interesting. Thanks!
mumbiover 11 years ago
My question is this: if the rats knew that taking the morphine after moving to the park would keep the withdrawals away, would they have still taken the water?
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marincountyover 11 years ago
I hope there&#x27;s more studies done like this. I have always felt there&#x27;s a lot of false information about drug addiction out there--even among Psychiatrists. I know that there&#x27;s many addicts out there who are literally afraid of quitting a drug; especially opiates and alcohol. &#x27;I&#x27;m not going to get dope sick&#x27;, &#x27;my doctor wants me to spend my last 30 grand on rehab&#x27;, &#x27;I was told I will have the DT&#x27;s.&#x27; I have found with most drugs-- tapering off works. This is especially true with alcohol, and opiates. No, it&#x27;s not simple, but many of you don&#x27;t need to wipe out your savings on hysteria. Most MD&#x27;s won&#x27;t talk about tapering because of liability, but if you don&#x27;t have the money for a fancy rehab, many of you can taper off alcohol, and opiates, and even benzodiazepines.