Addiction 101

[Moonlight Graham]

This is an amazing lecture on addictions and why they occur and how the brain functions with addictive behaviour. This talk is by physician & best-selling author Gabor Mate, who "for over ten years has been the staff physician at the Portland Hotel, a residence and harm reduction facility in Vancouver's Downtown Eastside".

The video is long, but give it 5-6 minutes and see if it interests you. Intellectually fascinating in my opinion. This man is brilliant.

Edited October 29, 2010 by Moonlight Graham

[Guest TrueMetis]

Look's very interesting, I'll be watching the whole thing tomorrow.

[Slim]

Phenomenal. This is an enlightening and awesome video on addiction. Thanks for posting.

[Pliny]

Some sage advice at the end that could apply in any relationship.

Several things I liked about Dr. Mate's ideas and kudos to him for his efforts.

I liked the idea of non-stressed, emotionally and constantly available parenting. The idea of the family was evoked where the mother, or to be politically correct, one parent is ensuring that the other is non-stressed, protected and can be constantly and emotionally available. The family unit is not entirely what he meant although in my view it provides those necessities to infancy of which he speaks.

When he started talking about implicit memory I thought, "Shades of Sigmund Freud and the subconscious mind!" I was under the impression that Freud had been totally discredited years ago and deemed entirely irrelevant by his current peers, and I think he has been for the most part. Implicit memory is not a new concept.

Let me ask a few questions of forum participants regarding a couple of things he said.

He says drug addiction has nothing to do with the drug itself? Do you believe that to be true?

He also says it has nothing to do with genetics? Is that true?

I would argue those last two points in the affirmative. Does anyone disagree with Dr. Mate?

[GostHacked]

He says drug addiction has nothing to do with the drug itself? Do you believe that to be true?

I've yet to watch this vid, I'll do that this weekend.

but.

Some drugs you take can make you chemically dependent on them to make you feel better. Some drugs you can take for a while and then not take won't have any affects on you. Some are downright dangerous. For me, I am a pothead. I can go for days without it, and the only side effect so far is my sleeping. I've never slept a full 8 hours a night until I started smoking pot. I get a better sleep. If I don't I am up for most of the night, making my next day pretty crappy.

It's more of the habit of it all. It's ritualistic in nature. Smoking pot or cigs can be habit forming, and that habit/association needs to be axed in order to cure the addiction. Everyone I know self-medicates in one fashion or another. No matter if it is booze, smokes or any other form of drug.

But some drugs can make you dependent on them, and no matter what you do, no matter how hard you try, you can't put it down. So you end up chasing dragons forever. It can take control of you and consume you. Many of us have seen that first hand with a relative of a friend who is no longer with us.

He also says it has nothing to do with genetics? Is that true?

I believe genetics does come into play here. This is why some drugs affect some people more than others. Kind of the same reason the doctors put you on several meds before finds the one that works with your body chemistry.

I would argue those last two points in the affirmative. Does anyone disagree with Dr. Mate?

Overall no. But I make the caveat with addiction.

[Pliny]

I've yet to watch this vid, I'll do that this weekend.

Overall no. But I make the caveat with addiction.

Well,watch the video and then see if you feel the same way.

[TimG]

He says drug addiction has nothing to do with the drug itself? Do you believe that to be true?

No. Drugs with intense highs/lows are more likely to trigger addiction because use leads to more use. Most people who abuse alcohol don't automatically seek to drink more to cure a hangover (the nausea often makes this impossible). From what I have been told by addicts this is not true with drugs like cocaine and heroine.

He also says it has nothing to do with genetics? Is that true?

They have found genetic markers for alcoholism but like similar markers for things like cancer they only indicate a predisposition for addiction. This means the environment has a role in triggering the addiction. The genetic aspect should not be dismissed - a lot of mothers are stressed. If it really only took a stressed mother we would see addiction rates much higher than they are.

http://alcoholism.about.com/cs/genetics/a/aa990517.htm

I also thought his claim that addictions did not exist before industrialization to be nonsense. Early works of literature document addictive behavior (i.e. Chaucer Pardoner's Tale). They only thing that could have changed with industrialization is the availability of cheap booze increased. My personal opinion is the availability of a drug is a huge factor in its abuse. It is much harder get addicted to something that cannot be accessed easily.

His claim that every addict he dealt with was abused was dishonest even though he did explain that his definition of abuse included emotional neglect. Abuse is understood by most people to mean sexual or physical abuse. Attempted to expand the meaning is an exercise in political activism that undermines effective communication.

That said, I thought the talk was very good but worth remembering that he is just expressing one opinion on the topic.

Edited October 30, 2010 by TimG

[Sir Bandelot]

Inject anyone with heroin or opiates for long enough and they will become addicted. The drug itself is part of it. The other part is a mental weakness that makes a person foolish enough to go for it. Some are drawn to doing the dope, others simply are not. Enough of this apologetic swaddling of the weak minded drug addicts. Drugs are a crutch used to make up for something that's gone bad with the person. That is what makes them predisposed. I'm talking about the habitual user, the addict.

[TimG]

Inject anyone with heroin or opiates for long enough and they will become addicted. The drug itself is part of it. The other part is a mental weakness that makes a person foolish enough to go for it.

Obsessive behavoirs are a common trait in humans and in many cases it is these obsessives that advance human society through the discovery of new ideas. Drug addition is simply a negative manifestation of the same human trait. It is not necessarily a weakness.

Drugs are a crutch used to make up for something that's gone bad with the person. That is what makes them predisposed. I'm talking about the habitual user, the addict.

Well, most would agree that the drugs are a crutch and getting off them requires that the underlying issues be addressed. It would be more useful to ask what can be done to convince the addict that they need face those underlying issues without chemical assistance. Condemning them as hopeless losers is not a very effective approach.

[Pliny]

So there are disagreements with Dr. Mate. Some here think he is brilliant others think there are obvious flaws in his approach.

The fact of the matter is that addiction is a problem and has not been resolved so there are still things to learn about it.

I have a fundamental that I hold to be true. And that is that a person acts in his best interests.

In the beginning of the video Dr. Mate asks a pertinent question about addiction and that question is that one has to ask what benefit the addict receives from the drug that he will continually return to taking it. That is a good question. How come the person feels he is acting in his best interests? That he is receiving a benefit cannot be denied. Even if that benefit is simply the satisfying of a craving.

This is what I believe an addiction is. It is a morphing from the initial stage of just taking the drug for fun or escapism or being one of the crowd or whatever the initial reason into the eventual necessity to satisfying the craving to have it and justifying that necessity. The justification is the supposed benefit. The real benefit has become the satisfaction of the craving to have it. Most addicts will deny they need the drug and are in control or if they admit they need it will say it provides them a benefit of some sort and that is the reason they take it. Not being able to quit if one wishes to is of course the indication of addiction. One may say, "well, I don't need this anymore and I'm not going to do it and then proceeds to try and avoid it but winds up changing his mind - still denying any addiction and saying it is just fun or eases life's stresses anyway.

This information is my paraphrasing from an expert on addiction and I have to acknowledge him at this point. His name is Allen Carr and he wrote a book called "The Easy Way to Quit Smoking".

[Pliny]

Obsessive behavoirs are a common trait in humans and in many cases it is these obsessives that advance human society through the discovery of new ideas. Drug addition is simply a negative manifestation of the same human trait. It is not necessarily a weakness.

I agree it is not necessarily a weakness.

Well, most would agree that the drugs are a crutch and getting off them requires that the underlying issues be addressed. It would be more useful to ask what can be done to convince the addict that they need face those underlying issues without chemical assistance. Condemning them as hopeless losers is not a very effective approach.

Considering them hopeless losers means you have no solutions and it is not your problem.

[Sir Bandelot]

In the beginning of the video Dr. Mate asks a pertinent question about addiction and that question is that one has to ask what benefit the addict receives from the drug that he will continually return to taking it. That is a good question. How come the person feels he is acting in his best interests? That he is receiving a benefit cannot be denied. Even if that benefit is simply the satisfying of a craving.

This is what I believe an addiction is. It is a morphing from the initial stage of just taking the drug for fun or escapism or being one of the crowd or whatever the initial reason into the eventual necessity to satisfying the craving to have it and justifying that necessity. The justification is the supposed benefit. The real benefit has become the satisfaction of the craving to have it.

The craving may not be the only reason. As with many things in human nature, statements that generalize can often be proven to be false. I believe many turn to drugs to escape from a problem. The problem may be too painful for them to deal with directly. Depression is a very widespread problem, and in some cases there might not be an obvious reason why someone is depressed. Faulty brain chemistry, perhaps. Drugs alter the brain chemistry. That is what a person who takes drugs is ultimately doing. We are all drug users, in some ways. I don't say they are useless losers.

I oppose criminalization of a person simply because they have a substance abuse problem. That's probably the least effective thing to do to help a drug user, and likely creates even more problems in their life, putting them into a spiral of social problems, drug use, criminalization and poverty. What a stupid approach to the problem. But of course any illegal actions taken while someone is "high", like violence or theft is a whole different matter.

Edited October 30, 2010 by Sir Bandelot

[TimG]

The craving may not be the only reason.

We can play games with different rationalizations and explanations but when it comes to dealing the problem the following steps are necessary:

1) Acknowledge that addiction has a biological component that makes stopping more than a matter of will power.

2) Remember that the addiction is being used to cope with unresolved issues.

3) It is the responsibility of the addict to choose to face these unresolved issues without chemical assistance.

4) If the addict makes the choice to face these unresolved issues society will provide appropriate assistance.

In short, the message to addicts is: your current situation is not your fault but getting better is entirely your responsibility. No one can help you unless you are willing to help yourself.

Edited October 30, 2010 by TimG

[Shwa]

This is an amazing lecture on addictions and why they occur and how the brain functions with addictive behaviour. This talk is by physician & best-selling author Gabor Mate, who "for over ten years has been the staff physician at the Portland Hotel, a residence and harm reduction facility in Vancouver's Downtown Eastside".

The video is long, but give it 5-6 minutes and see if it interests you. Intellectually fascinating in my opinion. This man is brilliant.

An interesting video for sure, by a well spoken person who obviously has experience in the field - it seems more oriented towards addiction case workers than actual addicts. However, I find his whole premise to be very similar to what one might find in Narcotics Anonymous or Alcoholics Anonymous programs where the drug or drink is considered a symptom of the problem, but not the actual problem itself.

[TimG]

However, I find his whole premise to be very similar to what one might find in Narcotics Anonymous or Alcoholics Anonymous programs where the drug or drink is considered a symptom of the problem, but not the actual problem itself.

It is no coincidence. Any medical professional would consult with people who have beat their addiction problems. A large majority of those did it by following the AA/NA program.

[Pliny]

The craving may not be the only reason.

If there is a benefit that is being received then there is no problem. The problem is when the person no longer has the problem and/or is no longer getting a benefit and wants to quit using but finds he can't.

As with many things in human nature, statements that generalize can often be proven to be false. I believe many turn to drugs to escape from a problem. The problem may be too painful for them to deal with directly. Depression is a very widespread problem, and in some cases there might not be an obvious reason why someone is depressed. Faulty brain chemistry, perhaps. Drugs alter the brain chemistry. That is what a person who takes drugs is ultimately doing. We are all drug users, in some ways. I don't say they are useless losers.

I oppose criminalization of a person simply because they have a substance abuse problem. That's probably the least effective thing to do to help a drug user, and likely creates even more problems in their life, putting them into a spiral of social problems, drug use, criminalization and poverty. What a stupid approach to the problem. But of course any illegal actions taken while someone is "high", like violence or theft is a whole different matter.

I oppose criminalization as well. We just need to learn more about addiction. I have to go so can't reply to anymore right now. I have to amend my position a bit on one of my points.

[Shwa]

A topical story from today's Star:

Why study says alcohol more dangerous than heroin, cocaine

Nutt argued that the government was making decisions on drug classifications using political, rather than scientific, criteria.

Nutt has argued in the past that tobacco and alcohol are a greater danger to society than marijuana or LSD.

Governments don't do that, do they?

“Once you look into the science … you will see that alcohol is currently doing the most harm in our societies,” said Dr. Jurgen Rehm, a senior scientist at Toronto’s Centre for Addiction and Mental Health who has done similar research in Canada. “We need to go over the arsenal of alcohol-control policies, and examine them rationally on what they can do for Canada.”

Rehm was one of the authors of a 2006 study that posited that the per capita cost to Canadian society of tobacco ($541) and alcohol ($463) far outweighs that of illegal drugs ($262).

But what the author does not calculate is the tax revenue from tobacco and alcohol that off-set that overall cost. I wonder if that was scientifically calculated too...

[TimG]

Rehm was one of the authors of a 2006 study that posited that the per capita cost to Canadian society of tobacco ($541) and alcohol ($463) far outweighs that of illegal drugs ($262).

The *biggest* factor affecting the cost of a harmful drug is how widespread the usage is. Cocaine, heroine and other hard drugs are used by a tiny minority of the population yet they have a per capita cost that more than half of that of alcohol (used by 70% of the population). That tells me these hard drugs are extremely dangerous and normalization would likely cause the per capita costs to skyrocket and the number of users increases. Edited November 1, 2010 by TimG

[Sir Bandelot]

The *biggest* factor affecting the cost of a harmful drug is how widespread the usage is. Cocaine, heroine and other hard drugs are used by a tiny minority of the population yet they have a per capita cost that more than half of that of alcohol (used by 70% of the population). That tells me these hard drugs are extremely dangerous and normalization would likely cause the per capita costs to skyrocket and the number of users increases.

But if you read the details of the study, there are other significant factors that make alcohol rank higher than the rest. Alcohol, taken in sufficient quantity damages every organ in the body. Alcohol is a form of poison. Hence "intoxicant"

And secondly the consideration if the drug tends to cause aggressive behaviour leading to violence, marital breakdowns. Like that.

[TimG]

Alcohol, taken in sufficient quantity damages every organ in the body. Alcohol is a form of poison. Hence "intoxicant"

All drugs have extremely harmful effects on the body (or anything taken to excess). All if takes is the destruction of one organ to make a drug dangerous

And secondly the consideration if the drug tends to cause aggressive behaviour leading to violence, marital breakdowns. Like that.

Hard drugs destroy families and increase crime in different ways.

It is really not possible to compare a illegal to a legal drug because legal drugs are widely used and a small negative can be greatly amplified. OTOH, illegal drugs come with a criminal sub-culture and it is difficult to distinguish between the harms caused by the criminal sub-culture and the drug itself.

If you really want to compare apples to apples you need to compare prescription drug abuse to alcohol. Prescription drug abuse is a huge hidden problem and causes harms that many people do not realize are caused by drugs.

My personal opinion is we should not even be talking about legalization of hard drugs until we have a better understanding of prescription drug abuse problem.

Edited November 1, 2010 by TimG

[Shwa]

The *biggest* factor affecting the cost of a harmful drug is how widespread the usage is. Cocaine, heroine and other hard drugs are used by a tiny minority of the population yet they have a per capita cost that more than half of that of alcohol (used by 70% of the population). That tells me these hard drugs are extremely dangerous and normalization would likely cause the per capita costs to skyrocket and the number of users increases.

I tend to agree, but for clarity's sake the article did says "illegal drugs" which would refer to many kinds of drugs and substances including pot & ectasy.

[Shwa]

If you really want to compare apples to apples you need to compare prescription drug abuse to alcohol. Prescription drug abuse is a huge hidden problem and causes harms that many people do not realize are caused by drugs.

Indeed a very large problem that doesn't seem to track as much as some of the smaller drug problems, like pot for instance.

My personal opinion is we should not even be talking about legalization of hard drugs until we have a better understanding of prescription drug abuse problem.

Although I am not sure if the article is talking about legalization of hard drugs per se, just more effort put into getting people off of them instead of tossing them in the can.

[Sir Bandelot]

I think the article is arguing that part of the reason some drugs are criminalized at the present time has to do with politics and economics. Also it indicates the need to make alcohol less readily available (but not illegal) by increasing the price.

Human nature says, do that and all you do is drive alcohol into the black market, where people who want to drink it can buy it cheaper. See Native Reserves and tobacco sales for further reference.

In doing so they lose the safety aspect of getting clean alcohol, as set out by federal regulations. For more on this, see Al Capone

[Pliny]

I think the study that Shwa cited has more to do with "scientific" evidence being used to formulate and back political policy regarding drugs. So the push from the study is twofold. It's politics and science once again scratching each others backs. The government can formulate policy based on "science" giving it irrefutable credibility and medical research receives grants to study the "problem" fully.

Nutt argued that the government was making decisions on drug classifications using political, rather than scientific, criteria.

Nutt has argued in the past that tobacco and alcohol are a greater danger to society than marijuana or LSD.

[eyeball]

All drugs have extremely harmful effects on the body (or anything taken to excess). All if takes is the destruction of one organ to make a drug dangerous

Hard drugs destroy families and increase crime in different ways.

It is really not possible to compare a illegal to a legal drug because legal drugs are widely used and a small negative can be greatly amplified. OTOH, illegal drugs come with a criminal sub-culture and it is difficult to distinguish between the harms caused by the criminal sub-culture and the drug itself.

If you really want to compare apples to apples you need to compare prescription drug abuse to alcohol. Prescription drug abuse is a huge hidden problem and causes harms that many people do not realize are caused by drugs.

My personal opinion is we should not even be talking about legalization of hard drugs until we have a better understanding of prescription drug abuse problem.

I've come to the opinion that all recreational drug use, from unwinding with a few drinks or a toke at the end of the day to heroin use, should be sanctioned by a physical fitness certificate issued by a doctor.

I fail to see why anyone should be allowed to purchase alcohol without a fitness certificate anymore than a person can by oxycodone without a prescription.

I was talking to someone I know who works in the local government liquor store and she mentioned the staff often wonder amongst themselves which of their customers is likeliest to be the next to drink themselves to death. I was reminded of the requirement that alcohol servers in bars are trained to know when someone has had enough to drink and are required by law to cut them off when they've had too much.