Why is addiction treated as a disease

[TimG]

Every disease where the treatment is basically 'lifestyle changes' is a choice because no one can force someone to accept the doctor recommended treatment. Diabetes is a good example. Many people are diagnosed early but refuse to make the required lifestyle changes and face major consequences as a result. So you can say diabetes is a disease of 'choice'.

When it comes to addiction there is a genetic predisposition - i.e. some people are more likely to get trapped in an addictive cycle. The choice of addiction depends largely on what is available. If there are no drugs it will be booze or maybe eating. But once someone is trapped in an addiction cycle the 'choice' to stop is not easy and always requires support.

What this means is policies that enable drug use will inevitably lead to more drug addicts. That does not mean the total number of addicts in society is increasing - just the ones involved in drugs.

Good drug policy is one that focuses on getting people to stop. The 'disease model' is actually quite useful on that front because it provides addicts with a reason for their actions that does not involve blaming themselves (something that usually prolongs the addition cycle). Addicts that succeed in recovery will often move beyond the 'its not my fault - its a disease' thinking and recognize that choice is a big part of the solution. But getting a practicing addict to that level of self awareness takes years.

Personally, I think people who are not involved in treating addicts should butt out of the question of whether it is a disease and focus on determining whether a drug policy is actually convincing addicts to seek treatment.

[jacee]

Every disease where the treatment is basically 'lifestyle changes' is a choice because no one can force someone to accept the doctor recommended treatment. Diabetes is a good example. Many people are diagnosed early but refuse to make the required lifestyle changes and face major consequences as a result. So you can say diabetes is a disease of 'choice'.

When it comes to addiction there is a genetic predisposition - i.e. some people are more likely to get trapped in an addictive cycle. The choice of addiction depends largely on what is available. If there are no drugs it will be booze or maybe eating. But once someone is trapped in an addiction cycle the 'choice' to stop is not easy and always requires support.

What this means is policies that enable drug use will inevitably lead to more drug addicts.

That's just stupid.

Did prohibition stop alcoholism?

Does drug prohibition stop drug addiction?

Hasn't yet!

That does not mean the total number of addicts in society is increasing - just the ones involved in drugs.

Good drug policy is one that focuses on getting people to stop. The 'disease model' is actually quite useful on that front because it provides addicts with a reason for their actions that does not involve blaming themselves (something that usually prolongs the addition cycle). Addicts that succeed in recovery will often move beyond the 'its not my fault - its a disease' thinking and recognize that choice is a big part of the solution. But getting a practicing addict to that level of self awareness takes years.

Personally, I think people who are not involved in treating addicts should butt out of the question of whether it is a disease and focus on determining whether a drug policy is actually convincing addicts to seek treatment.

The elephant in the room here is alcoholism, hugely more pervasive than hard drugs, and more damaging to families and society as a whole.

Should alcoholics be able to return their bottles for a deposit ... or should they be forced to reuse dirty ones in hopes that they'll catch a fatal disease and die, and spread it to their family and friends?

Those who exchange dirty needles don't get a deposit back!

This is the ridiculous nature of this thread debate:

Availability of drugs/clean needles doesn't cause drug addiction.

The real problem isn't drug addicts, but the organized criminals who profit from the drug trade.

Legalizing drugs will stop the criminals from profiting, killing, and ensnaring eg children and prostitutes in addiction.

And maybe we should talk about the pervasive genetically modified corn syrup that contributes to sugar addiction and diabetes too ... and is possibly a gateway to alcohol and drug addiction.

[TimG]

Did prohibition stop alcoholism?

No. But it reduced the number of people becoming alcoholic.

Does drug prohibition stop drug addiction?

A strawman. All I said is the number of drug addicts will go up if drugs are legalized. I never said prohibition could eliminate drug addiction.

The elephant in the room here is alcoholism, hugely more pervasive than hard drugs, and more damaging to families and society as a whole.

Nothing I said contradicted this statement. Why don't you try reading what was written instead of making stuff up?

Availability of drugs/clean needles doesn't cause drug addiction.

It does not cause drug addiction but it can prolong the addiction cycle by enabling addicts. This effect could be countered if the service providers use the outreach process to get more addicts into recovery. I am not convinced that this is the case given the idiotic ideological approach harm reductions advocates seem to take.

[jacee]

No. But it reduced the number of people becoming alcoholic.

A strawman. All I said is the number of drug addicts will go up if drugs are legalized. I never said prohibition could eliminate drug addiction.

Nothing I said contradicted this statement. Why don't you try reading what was written instead of making stuff up?

It does not cause drug addiction but it can prolong the addiction cycle by enabling addicts. This effect could be countered if the service providers use the outreach process to get more addicts into recovery. I am not convinced that this is the case given the idiotic ideological approach harm reductions advocates seem to take.

You have any evidence for any of those opinions?

Because they're all BS.

Alcohol consumption went down during prohibition?

That statement is,at best,misleading. In truth,nobody really knows exactly how much alcohol consumption increased or decreased during Prohibition. The reason was simple enough --people like Al Capone didn't pay taxes on their product and thereby report their production to the government. Licensed saloons became illegal speakeasies,and many common citizens took advantage of the high sales price of illegal booze by secretly manufacturing booze in their own bathtubs. That's one of the major problems with all drug prohibitions -- they greatly reduce the ability to make accurate judgments about the problem. There is no good way to count the number of illegal dealers,or the people who are secretly making gin in their own bathroom. Therefore,to make such a judgment,we have to rely on a number of indirect indicators.

By the greatest majority of indicators, the biggest drops in alcohol consumption and alcohol problems actually came before national prohibition went into effect. Those drops continued for about the first two years of Prohibition and then alcohol consumption began to rise. By 1926,most of the problems were worse than they had been before Prohibition went into effect and there were a number of new problems -- such as a drinking epidemic among children -- that had not been there before.

Legal availability does not increase alcohol abuse.

Legal prohibition does not decrease drug addiction: Like alcohol prohibition, it just puts the trade and profi?t in unscrupulous criminal hands and increases the danger to individuals and the damage to society.

Needle exchange programs reduce HIV and do not increase drug use

Edited September 28, 2012 by jacee

[TimG]

You have any evidence for any of those opinions?

http://fullcomment.nationalpost.com/2012/09/26/barbara-kay-addiction-is-a-disease-of-choice/

Heyman poses an awkward question for disease theorists. What “disease” can afflict 1% of people born between 1917 and 1936, but 14% of people born between 1952 and 1963? The answer is none. Disease rates don’t rise or fall depending on the hostility of the general culture toward them, but rates of drug use do — as the numbers above attest. And our culture, once highly contemptuous of drug use, now spurns the judgmentalism of yesteryear.

I see this point as self evident. People don't use drugs which are not socially acceptable within their peer group (peer group does not mean society as a whole). Drug addiction has risen because drug use has become more socially acceptable over the years. Making drugs legal would only serve to increase this acceptability and therefore increase the rate of people addicted to drugs.

That said a certain number of those new addicts would be people switching from alcohol and other currently legal drugs so it is not clear that the total addiction rate would rise. What is clear is the number of addicts to formally legal drugs would increase.

Needle exchange programs reduce HIV and do not increase drug use

Please read my posts instead of making up strawmen. I did not say that needle exchange programs would increase drug use. I said they prolong the addiction. Edited September 28, 2012 by TimG

[guyser]

Making drugs legal would only serve to increase this acceptability and therefore increase the rate of people addicted to drugs.

Nonsense.

See POrtugal and or prohibition.

[jacee]

http://fullcomment.nationalpost.com/2012/09/26/barbara-kay-addiction-is-a-disease-of-choice/

I see this point as self evident. People don't use drugs which are not socially acceptable within their peer group (peer group does not mean society as a whole). Drug addiction has risen because drug use has become more socially acceptable over the years. Making drugs legal would only serve to increase this acceptability and therefore increase the rate of people addicted to drugs.

That said a certain number of those new addicts would be people switching from alcohol and other currently legal drugs so it is not clear that the total addiction rate would rise. What is clear is the number of addicts to formally legal drugs would increase.

Please read my posts instead of making up strawmen. I did not say that needle exchange programs would increase drug use. I said they prolong the addiction.

That would be an increase in drug use.

These things are NOT self evident, and you've posted only uninformed opinion that's not accurate. BabaKay's opinion is not evidence, nor is it accurate, nor is yours.

Edited September 28, 2012 by jacee

[TimG]

See POrtugal and or prohibition.

Sure:

There is little reliable information about drug use, injecting behaviour or addiction treatment in Portugal before 2001, when general population surveys commenced. However, there was the indicators on lifetime prevalence amongst youth, collected as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD), and some other (less reliable) data available through the EMCDDA.[13]

Reported lifetime use of "all illicit drugs" increased from 7.8% to 12%, lifetime use of cannabis increased from 7.6% to 11.7%, cocaine use more than doubled, from 0.9% to 1.9%, ecstasy nearly doubled from 0.7% to 1.3%, and heroin increased from 0.7% to 1.1%[14]

http://en.wikipedia.org/wiki/Drug_policy_of_Portugal Edited September 28, 2012 by TimG

[TimG]

That would be an increase in drug use.

A fixed percentage of the population is genetically predisposed to addiction. An increase in drug use will increase the number of potential addicts using drugs. This will lead to a higher number addicts. There is no rational basis for your claim that an increase in drug use does not come with an increase in the number of drug addicts. Edited September 28, 2012 by TimG

[Guest Manny]

There would be an immediate increase in reported use, because for one thing more of the people who are already using will be brave enough to come out and admit it (and in some cases, finally reach out for help when they know they won't be prosecuted).

[TheNewTeddy]

Not everyone is strong enough to make every choice. If they were, we'd have no poor, they'd all be successful people.

Nobody WANTS to be addicted. Addicts are people who are not strong enough to make the right choice.

[Jiblethead]

Not everyone is strong enough to make every choice. If they were, we'd have no poor, they'd all be successful people.

Nobody WANTS to be addicted. Addicts are people who are not strong enough to make the right choice.

agreed. Even before people first get addicted, making the wrong choice to start using is not always their fault. I watch intervention a lot, and most of the people on the show are using drugs because of horrible things they have had to endure in their lives. People get raped, abused, etc. and it is easy to understand why they would turn to drugs to find an escape.

[Pliny]

There would be an immediate increase in reported use, because for one thing more of the people who are already using will be brave enough to come out and admit it (and in some cases, finally reach out for help when they know they won't be prosecuted).

This is true so it makes TimG right. However, I disagree over the long term that legalization will increase drug addiction. The true effects of drug use are hidden under our current system. They are bad and much worse than the average person thinks. Legalize it and after the initial rise, and destruction of people's lives the effects will be more real to people and they themselves will exercise restraint in their use.

I hate the argument that alcohol is far worse than other drugs or caffeine is a drug so if you partake you are a hypocrit, as though all drugs are equal.

Alcohol, and I'm not defending it, is not a chemical that remains in the body like THC or other chemicals so has less far reaching potential for harm to the individual. But over-consumption of alcohol causes physical damage. Some drugs like ecstasy cause brain damage. Take too much of anything and it will kill you.

I also don't agree that people who have had "horrible things they have had to endure in their lives, like rape, abuse, etc" will make wrong choices like taking addictive drugs. Some undoubtedly will if they live in and are exposed to the culture but the vast majority don't.

Addiction is the problem. If we could take or leave drugs there would be no problem except ignorance of the damage that they can do physically in the doses in which they are taken.

Heroin and morphine are both addictive but morphine is used as a painkiller in hospitals. Heroin would be cheaper and perhaps more humane for someone on their death bed than morphine. Oxycontin is addictive and is causing some social unrest as it is copiously prescribed.

Women use the argument that they need to be in control of their bodies and make decisions about abortion not government. The same could be said of drugs. Are we stupid about drugs and are women too stupid about abortion that they both need to be regulated? In both cases, perhaps some are, but not generally.

[jacee]

The reason for legalizing drugs is the protection of society from the crime and danger and destruction of the gangs and guns, driveby shootings, recruitment of youth into the drug trade, etc.

Addicts will be addicts, maybe fewer if they're not being unscrupulously hooked by criminal dealers ... but it really isn't about them.

It's about taking the drug trade out of the hands of dangerous criminals who make our streets and some neighbourhoods unsafe, especially for children ...

It's about putting the drug gangs out of business.

That's the purpose of legalizing drugs.

Put em all out of business.

[TimG]

That's the purpose of legalizing drugs.

Put em all out of business.

So you believe that *all* drugs should be available on demand without any requirement to see a doctor? Your argument falls apart completely if you say that we still need prescriptions because prescriptions are just another form of prohibition and criminals will always appear to provide a supply of prohibited drugs Edited October 21, 2012 by TimG

[dre]

A strawman. All I said is the number of drug addicts will go up if drugs are legalized. I never said prohibition could eliminate drug addiction.

Thats the conventional wisdom. Problem is theres a fair ammount of evidence suggesting its completely false and not much evidence to support that.

Unfortunately most governments today are still actively prosecuting the failed war on drugs, so there isnt too many case studies. The only western nation that has had the guts to try something different is Portugal. They decriminalized and replaced enforcement with treatment...

The result...

The use of almost every recreational drug is down in every age group.

The ammount of drug related violence is way down.

The number of drug related HIV cases is way down.

The ammount of people getting treatment is way up.

[TimG]

The use of almost every recreational drug is down in every age group.

But this is not true. Even fans of Portugal seem to acknowledge that drug use goes up but try to explain it away.

The amount of people getting treatment is way up.

This could actually support my claim that the number of addicts is increasing. You are simply *assuming* that the increase is because existing untreated addicts are getting treatment instead of new addicts needing treatment. Edited October 21, 2012 by TimG

[Sir Bandelot]

This could actually support my claim that the number of addicts is increasing. You are simply *assuming* that the increase is because existing untreated addicts are getting treatment instead of new addicts needing treatment.

It 'could', but until you provide some hard data this is conjecture as well.

It is pretty much expected that there will be increases in both demographics, new users, and old users coming out. How much, falls under the domain on sociologists.

[TimG]

It 'could', but until you provide some hard data this is conjecture as well.

But my conjecture has a rational basis: i.e. if the number of users increases (which appears to be the case) then the number of addicts must also increase since the number of people with the addict gene stays the same.

The people who want to dispute that assertion must provide data or at least a plausible counter argument for why the number of addicts could possibly decrease given what we know about the causes of addiction.

Edited October 21, 2012 by TimG

[Sir Bandelot]

But my conjecture has a rational basis: i.e. if the number of users increases (which appears to be the case) then the number of addicts must also increase since the number of people with the addict gene stays the same.

The people who want to dispute that assertion must provide data or at least a plausible counter argument for why the number of addicts could possibly decrease given what we know about the causes of addiction.

It's true; but likewise there WILL be some who no longer fear reprisal and are therefore wiling to come out. I personally don't condone legalization. Decrim, yes but I would want to see more treatment programs available. This would cost more, but is offset by the cost savings avoiding incarceration. Beyond that, we take some of the pressure off jails. More room for bad criminals. And taking control away from organized crime does appeal to me. The economic argument also appeals to me, in this time of fiscal restraint.

[TimG]

Decrim, yes but I would want to see more treatment programs available. This would cost more, but is offset by the cost savings avoiding incarceration

This is my view as well. some drugs are nasty if used incorrectly and as long as we take the position that people need to be protected from bad choices by restricting access to various medical drugs then there is no justification for making drugs legal.

[cybercoma]

This is my view as well. some drugs are nasty if used incorrectly and as long as we take the position that people need to be protected from bad choices by restricting access to various medical drugs then there is no justification for making drugs legal.

A great many legal, over-the-counter products are nasty if used incorrectly.

[jacee]

It's true; but likewise there WILL be some who no longer fear reprisal and are therefore wiling to come out. I personally don't condone legalization. Decrim, yes but I would want to see more treatment programs available. This would cost more, but is offset by the cost savings avoiding incarceration. Beyond that, we take some of the pressure off jails. More room for bad criminals. And taking control away from organized crime does appeal to me. The economic argument also appeals to me, in this time of fiscal restraint.

Taking control away from criminal gangs is the reason for legalizing drugs.

Decrim won't do it.

Edited October 22, 2012 by jacee

[Sir Bandelot]

A great many legal, over-the-counter products are nasty if used incorrectly.

It's only when things become a problem that action has to be taken. There's no law against inhaling petroleum fumes, for example. But hardly anyone does it, and there's no "black market".

There has to be at least some regulation or restriction, if anything to protect the public. These potheads making claims that marijuana is harmless need to be countered, lest naive people believe them.

[jacee]

It's only when things become a problem that action has to be taken. There's no law against inhaling petroleum fumes, for example. But hardly anyone does it, and there's no "black market".

There has to be at least some regulation or restriction, if anything to protect the public. These potheads making claims that marijuana is harmless need to be countered, lest naive people believe them.

You can't control what substances people choose to use/abuse, legal or illegal.

So forget that.

Instead focus on protecting the public from gangs with guns.

Put them out of business.

Take the drug trade away from them.

Legalize drugs.