[kephra]

Both do same error, that they start with premise of curing addicted people. The same error that nearly all psychologist or psychiatrists share. They declare people who are not normal as insane, and want to change them. A better way, imho, is to make people conscious that they are different, and thats important for them to find a place in life, where their difference is a bonus.

One of my favorite parable, is the imagination: You are very talented. You can lay eggs. Society defines being healthy as not picking on other chicken or own feathers. But its not you who is insane, the cages are a system of insanity.

The extreme cases of junkies on the street, and alcoholics in their flat come into mind, when thinking about addiction. Those are extreme cases of people who have no place in real life also. The drugs, are their way to find a place in life to be happy. Even if only for a short time. Teach them ways to become autonomic, to find their own path through life, and addiction will calm down by itself.

[tomhoward]

I can attest to this. In the past few years I've watched two close friends destroy their lives through addictions to alcohol and drugs. One of them died recently after years of severe alcoholism. The other is now in prison for drug-related offences.

I recall with fondness and sadness, both of them at their best... kind, generous, witty, intelligent; highly capable in their careers and loving and supportive to their families and close friends.

But each of them had ways in which they didn't quite fit in, and didn't always get the returns for the efforts they put in to try to achieve what they wanted in life, and as their frustrations grew, their self-destructive behaviours escalated, and the key support structures in life - most crucially their jobs and relationships - began to fall away.

But it was absolutely not the substance abuse issues that came first; in both cases that happened after the heavy knocks of life took their toll.

From observing these stories, I've become painfully aware that society just isn't very good at equipping people to understand why and how they're going wrong in life and how they can correct and achieve happiness and fulfilment. The support services that do exist, like therapy, AA, rehab etc, only become available when the problem is already entrenched and that much harder to turn around. I learned this when I recognised that I was starting to head down the wrong path in life and sought help before it got out of control, but the response was generally something like "you're pretty fine, don't waste our time".

I did end up finding an effective way of getting my life on track, and things are now going very well for me. I hope to live to see a time when it's much easier for far more people in the world to recognise their own failings and risk factors before they get out of control and find a better path before it's too late, and I'll be doing what I can to contribute to that cause.

[uptownJimmy]

Thanks for writing this. It roughly describes my own experiences. I managed to pull out of my own spiral primarily because the love of my life didn't leave my side, and because I continued to feel hope and the possibility for change. And I worked my butt off to get out of the hole.

The hopelessness and loneliness and anxiety came first, though. Heavy knocks of life, indeed.

[im3w1l]

If you feel comfortable sharing it, how did you get your life back on track?

[slfnflctd]

There are sure to be several ways we could categorize different types of addictions and the people they affect. It does seem, however, that much of the underlying machinery is consistent.

For me, there were signs of compulsive behavior very early on - from food to reading novels nonstop - and I knew after the first time I experienced a 'buzz' as a child (probably an antihistamine) that this could cause me even more trouble.

Would I have sought escapes out less if my family and social lives had been better, or would I have been drawn in no matter what? I have no idea. Regardless, I did manage to learn with time that 'finding a path', as you say, led me to deeper experiences that not only reduced my desire to escape, but made even the escapes richer and more enjoyable. Of course, the pendulum swings, but it is good to know there are other ways one can live-- which is not always clear to younger people, simply because they haven't proven it to themselves yet.

One of the worst ways we fail young people seeking meaning is by giving them incomplete, conflicting and downright false ideas about what to value. I suspect this in large part because we haven't quite properly reached consensus on this as a species. In any case, I certainly believe we can do better.

[Ollinson]

I was under the impression that this is what psychology/psychiatry is supposed to do by charter.

Most professionals I know in the field take the attitude that a patient's psychological state should only be corrected if that patient feels they are an impediment to their own goals. This also goes along with the popular alcoholics anonymous mantra "we can't help you till you want to help yourself" (I'm not advocating AA just that it's a popular approach).

Of course this doesn't apply to people who have behavior disorders or are violent and end up committed.

[foobar2020]

It is true that a mental patient can be forced to treatment only if (s)he is considered a serious danger to the society, or herself/himself (includes suicidal tendencies). In many jurisdictions a court's decision is necessary, usually obtained on a rather short notice (24-48 hours).

But this does not mean that patient's consent is required for a valid diagnosis of a mental disorder. Denial is a serious problem and somehow an internal part of certain diseases such as mania, or, as you mentioned, early stage addictions.

[foobar2020]

The real problem, I believe, is the shame associated with mental disorders, and addiction in particular. Addiction is in many cases a (sign of a) legitimate disease, rooted deeper than just a nasty habit of popping Hydrocodone pills. We have reasons to believe that while addiction can be influenced by individual's choices, it is often not exclusively the patient's fault.

We allow patients to follow a slightly different path than the rest of the society till full recovery in the case of disorders such as cancer or depression, which can take years. Addiction should be treated the same way.

[digi_owl]

I would not call it shame, more that society does not take it seriously. I have often mused that if my mental issues had turned my skin bright blue or similar i would get a whole lot more sympathy.

Just try it, wrap a bandaid around your otherwise functioning arm (so its visible) and watch people become more helpful.

[eivarv]

I think it's more about society more easily understanding and thus being able to sympathize with physical pain and disability rather than the visibility of it itself.

Stigma is, after all, more about stereotypes and misinformation (or lacking information) than anything else.

If mental illness also affected skin hue, mental illness might just become more readily identifiable, and (some) people might just be bigoted against blue people instead.

[paublyrne]

Teach them ways to become autonomic, to find their own path through life, and addiction will calm down by itself.

Yes, but as addiction goes deeper it becomes more difficult to escape. It's not a nice thing to say, but there is probably a point of no return for many, after long periods of drug and alcohol abuse. Early interventions are crucial.

[digi_owl]

In essence, addiction is many things rolled up in a single term.

Yes, it is a chemical reaction inside the brain. But over time that chemical reaction gets padded by conditioned reflexes. This to the point that one may find some relief by mimicking the actions related to the chemical reaction.

The real crazy stuff comes when it becomes harder to kick those conditions reflexes than the chemical addiction itself. Meaning that the body no longer craves the chemical, but still react to external stimuli by attempting to go through the actions related to taking the chemical.

[girvo]

As an example: when I was an addict, and was in severe withdrawals, I would go through the motions and inject saline solution. This would, despite me knowing it's not actually a drug, get rid of my withdrawals for a while; the placebo effect coupled with the "ritual" is very powerful. After I got clean, and the cravings went away, I would still have dreams of injecting drugs; not heroin, but anything. The behaviour was an addiction in and of itself.

[rokhayakebe]

This is a great insight; the behavior is an addiction just as much as one can be addicted to the substance.

[facetube]

Here's an example of a real difference in the brain that predicts an interesting relationship with psychoactive substances, both endogenous and exogenous: the OPRM1 A118G SNP. There's evidence that it predicts (i) a much greater risk of alcohol dependence; (ii) a much greater chance that naltrexone can be used to successfully treat said alcoholism once it happens; and (iii) a requirement for dramatically more opioid pain medication to achieve equal pain relief after surgery. This is a functional polymorphism that changes the way beta-endorphin binds in the brain; i.e. it's a real physical thing that you're born with. FAAH 385A is another interesting one.

[andreasvc]

> Teach them ways to become autonomic, to find their own path through life, and addiction will calm down by itself.

How is this any different from the "premise of curing addicted people"? It seems naive to expect problems to go away by themselves.

Your comment seems to present some sort of anti-psychiatry narrative, which is a dangerous and irresponsible set of ideas, IMHO.