[FloatArtifact]

Underlying assumption is that moderation is the issue, however it's addiction for those that can't quit. In layman's terms, the brain's chemistry has been altered permanently. This can happen for some even after the first use THC, opioids, alcohol and you name it.

Obviously the progression doesn't happen as fast for some. However, the key being they can't quit in moderation or in excess. Some can abstain for 3 months, some for six, thinking they don't have a problem but then find themselves using even a little. There's a self-rationalization as well as self-centeredness that's part of the disease process of addiction. I would say it's not only a disease process but it is a huge factor. Cross addiction substituting one substance for another is also part of that self-rationalization.

[bko]

I hear this claim often that your brain chemistry changes from substance use and it makes sense when you look at addicts. But with other things relating to addiction, I found claims to be hyperbole. An example is addiction is a disease no different than cancer. We don't want to tell addicts to just cut it out. But is it true? Are there scans of people before and after a while of chronic substance abuse that shows brain differences? Can we scan someone's brain and tell that they're addicts? Honest question, I don't know

[finfrastrcuture]

I think a nuance that's lost is the difference in addiction between a pharmacological substance vs a behavior. "Brain scans" and their equivalents will do a much better job revealing the former than the latter. That doesn't make behavioral addictions any less damaging from a holistic view of the patient's health (i.e. their overall quality of life).

To me, I feel as though that behavioral addiction is completely disregarded by the medical community. If someone is lighting up every night / having a drink and want to stop, they need an alternative way of closing out the day. Otherwise of course it'll be difficult.

[FloatArtifact]

Well what's behavior and what's addiction? Let's go down a thought exercise. Imagine yourself in the following scenarios:

1. Imagine you're going to Walmart. You see a friend. "You say hi and raise your hand to draw attention" However, they walk right past you without even acknowledging your presence.

What is your first thought? Maybe "Jerk!", "he's busy?".

You don't have control over that first thought, but you do have control over that second thought and your actions thereafter. Addiction messes with your first thoughts and attention. Next scenario

2. A wife and a husband are driving down the road. The wife notices Kohl's is having a 50% off and the husband notices that Andy's liquor store has two six pack for the price of one.

In this case, due to addiction, the husband noticed that Andy's liquor store and that's a craving. His awareness was drawn to that sign with a subconscious cue influenced by addiction.

Therefore, someone who wishes to maintain sobriety has to be very self-aware of their thoughts and actions. They have to guard themselves from triggers, situations, people and then manage those other aspects they can't control.

[FloatArtifact]

It's important to acknowledge that addiction is a disease as framed in the above scenarios. However, it does require a conscience behavioral change maintaining a certain level of awareness of self to sustain sobriety.

It isn't helpful for people to view themselves as simply a character flaw when going through addiction because their brain is scarred. It doesn't mean they can't make poor choices and not choose to maintain to pursue sobriety. Their behavior matters and their disease matters.

[kat_rebelo]

I am not sure about other drugs, but in the case of alcohol the rewiring is certainly not hyperbolic and not even limited to the brain. Humans have a special physiological relationship to alcohol and the human body will literally rewire both its neurological and digestive system to accommodate the increasing intake of long term alcoholics. It takes months to years for these changes to be undone, if they can be undone at all.

[FloatArtifact]

There are correlated changes in the brain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851068/

https://www.nature.com/articles/s41398-018-0220-9

[j16sdiz]

> ... it's addiction for those that can't quit.

...can't quit without side-effects.

Most addicts can stop using immediately with the side-effect that becoming less productive/energetic.

For THC, it is relatively easy to mitigate most side effects by adjusting the dose.

Modulation is not the key, but helps a lot

[FloatArtifact]

You're talking about withdrawal which is semi-related to an underlying diagnosis of addiction. That is to say someone can go through quitting a substance without withdrawals symptoms yet still have an addiction.