What Science Says to Do If Your Loved One Has an Opioid Addiction • Hacker News Board

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#121

Post by taylorswift_ » Wed, Sep 13, 2017, 10:00 PM UTC

I read this, as a recovering addict that went through my own hell mostly from alcoholism, and wondered where the "science" part was?

For instance this sentence "More than 13 percent of its participants died after treatment,1 mainly of overdoses that could potentially have been prevented with evidence-based care." The argument is that they "could" have been prevented but how do they really know that? How many people in general die of an overdose after X number of stays in a rehab? Through my own experiences going to rehab, I have known of many people who die. The fact is you can't predict which people will "get" it any better than you can predict if it will rain next month.

I also disagree with this notion that being on suboxone or methadone indefinitely is a legitimate solution. Like what? You're advocating to stay on a drug the rest of your life? That isn't recovery at all, it's a band-aid that will likely lead to relapse and promotes a perpetual notion of being sick.

I also disagree that their supposed evidence that CRAFT gets twice as many people into rehab has much relevance. How many of those people relapsed? How many of the people that didn't go to rehab ended up overdosing OR recovering? We don't get the whole picture so the "evidence" is mute.

They knock 12-step which is fine but it turns out that it works for millions of people.

There is no silver bullet here.

While I have mixed feeling about the "tough love" approach, I can tell you from personal experience that the only reason I'm not buried right now is because at a certain point the floor dropped out too low, my family and friends abandoned me, I lost everything for a moment, and the pain and horror reached a level that finally I had a change of psyche on my OWN and realized I wanted to get better.

In my own humble opinion the only "science" that matters on this subject are the opinions of those whom have lived it and recovered. Go survey the opiate addicts that didn't end up dead and find out what worked for them.

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#122

Post by gozur88 » Wed, Sep 13, 2017, 10:06 PM UTC

tptacek wrote: post #109

gozur88 wrote: post #104

Earlier quoted context omitted.

If this were a group of white politicians and community leaders seeking tougher sentences for crimes occurring in their neighborhoods, I'm pretty sure we'd be hearing a debate on the merits of the proposal. But because black politicians and community leaders came to the conclusion that tougher sentences for crack dealers are warranted based on their experience it must be because of institutional racism. It's like the…

You keep repeating this argument. Its premise is invalid. It was not in fact black politicians that raised the sentences for crack cocaine in relation to powder cocaine; it was the overwhelmingly white US federal legislature.

That's... completely irrelevant. The harsher sentences had wide support from black leaders and politicians.

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#123

Post by Notre1 » Wed, Sep 13, 2017, 10:06 PM UTC

mrguyorama wrote: post #107

biggerfisch wrote: post #38

I think the saddest part of this article is perhaps the glancing statement it makes about how prison isn't a place of recovery and rehabilitation. The prison system here really is too focused on punishment and locking people up forever rather than helping them get back on their feet and being productive members of society

The prison system is highly privatized. Prisons with more people in them make more money and have a higher return on investment. Prisons that have repeat visitors can out compete prisons that do not. Therefore, there is a selection towards not keeping an inmate out of prison in the future. I hate how tinfoil hat-y this sounds, and I'm certainly no expert, so feel free to offer alternatives

The ACLU, using from the Bureau of Justice Statistics, says that "for-profit companies were responsible for approximately 7 percent of state prisoners and 18 percent of federal prisoners in 2015"

I don't think that count's as "highly" privatized. I personally think the incentives involved in the private prison system present major ethical issues, but I think we need to look at the incentives involved with the our legal system and governmental prisons, also.

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#124

Post by gozur88 » Wed, Sep 13, 2017, 10:08 PM UTC

rexpop wrote: post #111

gozur88 wrote: post #104

Earlier quoted context omitted.

If this were a group of white politicians and community leaders seeking tougher sentences for crimes occurring in their neighborhoods, I'm pretty sure we'd be hearing a debate on the merits of the proposal. But because black politicians and community leaders came to the conclusion that tougher sentences for crack dealers are warranted based on their experience it must be because of institutional racism. It's like the…

> If this were a group of white politicians... we'd be hearing a debate on the merits of the proposal. You can't know that.

When was the last time white community leaders and politicians proposed a policy to address a problem in their own neighborhood and were accused of institutional racism?

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#125

Post by tree_of_item » Wed, Sep 13, 2017, 10:09 PM UTC

taylorswift_ wrote: post #114

anythingnonidin wrote: post #12

Also interesting and related: https://news.ycombinator.com/item?id=15241874 "Psychedelics Help Reduce Opioid Addiction, According to New Study"

Have you also read "Abstinence Helps Reduce Opioid Addiction, According to New Study"?

No, I haven't read that one. Did you have some point to make by making up a fake study title?

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#126

Post by tree_of_item » Wed, Sep 13, 2017, 10:11 PM UTC

wbl wrote: post #14

Justsignedup wrote: post #3

Interesting question: The replacing opioid addiction with maintenance drugs... I could understand that drug being an okay interim solution, but in the end the person still needs to go through withdrawal, the drug just replaces withdrawal with another drug. Withdrawal is hard. Yes. But at least the person is in the right mindset to go through it once they are off the compulsory addiction, even if it takes a year to ge…

I'm physically dependent on caffeine. Why bother fixing that when it is cheap legal and available?

No you aren't. Caffeine "withdrawals" are trivial and not life threatening at all.

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#127

Post by azernik » Wed, Sep 13, 2017, 10:13 PM UTC

refurb wrote: post #98

liveoneggs wrote: post #31

Earlier quoted context omitted.

crack vs cocaine sentencing doesn't agree with you. It was clearly making the "black" crime of crack possession worse than the "white" crime of coke possession. Obama got a whole law passed in 2010 to address it!

If you were around back in the 1980's, you'd realize it was because crack was labelled an "epidemic" and ended up on the nightly news often. "Something had to be done" That wasn't happening with powdered cocaine.

That is the mechanism by which race-biased views of different drugs and crimes and other social problems operate.

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#128

Post by bsder » Wed, Sep 13, 2017, 10:14 PM UTC

guildwriter wrote: post #10

kchoudhu wrote: post #2

Now that the opioid crisis is a problem for white people, science makes an appearance in the policy discussion. Contrast to the crack epidemic in the 80s: fuck'em, throw them all in prison. Edit to add: I wish the best of luck to those who have been caught up in this crisis: I'm rooting for you, and I hope every last one of you find the treatment you need. For those of us who aren't affected, it's time for some deep…

Not to argue that there wasn't and still is racial inequality when it comes to drug enforcement, but how advanced was our understanding on how to treat opiate abuse even by the 1980s? To make things clear, I'm curious about the history of treatment methods involved with addiction. Not about excusing bad policy. I don't know much about the subject but when I try to do a bunch of cursory searches, most of what I find a…

> I don't know much about the subject but when I try to do a bunch of cursory searches, most of what I find are histories on alcoholism and the variety of treatment methods.

And alcohol is a very strange drug. It doesn't quite work like others. For example, if you block the high, most people quit wanting opioids. That doesn't seem to be true of alcohol. In addition, drying you out from alcohol seems to actually damage the impulse control centers in your brain, so avoiding relapse is much more important. etc.

> It's also worth noting how small the problem with cocaine and other opiates was in the past. The crack cocaine epidemic was probably the first time the nation as a whole had to learn what this stuff actually was.

I think the real issue is that modern production methods at that point started making far more potent drugs.

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#129

Post by tree_of_item » Wed, Sep 13, 2017, 10:15 PM UTC

otakucode wrote: post #27

Great article, but if your loved one has an opioid addiction and wants to quit without suffering the devastating withdrawal, I would strongly recommend investigating kratom. It is a non-opiate tree which grows primarily in Thailand and similar regions. It contains an alkaloid called mitragynine. This alkaloid is a selective opioid receptor agonist. Specifically, research shows that it is an agonist to several opioid…

Please note that kratom extracts are also extremely addictive and you can end up in largely the same situation as an opiate addict (minus the needles) if you go too far.

Re: What Science Says to Do If Your Loved One Has an Opioid Addiction

#130

Post by bsder » Wed, Sep 13, 2017, 10:17 PM UTC

taylorswift_ wrote: post #121

I read this, as a recovering addict that went through my own hell mostly from alcoholism, and wondered where the "science" part was? For instance this sentence "More than 13 percent of its participants died after treatment,1 mainly of overdoses that could potentially have been prevented with evidence-based care." The argument is that they "could" have been prevented but how do they really know that? How many people i…

Alcohol != opioid.

As I said in another comment, alcohol is an odd drug. It's mechanisms work very differently from opioids and needs very different behaviors and strategies to combat.