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

fivethirtyeight.com

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

#191

Post by swift »

refurb wrote: post #100
tptacek wrote: post #87

Earlier quoted context omitted.

No, that's not at all true. The Anti-Drug Abuse Act of 1986 was passed by an overwhelmingly white Congress and an overwhelmingly white Senate, and signed by overwhelmingly white Ronald Reagan.

This is the whole "dammed if you do, dammed if you don't". Situation: Crack use climbs in black communities leading to major social problems. Option A: Create tough laws to stop crack use. WRONG, YOU ARE RACIST (for singling out the black community). Option B: Don't create tough laws. WRONG, YOU ARE RACIST (for not caring about the black community).

There are options other than "tough laws" for helping communities struggling with high rates of addiction.

Your breakdown of this situation makes it sound like you think it doesn't matter what you do, because someone will call you a racist no matter what. In other words, that accusations of racism are totally arbitrary. That's not true.

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

#192

Post by jlg23 »

tudorw wrote: post #179
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…

I have a couple of friends on methadone, they are cordial, relatively together and in a totally safer place than prior. I would rather that than the other so it's legitimate approach in my eyes, they have the rest of their lives to figure out when they can stop. "Detoxifications and drug free modalities, although appealing to an understandable desire for recovery without medications, produces only 5-10% success rate.…

> I have a couple of friends on methadone, they are cordial, relatively together and in a totally safer place than prior.

From my work with injecting drug users about a decade ago: None prefers methadone, they only take it because, when in a treatment program, they get it for free and unadulterated. When it comes to actually ceasing consumption, at least on the mindvox drug users list, the consensus seemed to be, that is is easier when first switching back to heroin.

Ask your friends whether it is the methadone as a substance that helped them or the decriminalization and steady supply they don't have to worry about. From experience, I bet on the latter.

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

#193

Post by rdtsc »

bsder wrote: post #182
taylorswift_ wrote: post #147

Earlier quoted context omitted.

In my opinion you can't simply discard the debate as comparing apples to oranges... There are many similarities. It's a drug addiction at the end of the day.

So, we should give alcoholics naloxone? Okay, so now we've established that alcohol and opiates do different things in the brain. So, at this point, I'm going to ask you: "Why should you assume similarity rather than assuming difference?" Just because viruses and bacteria are both harmful does not mean we should use antibiotics for both.

> Just because viruses and bacteria are both harmful does not mean we should use antibiotics for both

But getting rest and good nutrition will help the body fight both. So they work differently but some treatment is the same. Not unlike what gp was pointing out.

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

#194

Post by tpallarino »

shawndrost wrote: post #166
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…

Wow. At the time I'm writing, there are 11 other responses, and they're all unconvinced/opposed/offended regarding the parent comment. I'm embarrassed by the deliberate ignorance on display. Race was and is a key factor in American politics, and in politics everywhere. (I don't know anything about politics in, say, Cambodia, but I can tell you race is a key factor.) The civil rights movement, 20 years before crack wa…

How about this? Instead of saying that it's so obvious and that people are "deliberate" in their ignorance, you present some data that support the hypothesis that this is a racial issue.

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

#195

Post by Zarath »

eropple wrote: post #110
Zarath wrote: post #105

Earlier quoted context omitted.

Really sad that this is the top comment here. How about instead of immediately making it a racial issue, maybe we consider that we've learned something from the crack epidemic of the 80s on how to better deal with such problems? Or we could also consider that the opioid problem is different because the source of such problems is pharmaceutical companies and the doctors prescribing them, rather than some illegal drug…

You are "not saying any of these hypotheses are correct," but boy howdy are you really up on making sure he doesn't put forward one you don't like, yeah? Saying "X is X" does not mean you are "making it X". If you think he's making it a racial issue , you might want to consider that it just might be actually a racial issue .

> but boy howdy are you really up on making sure he doesn't put forward one you don't like, yeah?

What? I made one comment. Not only was parent's comment only loosely relevant to the article itself, but they provided no evidence to support their position, all with an undertone of maliciousness. I'm willing to accept it's a racial issue if you present evidence that reasonably eliminates confounding factors like the ones I brought up. As for the opioid epidemic: I care about as much as I care about the crack epidemic, which is about as much as I can care without having anyone close to me be affected.

> Saying "X is X" does not mean you are "making it X". If you think he's making it a racial issue, you might want to consider that it just might be actually a racial issue.

They are "making it a racial issue" because the article is about how to best help someone with an opioid addiction, not why people write so many articles about opioid addiction, or why so many people care about opioid addiction, or why the method of dealing with the opioid epidemic seems different than that of the crack epidemic. Parent's comment is, again, only marginally relevant to the content of the article.

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

#196

Post by setrofim_ »

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…

First of all, thank you for sharing your experience. It was insightful, and I completely agree with your criticism of the article.

I would like to make a small, and perhaps somewhat pedantic comment regarding your last statement:

>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.

There is a problem of silent evidence and survivor bias here. What is important is not what they did that led to their recovery, but what they did differently (or, more generally, what was different in their circumstances) from those that tried to recover, but didn't.

So, IMHO, what is needed is not _just_ the opinions of those that recovered, but a longitudinal study to identify which, out the many factors that were involved in the recovery process, have been the most instrumental.

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

#197

Post by Zarath »

tptacek wrote: post #108
Zarath wrote: post #105

Earlier quoted context omitted.

Really sad that this is the top comment here. How about instead of immediately making it a racial issue, maybe we consider that we've learned something from the crack epidemic of the 80s on how to better deal with such problems? Or we could also consider that the opioid problem is different because the source of such problems is pharmaceutical companies and the doctors prescribing them, rather than some illegal drug…

I'd say it does the good of reminding us that where black communities face retributive drug policies, white communities tend instead to get therapeutic drug policy. That seems like an important detail, not an artificial concern.

I agree with your point but that feels like more of a class issue than a race issue, though of course race and class aren't independent unfortunately.

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

#198

Post by tudorw »

rantanplan wrote: post #186
tudorw wrote: post #184

Earlier quoted context omitted.

never and alive is just fine, methadone satiates the addiction though does not really deliver a 'high' anymore so these friends can fill their lives with more interesting things, at some point methadone might get de-prioritised, in the meantime, I support them with love and encouragement, they recognised they were in a situation and took intelligent pro-active steps to move their lives forward, I'm not them, I'm not…

No one is judging no one. And you should keep supporting them any way you can. But I am just stating facts. > at some point methadone might get de-prioritised But that is wishful thinking, not reality. Open-ended programs do not work. Period. By far most people in such programs relapse multiple times. You can't expect from the addict to kick the drug off out of sheer will and good intentions. > took intelligent pro-a…

You're talking in absolutes, with no references, do you have any supporting evidence, did you read the linked article, I seem to some good science on my side.

"For opioid addiction itself, however, the best treatment is indefinite, possibly lifelong maintenance with either methadone or buprenorphine (Suboxone). That is the conclusion of every expert panel and systematic review that has considered the question — including the World Health Organization, the Institute of Medicine, the National Institute on Drug Abuse and the Office of National Drug Control Policy."

https://fivethirtyeight.com/features/what-science-says-to-do...

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

#199

Post by dredmorbius »

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…

My read is that the science was principally this 'graph:

For opioid addiction itself, however, the best treatment is indefinite, possibly lifelong maintenance with either methadone or buprenorphine (Suboxone). That is the conclusion of every expert panel and systematic review that has considered the question — including the World Health Organization, the Institute of Medicine, the National Institute on Drug Abuse and the Office of National Drug Control Policy.

With four links in that last sentence.

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

#200

Post by Zarath »

kchoudhu wrote: post #117
Zarath wrote: post #105

Earlier quoted context omitted.

Really sad that this is the top comment here. How about instead of immediately making it a racial issue, maybe we consider that we've learned something from the crack epidemic of the 80s on how to better deal with such problems? Or we could also consider that the opioid problem is different because the source of such problems is pharmaceutical companies and the doctors prescribing them, rather than some illegal drug…

Given that justice reform for low level drug offenders has gone precisely nowhere in the last 30 years, I'm thinking we haven't really learned anything from the epidemic in the 80s. I'll let you fill in the blanks: If the 80s epidemic and the current opioid crisis are experiments and the sentencing scheme remains identical, what is the independent variable?

- Ease of obtaining opioids compared to crack as a member of the middle class. - Ease of becoming addicted to opioids when the original intent of use was medical, rather than recreational - Arguably larger reach of opioid epidemic, specifically that it is less isolated to a few geographical areas - Socioeconomic class of people that are affected - More accepting/understanding of addiction and drug use in general, even if the laws yet aren't
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