Live data from Hacker News

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

fivethirtyeight.com

211–220 of 302 posts

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

#211

> When a family member, spouse or other loved one develops an opioid addiction — whether to pain relievers like Vicodin or to heroin — few people know what to do. Faced with someone who appears to be driving heedlessly into the abyss, families often fight, freeze or flee, unable to figure out how to help. OK, if someone wants to be an opioid addict, why not just let them? The "driving heedlessly into the abyss" aspec…

A lot of people are dying from overdoses.

https://www.asam.org/docs/default-source/advocacy/opioid-add...

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

#212

> When a family member, spouse or other loved one develops an opioid addiction — whether to pain relievers like Vicodin or to heroin — few people know what to do. Faced with someone who appears to be driving heedlessly into the abyss, families often fight, freeze or flee, unable to figure out how to help. OK, if someone wants to be an opioid addict, why not just let them? The "driving heedlessly into the abyss" aspec…

A lot of people are dying from overdoses. https://www.asam.org/docs/default-source/advocacy/opioid-add...

People are dying of overdoses because opioids aren't available legally, with regulated strength and purity, and at reasonable prices. If opiods with regulated strength and purity were as readily available as liquor, few people would be overdosing. In parts of the Middle East, where alcohol isn't available legally, methanol poisoning isn't uncommon.

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

#213

Earlier quoted context omitted.

I'm talking with more than 20 years of experience being close to people who follow these treatments. One has to wonder why would we not choose a treatment(3-12 months, depending on the person/situation) since it can demonstrably help people recover completely from opioids and instead choose life-long dependence on particular drugs. Are these the same scientists that think prescribing Vicodin, as if it's aspirin, is a…

> One has to wonder why would we not choose a treatment(3-12 months, depending on the person/situation) since it can demonstrably help people recover completely from opioids and instead choose life-long dependence on particular drugs. Who cares? Nobody talks this way about a person who has to take heart medicine every day to survive, and not that many talk this way about me when I take Lexapro every day to not get de…

> What makes methadone so different?

You can survive without it for starters. Not the case with heart medicine I guess?

If you saw people, with the same condition as yours, having a good quality of life without medicine wouldn't you not wonder if that could apply to you too?

In the case of drug addiction, I've seen many people successfully kicking off the habit in months and living a perfectly healthy life, as if almost nothing happened.

Life-long methadone users? Not so much. I can tell that people really think it's different from heroin but it's not really. It's just regulated. Think about it ;)

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

#214
post #203
post #28

Earlier quoted context omitted.

> any non-profits ... working to increase people's sense of community at a mass scale You're describing most religions that I'm aware of. Say what you will about their beliefs, but most of them (definitely not all) work hard to have an inclusive and supportive community.

> work hard to have an inclusive and supportive community. With the condition that you abide by the rules. It's the assurance that everyone adheres to more-or-less the same values that glues the community together. Also, if I may venture slightly off-topic, the modern western definition of "inclusive" seems to imply "without requiring people to adhere to anything", which is the opposite of what you need to build a co…

> With the condition that you abide by the rules.

The rules are generally in place to protect the community from sociopaths and serve as the communities immune system.

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

#215
post #202

Earlier quoted context omitted.

We now have a methadone clinic in our local shopping center, right next to a large childcare facility. Since then, crime has gone way up. The grocery store now has armed guards. This is not what a solution should look like.

>This is not what a solution should look like. I'm not necessarily a supporter of suboxone / methadone / whatever , but this NIMBY rhetoric isn't helpful, either. It's rare for the down-turn of an area to have one extraordinary cause. I guess that the suggestion is that methadone clinics create crime where there otherwise wasn't -- but I don't see it that way in my community. What I see these clinics provide is a cen…

> It's rare for the down-turn of an area to have one extraordinary cause.

no it's not. he's talking about a single store. in my town it's the homeless shelter and halfway house that causes a 5 block radius around it to be a terrible place to live.

we're not talking about building more housing, or zoning for high density commercial/residential mixes, or building public transit, or eliminating cars from downtown cores, or building more bus routes, or bikeshares, or uber, or any number of things that people actually want. we're talking about methadone clinics and halfway houses next to where affluent people live.

if you pretend like it's hard to understand why people don't want those things in their residential/shopping neighborhoods, you're just going to alienate everyone you communicate with. you can't just invoke the magic 'nimby' and get people to change their minds. __they don't want these things next to where they live__.

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

#216

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…

Not only what they did differently. It might be something they didn't do as well. Since data is laking any personal effort might be completely irrelevant and only the environment might make the difference. I presume there is a large personal effort involved but we don't know.

On survivorship bias: the B 17:s in 2nd world war that generally are used as the practical example of this principle had bullet holes exactly in those parts of the plane that were fine. The parts that had not taken a beating in the survived planes were the ones that needed more armourplating.

So, where are the psychological bullet holes in those who've not beaten addiction?

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

#217
post #202

Earlier quoted context omitted.

>This is not what a solution should look like. I'm not necessarily a supporter of suboxone / methadone / whatever , but this NIMBY rhetoric isn't helpful, either. It's rare for the down-turn of an area to have one extraordinary cause. I guess that the suggestion is that methadone clinics create crime where there otherwise wasn't -- but I don't see it that way in my community. What I see these clinics provide is a cen…

> It's rare for the down-turn of an area to have one extraordinary cause. no it's not. he's talking about a single store. in my town it's the homeless shelter and halfway house that causes a 5 block radius around it to be a terrible place to live. we're not talking about building more housing, or zoning for high density commercial/residential mixes, or building public transit, or eliminating cars from downtown cores,…

> __they don't want these things next to where they live__.

Which is the precise definition of Not In My Back Yard...

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

#218

Earlier quoted context omitted.

> It's rare for the down-turn of an area to have one extraordinary cause. no it's not. he's talking about a single store. in my town it's the homeless shelter and halfway house that causes a 5 block radius around it to be a terrible place to live. we're not talking about building more housing, or zoning for high density commercial/residential mixes, or building public transit, or eliminating cars from downtown cores,…

> __they don't want these things next to where they live__. Which is the precise definition of Not In My Back Yard...

yeah, and good luck convincing anyone, anywhere that building a methadone clinic in their back yard is a good idea.

here's another turn of phrase you might find handy: choose your battles.

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

#220

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…

> 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.

That's assuming they did anything different at all. It could just be that there is not a one size fits all treatment for this problem, and part of the solution is to match the right treatment for each particular addict.

Post reply on HN