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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

#221

Post by CodeWriter23 »

setrofim_ wrote: post #196
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…

While I agree with your points about collecting empirical and unbiased data, I want to point out that when it comes to opioids, "Science" is moving the goal posts. They are measuring social acceptability of a subject while under the influence of doctor-prescribed dope, while ignoring the numerous addicts who maintain similar levels of social acceptability while using Street dope, then declaring their method a "success".

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

#222

Post by astura »

taylorswift_ wrote: post #146
rbobby wrote: post #135

Earlier quoted context omitted.

> In the U.K., researchers looked at data from more than 150,000 people treated for opioid addiction from 2005 to 2009 and found that those on buprenorphine or methadone had half the death rate compared with those who engaged in any type of abstinence-oriented treatment. That's some pretty scary data. Half the death rate... that's a very significant number. > You're advocating to stay on a drug the rest of your life?…

If there were 0 people who recovered from opiate addiction without being hooked on a maintenance drug for the rest of their lives then it'd have more credence. If you give an alcoholic xanax for the rest of their life because it affects the same area of the brain but they aren't drunk anymore, are they recovered? Not to mention, that seems like a pretty horrible and bleak outlook to make people believe they can't mak…

If someone replaces a drug that's doing them very serious harm with a drug that doesn't do them harm, I don't see the problem.[1] I take doctor prescribed medication daily that I could live without but it significantly increases my quality of life, I don't see a difference between me and a person who is on methadone but otherwise well in life - has job, money, clothes, friends, community, etc.

[1] Xanax has a lot of problems with long term use though, so Xanax, specifically, would likely not be a good candidate.

My MIL replaced alcohol and cocaine addictions with a coffee addiction. It's been over a decade and she doesn't seem to have any significant negative outcomes with the coffee and coffee is cheap and readily available almost everywhere. From what I see, I believe the coffee is more of a psychological crutch for her - but it's not harming her.

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

#223

Post by matt4077 »

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…

Cocaine isn't an opioid.

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

#224

Post by astura »

slv77 wrote: post #214
hasenj wrote: post #203

Earlier quoted context omitted.

> 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.

What!? Religious rules are not "to protect the community from sociopaths." For example, eating pork is not sociopathic behavior and yet a large part of the world's religions forbid pork eating.

People who have problems with the religious community usually are for their arbitrary rules rather than they'd much rather be sociopaths.

(I'd make the argument they aren't particularly good about keeping sociopaths out anyways but that's another topic)

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

#225

Post by setrofim_ »

CodeWriter23 wrote: post #221
setrofim_ wrote: post #196

Earlier quoted context omitted.

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…

While I agree with your points about collecting empirical and unbiased data, I want to point out that when it comes to opioids, "Science" is moving the goal posts. They are measuring social acceptability of a subject while under the influence of doctor-prescribed dope, while ignoring the numerous addicts who maintain similar levels of social acceptability while using Street dope, then declaring their method a "succes…

Yes, fair point. This is a common problem for social studies. One must keep in mind and be explicit about the population the study sample is drawn from; and very cautious about extrapolating the findings to other populations.

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

#226

Post by matt4077 »

seabta wrote: post #33
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…

Interesting, I hadn't thought of it that way. I wonder if white people are the only racial group that demonstrate some kind of a preference for other members of their racial group, and if not, what the implications would be if one racial group stopped having such a preference and other racial groups did not follow suit.

That reads like a barely veiled attempt to justify racism as something that "everyone does".

Because it's well-known that stereotyping works on everyone. And yes, black people can be racist against whites, or also against other blacks.

But that doesn't justify anything. In the particular case of the US, it also ignores that white (men) overwhelmingly control the levers of power, answering your question with a resounding "nothing bad".

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

#227

Post by matt4077 »

flachsechs wrote: post #9
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…

to be fair when meth was ravaging poor/rural white people nobody really seemed to care much either. in fact it was something of a joke i.e. the "not even once" memes etc. i think the real issue is opiates seem to be heavily affecting affluent suburban and urban people, who are predominantly white, and make up a huge amount of the tax base.

That's mostly wrong in that the opioid crisis overwhelmingly affects the rural white population, not urban.

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

#228

Post by ForRealsies »

hasenj wrote: post #203
DougN7 wrote: 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…

Does group B have any sense of community? Offline, not Online.

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

#229

Post by cloverich »

rantanplan wrote: post #207
tudorw wrote: post #198

Earlier quoted context omitted.

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 — inclu…

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…

> I'm talking with more than 20 years of experience

Experience is valuable but for driving systematic changes, unreliable. Its too easy to color personal experience with bias of many kinds. That's the entire point of science, to eliminate those biases and document the underlying evidence to support a claim like: "Methadone does not work."

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

#230

Post by tptacek »

Zarath wrote: post #197
tptacek wrote: post #108

Earlier quoted context omitted.

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.

No, it's not. The opiate epidemic, like crack cocaine, is mostly a phenomenon of the lower class. But opiates involve white people and generate therapy, while crack involves black people and generates prison time.
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