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

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

#261

Post by soundwave106 »

Kluny wrote: post #236
astura wrote: post #224

Earlier quoted context omitted.

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 anyway…

The parent commenter probably read this book: https://www.gitbook.com/book/hintjens/psychopathcode/details I read it to. The thesis is basically that - societal norms are designed to make it easy for normal people to notice psychopaths and avoid them. The book is pretty convincing, I'd give it a look. I didn't notice too many numbers or studies quoted in it, though. Presented without evidence though, parent commenter…

In a way, I buy that. However, the problem with many religious / community "rules of order" is that they too often are based more on tribal patterns and/or irrational logic instead of evidence.

Not only has that sometimes caused harm to harmless people "not in the tribe", but sometimes legitimate sociopaths have actually exploited "the rules and norms" to their end. (A particularly notorious example of the later that I can think of is Ted Bundy.)

Agreed with the idea that religion does foster a sense of community. If you can get that without the nasty tribalism side effects you sometimes see from it, it would work.

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

#262

Post by criddell »

emodendroket wrote: post #257
criddell wrote: post #250

Earlier quoted context omitted.

I've been thinking about similar things in the context of a basic income. If we were to just pass a law and guarantee a significant basic income I think it would have disastrous effects and fail miserably. A guaranteed income is a good goal, but before we do that we need to figure out how to replace meaningful employment with other meaningful activities. People need a purpose. If we can alter our culture and separate…

> I've been thinking about similar things in the context of a basic income. If we were to just pass a law and guarantee a significant basic income I think it would have disastrous effects and fail miserably. A guaranteed income is a good goal, but before we do that we need to figure out how to replace meaningful employment with other meaningful activities. People need a purpose. I don't think so. I think people can f…

> I don't think so. I think people can find a purpose without us imposing one on them.

I didn't mean to say a purpose should be imposed. Today it kind of is. A purpose is often closely tied to a job and a job is pretty much required to survive.

I was trying to convey that we should look for more ways to help people find a purpose or whatever you want to call some activity that is meaningful and fulfilling to that individual and socially healthy.

> If some people just want to hang around, is that really a "problem" we need to address?

Maybe, maybe not. If they are hanging around because it's what they want to do and they are happy and healthy doing so, then I don't see a problem.

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

#263

Post by FidelCashflow »

emodendroket wrote: post #244

> Consequently, do not try to use legal consequences as a way to help people you love, and if possible, bail them out if they get arrested for drug crimes. This doesn’t mean you shouldn’t hold them accountable, but do so in ways that are less likely to lead to lifelong problems. Meaningful employment is an important factor in recovery — and few things are more harmful to the chances of getting a good job than having…

> reform. Agreed, drug problems need to be treated for what they ultimately are; issues of public health.

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

#264

Post by hasenj »

ForRealsies wrote: post #228
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…

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

Depends. If they have their own set of values and rules (no matter how arbitrary) that don't include sexual restrictions, they might end up having their own sense of community.

If their lack of sexual rules is part of a bigger 'no rules or values needed' system, then I would really doubt that they can develop a pepper sense of community.

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

#265

Post by soundwave106 »

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…

The issue with some of these therapies is more or less that they are defaults, not that the therapy itself is bad in itself.

12 Step programs for instance... well, they really don't have a great success rate. It seems like the success rate is around 5 to 10 percent for AA. (http://www.npr.org/2014/03/23/291405829/with-sobering-scienc...).

But for me, I think that the issue is less the program than it is the default option, often ordered by the courts. 12 step therapy probably does work with certain personalities. For others, it will do nothing, or maybe even make things worse.

This is probably the same for "tough love" type rehab programs. Some people would be okay with this. Others would react better with other options (your CBTs, BCTs, etc.)

I will say this from a "non-expert" perspective: suboxone honestly is what you want to do from a chemical perspective for opioids. Suboxone is a combination of a mild opiate (buprenorphine) and naloxone, a μ-opioid antagonist that's there mainly to prevent abuse.

For an addiction, chemically, moving to something milder seems like a great intermediate step, akin to some methods of getting off of nicotine (eg, slowly decreasing mg of patches etc). The nicotine patches don't work too well -- it seems like the effectiveness rate is only about 17% (http://www.mdedge.com/jfponline/article/60156/addiction-medi...). But this is a significant increase from placebo (another study -- https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0010505/ -- says 50-70% more likely).

Agree that there is no silver bullet; probably the best route out is a combination of something to handle the chemical side with some form of therapy to handle the other end. The type of therapy would probably have to heavily depend on the person, given that the therapy must be something the person is willing to commit to in order to work.

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

#267

Post by Bartweiss »

pjc50 wrote: post #190
anythingnonidin wrote: post #18

OP here. An interesting takeaway I had was the importance of community. Does anyone know any non-profits or startups working to increase people's sense of community at a mass scale? It seems this is missing from large parts of the western world and has many consequences.

> non-profits or startups working to increase people's sense of community This is non-profit territory, absolutely not startup territory. You can only build a classic VC-funded startup by promising that eventually you're going to extract value (usually monopoly profits!) from the community. "Sense of community" is one of those things that's traditionally ranked well below profits and been destroyed in the search for…

Cynically: 'sense of community' gets destroyed in the search for profit when you're profiting from something else. If you're getting your profits from the community, you'll build it up just fine. Not necessarily in a healthy way, but at least in a persistent one.

Hell, I think you could convincingly argue that opening a new pub counts as founding a startup aimed at increasing people's sense of community. It doesn't have the unlimited scale of a tech startup, but it is a company that profits from offering a 'third place'. For that matter, plenty of churches have been run more like businesses than non-profits while still creating strong communities.

As long as the sense of community is profitable, it might do well with startups. That just hasn't been a common state of affairs lately.

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

#268

Post by nipplesurvey »

tomohawk wrote: post #185
tudorw wrote: post #179

Earlier quoted context omitted.

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.…

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.

the methadone clinic near(ish) my house is a well known place to score dope.

the junkers have basically turned the nearest subway into hamsterdam.

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

#269

Post by JamesBarney »

criddell wrote: post #250
emodendroket wrote: post #244

> Consequently, do not try to use legal consequences as a way to help people you love, and if possible, bail them out if they get arrested for drug crimes. This doesn’t mean you shouldn’t hold them accountable, but do so in ways that are less likely to lead to lifelong problems. Meaningful employment is an important factor in recovery — and few things are more harmful to the chances of getting a good job than having…

I've been thinking about similar things in the context of a basic income. If we were to just pass a law and guarantee a significant basic income I think it would have disastrous effects and fail miserably. A guaranteed income is a good goal, but before we do that we need to figure out how to replace meaningful employment with other meaningful activities. People need a purpose. If we can alter our culture and separate…

I think you are way over estimating the amount of meaningful work, as well as how many people with meaningful work would be on basic income. Most of the people on basic income would be people who were previously flipping burgers at McDonald's not directors as 80000 hours.

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

#270

Post by marojejian »

anythingnonidin wrote: post #18

OP here. An interesting takeaway I had was the importance of community. Does anyone know any non-profits or startups working to increase people's sense of community at a mass scale? It seems this is missing from large parts of the western world and has many consequences.

Shameless plug: I've been working on a service (www.campfire.care) to build peer support groups for any focus. Groups of 5-10 people with the same issue meet regularly via video and stay connected via chat. The idea is that we are fundamentally social creatures, and struggling with a challenge alone is unhealthy.

Campfire is not therapy or a replacement for therapy. But peer support can be powerful + inexpensive. And being part of a true peer group can provide a kind of value that professional mental health can't. You can't be friends with you therapist, and their job is not to truly empathize with you.

Would love any thoughts / feedback!

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