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At St. Paul 'wet house,' liquor can be their life - and death

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Re: At St. Paul 'wet house,' liquor can be their life - and death

#71

Post by jacques_chester »

Groxx wrote: post #70
jacques_chester wrote: post #69

Earlier quoted context omitted.

Oh hey, someone who mocks the use of antidepressants. I suffer from congenital depression. Zoloft helps me to be a functioning, productive member of society. It has prevented many deaths from suicide. People like you prevent people from seeking help because they buy into the "just harden up" bullshit. Should people with diabetes just kick the insulin habit? Please.

Where the hell are you getting that from? Read what's written, not what you want to see. I said America is on a happy kick, not that such drugs don't work or that they're unnecessary. There's an obsession with appearing happy that hides and / or causes a lot of problems, including depression.

I've applied a simple stereotype. Everyone I've ever seen saying "America / society / the world are on a mandatory happy kick" usually segues into a rant about the pharmaceuticals themselves, written in a disparaging tone.

You fit the profile, and it's a profile I find repugnant and dangerous to the mental health of depressed people everywhere.

There is an important difference between unhappiness due to life events and clinical depression. One may trigger the other; but the fact is that depression is a neurochemical disorder that is, in most cases, directly and immediately treatable with cheap, safe, effective pharmaceuticals with a minimum of fuss.

I've had the deep dark nights of despair. The black nights of the soul. I spent years trying to stare down the black dog. It is exhausting and I gained nothing by it. It has borne me no fruit whatsoever.

Re: At St. Paul 'wet house,' liquor can be their life - and death

#72

Post by Groxx »

jacques_chester wrote: post #71
Groxx wrote: post #70

Earlier quoted context omitted.

Where the hell are you getting that from? Read what's written, not what you want to see. I said America is on a happy kick, not that such drugs don't work or that they're unnecessary. There's an obsession with appearing happy that hides and / or causes a lot of problems, including depression.

I've applied a simple stereotype. Everyone I've ever seen saying "America / society / the world are on a mandatory happy kick" usually segues into a rant about the pharmaceuticals themselves, written in a disparaging tone. You fit the profile, and it's a profile I find repugnant and dangerous to the mental health of depressed people everywhere. There is an important difference between unhappiness due to life events a…

If that's your standard response to such an apparently-vague profile, without them actually stating such things, you're going to be jumping the gun a lot and probably win more enemies than successes. Do you also leap at people who think we're over-medicating?

Re: At St. Paul 'wet house,' liquor can be their life - and death

#73

Post by jacques_chester »

Groxx wrote: post #72
jacques_chester wrote: post #71

Earlier quoted context omitted.

I've applied a simple stereotype. Everyone I've ever seen saying "America / society / the world are on a mandatory happy kick" usually segues into a rant about the pharmaceuticals themselves, written in a disparaging tone. You fit the profile, and it's a profile I find repugnant and dangerous to the mental health of depressed people everywhere. There is an important difference between unhappiness due to life events a…

If that's your standard response to such an apparently-vague profile, without them actually stating such things, you're going to be jumping the gun a lot and probably win more enemies than successes. Do you also leap at people who think we're over-medicating?

You're right that I jumped the gun. I'd apologise, but it would be disingenuous as I still can't shake you out of the profile I put you in at first.

It's not fair, and it's not rational, but if there's anything I've learnt from taking zoloft it's that dualism is rubbish. We are illusions of ourselves, running on a largely hacked-together substrate made of meat.

I used to put the position that the drugs are over-prescribed, that it's a societal problem etc. But I don't feel that way any more, because thinking like that was another reason that I did not seek treatment. I basically lost my 20s to this disease, I don't want others to suffer as I did.

If that means erroneously attacking a few false positives on HN, so be it.

Re: At St. Paul 'wet house,' liquor can be their life - and death

#74

Post by iamelgringo »

Groxx wrote: post #58
iamelgringo wrote: post #39

Earlier quoted context omitted.

long-term non-profit euthanasia Not really. Euthanising long-term alcoholics would mean taking a syringe full of paralytics, potassium, versed and morphine and pushing as a lethal injection. Hospice is realizing they are dying from their disease and providing for them while the disease runs its course.

If someone is dying from a disease you have cures for (it's simple, but hard: stop drinking), but they're not taking them, so you instead support that disease, how far from euthanasia is that really? It's absolutely hospice care in the approach, but they are literally helping them die more quickly. More happily, but more quickly. And euthanasia has nothing to do with absolute speed, only relative; a less-painful deat…

If someone is dying from a disease you have cures for (it's simple, but hard: stop drinking), but they're not taking them, so you instead support that disease, how far from euthanasia is that really?

The difference is that people have the right to choose what treatment they take or don't take. Forcing a treatment on someone (antibiotics, chemotherapy, sewing a laceration) when they don't want it is legally called medical battery, and it's against the law.

This is particularly poignant in the case of diseases like alcoholism or drug addiction. I often have conversations with alcoholics along the lines of "Your alcohol level was 5 times the legal limit. If you keep drinking at this level, in a couple of years, your liver will be shot, and you're going to die of liver failure. Liver failure is one of the worst ways to die, because you die looking like a swollen yellow gourd."

Most don't care, and keep on drinking. Same thing with smoking. I smoked for 10 years while I was a Critical Care nurse. It was my choice and my addiction. It took trying to quit 15 times before I did it successfully. Some people aren't able to quit, or don't want to quit, and it kills them.

Should we deny people with lung cancer hospice because their disease was self inflicted? Should we deny people with heart disease hospice because they didn't manage their cholesterol properly? Should we deny people with type 2 diabetes hospice because they didn't manage their diet appropriately, exercise or lose weight?

Re: At St. Paul 'wet house,' liquor can be their life - and death

#75

Post by Groxx »

iamelgringo wrote: post #74
Groxx wrote: post #58

Earlier quoted context omitted.

If someone is dying from a disease you have cures for (it's simple, but hard: stop drinking), but they're not taking them, so you instead support that disease, how far from euthanasia is that really? It's absolutely hospice care in the approach, but they are literally helping them die more quickly. More happily, but more quickly. And euthanasia has nothing to do with absolute speed, only relative; a less-painful deat…

If someone is dying from a disease you have cures for (it's simple, but hard: stop drinking), but they're not taking them, so you instead support that disease, how far from euthanasia is that really? The difference is that people have the right to choose what treatment they take or don't take. Forcing a treatment on someone (antibiotics, chemotherapy, sewing a laceration) when they don't want it is legally called med…

I should point out that I do enjoy playing Devil's Advocate. But I'm not just trying to be contrary, these are essentially things running through my mind.

I largely agree with what you're saying (how could I not?), but I'm having difficulty finding testable definitions in it. Something hard-edged and consistent that can serve as a basis.

One of the problems with respecting the person's choices in cases of addiction is that there's room for arguing that they're not capable of making decisions for themselves due to the addiction. This comes up all the time in legal and medical situations - otherwise, we'd have no insanity clause, no forced rehab, no insane asylums (not that I think those are fantastic places, of course). I have no idea where the legal line lies in most situations, but would be interested if anyone does know it.

At what point do we decide whether it's the person or the disease that's talking? Alcohol in particular has a far longer history than the newer, "harder" drugs that our society has drawn clear distinctions for, and it's going to be much harder to find or make or convince others where the line for it lies.

Re: At St. Paul 'wet house,' liquor can be their life - and death

#76

Post by Daishiman »

6ren wrote: post #46

I don't like to think anyone is hopeless. That's because to be truly hopeless requires mathematical certainty, which usually isn't possible in the real world. In the real world, we don't know everything; there are always unknowns. Where there are unknowns, there is a chance; there is hope. Giving love and care and respect to these alcoholics... I would expect that that might help some of them to recover. The article…

If the money saved on treatment for these people can be better spent in improving policy and other aspects in society, then it appears to be money well spent.

Transplant patients are prioritized, among other things, on the chance that they will be able to recover from their illnesses. Alcoholics are never given transplants for that reason.

At some point you have to take into account what works best statistically, otherwise you are being unfair to those who have not wasted their chances.

Re: At St. Paul 'wet house,' liquor can be their life - and death

#77

Post by Daishiman »

reeses wrote: post #63
ekoontz wrote: post #11

Earlier quoted context omitted.

Seriously though, I found it interesting and am glad it was on Hacker News. Social engineering is engineering, and engineering is Hacker News. You are minimizing the harm and cost in a society by providing a place where people can safely use alcohol. It's far better and cheaper than leaving them to do it on the streets.

How are you measuring the minimization of the harm and cost? Where is the methodology? What hypothesis were they testing when they conducted this "experiment?" What are the second order effects on public infrastructure? And social engineering is not engineering, unless anything involved in influencing the universe through action is engineering. Your analogies are based on logical fallacies.

The effects of this clinic can be easily compared to those of other institutions if proper statistics are kept. Judging from the article, they most likely are.

Aside from that, bioethical issues, while using quantified information as tools to measure effectiveness, need an equal or greater amount of thought to the basic philosophy of the clinic, and ultimately require human judgement where we determine what is "better" and what we want as a society.

So, yeah, wrong on all counts.

Re: At St. Paul 'wet house,' liquor can be their life - and death

#78

Post by iamelgringo »

Groxx wrote: post #75
iamelgringo wrote: post #74

Earlier quoted context omitted.

If someone is dying from a disease you have cures for (it's simple, but hard: stop drinking), but they're not taking them, so you instead support that disease, how far from euthanasia is that really? The difference is that people have the right to choose what treatment they take or don't take. Forcing a treatment on someone (antibiotics, chemotherapy, sewing a laceration) when they don't want it is legally called med…

I should point out that I do enjoy playing Devil's Advocate. But I'm not just trying to be contrary, these are essentially things running through my mind. I largely agree with what you're saying (how could I not?), but I'm having difficulty finding testable definitions in it. Something hard-edged and consistent that can serve as a basis. One of the problems with respecting the person's choices in cases of addiction i…

I have no idea where the legal line lies in most situations, but would be interested if anyone does know it.

Sure, I deal with this on a nightly basis, when I'm at work. Most state laws stipulate that the only reason a hospital can hold someone against their will, is if they are a danger to themselves (in imminent danger of committing suicide), a danger to others (in imminent danger of committing homicide.) or gravely disabled ( e.g. walking around quacking like a duck and drinking from puddles).

And, even then, an ER can only place someone on a 72 hour hold. Then it has to go to court to hold someone against their will on a 10 day paper.

Getting someone committed to rehab for alcoholism is generally a court driven exercise that happens after a person has multiple DUI's or instances of committing crimes that are drug use related.

The law takes committing someone to drug, alcohol or psychiatric treatment against their will very, very seriously and only does so in extreme circumstances. And, frankly, providing a wet house for people to continue to choose to drink themselves to death is probably the path of least resistance, it's cheaper and in my opinion is the most humane of all the bad options.

Re: At St. Paul 'wet house,' liquor can be their life - and death

#80

Post by Groxx »

iamelgringo wrote: post #78
Groxx wrote: post #75

Earlier quoted context omitted.

I should point out that I do enjoy playing Devil's Advocate. But I'm not just trying to be contrary, these are essentially things running through my mind. I largely agree with what you're saying (how could I not?), but I'm having difficulty finding testable definitions in it. Something hard-edged and consistent that can serve as a basis. One of the problems with respecting the person's choices in cases of addiction i…

I have no idea where the legal line lies in most situations, but would be interested if anyone does know it. Sure, I deal with this on a nightly basis, when I'm at work. Most state laws stipulate that the only reason a hospital can hold someone against their will, is if they are a danger to themselves (in imminent danger of committing suicide), a danger to others (in imminent danger of committing homicide.) or gravel…

>Then it has to go to court to hold someone against their will on a 10 day paper.

I don't quite follow that sentence... is that to get a 10 day period enforcement, or to go over 10 days? Or something else?

All in all, pretty clear, thanks! That sounds like a pretty rational set of rules. My main difficulties lie in that people seem to only care about things when they become imminent and obvious, while ignoring steady trends that are just as dangerous (or more). Legally, imminent is a nice, clean line to choose, because it's pretty clear most times. It's a line that can be protected, which is hugely important.

Ethically, I don't know, and any actions would be at odds with their free will... unless you view addictions as violations of their free will to begin with. A loss of free will that they chose, but that decision doesn't hold up against extremes like suicide. Is suicide somehow worse when it's immediate rather than over the course of, say, a year? What if they planned it for a year, and you only interrupted it at the crucial moment?

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