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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

#131

Post by betenoire »

javajosh wrote: post #40
betenoire wrote: post #26

Earlier quoted context omitted.

That's not helpful at all. Yes, addiction is "filling" "something" "broken". Now what?

Now you address the environmental factors that created the void in the first place, such that the drugs are no longer desirable. See: Rat Park. https://en.wikipedia.org/wiki/Rat_Park Also, downvoted for needlessly confrontational pedantry.

I'm sorry you felt I was being confrontational. But I stand by it. Telling someone there is a reason for what they are going through, then saying, "now find it and fix it" is NOT helpful.

I sincerely believe that anyone that thinks pointing out the obvious to an addict will help has not actually done it. And I consider "It's something in your environment" to be obvious, true, and totally not actionable.

Furthermore, the idea that addiction is necessarily filling a void is, to be blunt, bullshit.

https://news.ycombinator.com/item?id=15243828

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

#132

Post by astura »

otakucode wrote: post #52
jtmcmc wrote: post #4

Earlier quoted context omitted.

Why? The problems with addiction - specifically opioid addiction - is that it causes negative, destructive behavior. This isn't a consequence of having a physical dependence we are all physically dependent on things after all.

No, it does not cause negative, destructive behavior. It causes you to lie down and feel good. And it also causes constipation. And, if your supply is interrupted, withdrawal symptoms. The rest is caused primarily by the laws and social environment. Having to interact with criminals? Getting uncertain doses? Overdosing? Those things are because it is illegal, not because it's an opiate.

"Negative distractive behavior" can also include things like "spending so much money on drugs you can't afford basic living expenses," "destroying relationships with your friends/family," "being unable to take care of your children," "getting fired from your job," "not being able to take care of your basic commitment," "'lying down' while driving," etc., etc.

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

#133

Post by betenoire »

otakucode wrote: post #35
betenoire wrote: post #26

Earlier quoted context omitted.

That's not helpful at all. Yes, addiction is "filling" "something" "broken". Now what?

It is extremely helpful. It is very incovenient, to be sure, but it is very helpful. If you want people to not use drugs, then you have to provide them with a fulfilling life or the opportunity for such. If your desire is to operate a society that grinds people down, restricts them in ways that feel burdensome to them, insults them, and also does not have people using drugs? You might as well wish to fly. Because you…

This is not true in the general sense. If I take a pill that my doctor prescribes, I run the risk of becoming addicted.

Now you put it on me and my happiness? Not helpful either.

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

#134

Post by tptacek »

gozur88 wrote: post #122
tptacek wrote: post #109

Earlier quoted context omitted.

You keep repeating this argument. Its premise is invalid. It was not in fact black politicians that raised the sentences for crack cocaine in relation to powder cocaine; it was the overwhelmingly white US federal legislature.

That's... completely irrelevant. The harsher sentences had wide support from black leaders and politicians.

It's obviously not completely irrelevant, as your argument depends on a causal link between black support for crack sentencing laws and the adoption of those laws. In fact, no such causality is established, and it is indeed unlikely, given that the laws were passed by an overwhelmingly white legislature in the grip of a nationwide (largely unjustified) freakout about crime.

John Pfaff's "Locked In" is a great source for the background on this stuff (Pfaff would be the first to say that drug sentencing laws are not the reason for mass incarceration in the US, but that's not the question at issue in this thread).

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

#135

Post by rbobby »

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…

> 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?

Why not? It saves lives (hello insulin). And here's a telling bit from the article:

> When patients take a stable, regular and appropriate dose, maintenance medications don’t cause impairment, and the patient can work, love and drive. In essence, what maintenance does is replace addiction — which, remember, is defined as compulsive use despite consequences — with physiological dependence, which, as noted above, is not harmful in and of itself.

Here's the link with much more info about buprenorphine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293937/

Certainly it would be nice to have an effective solution that didn't require daily use... but we don't. What we have is a safe drug that cuts the death rate by half.

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

#136

Post by paganel »

intopieces wrote: post #15
flachsechs wrote: post #9

Earlier quoted context omitted.

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.

Doesn't the fact that the "not even once" ads existed in the public consciousness saliently enough to have a meme show that people did really seem to care?

Never been to the States, but from half a world away and just by reading on reddit about it it all looked more like people were making fun of said meth-addicts, they (the redditors making the jokes) didn't seem to care that much about those meth addicts. This was all happening about 3-4 years ago, I'd say, and it's in very sharp contrast with the present-day opiate-related discussions which can get pretty personal. It's also interesting that the HN crowd has also joined the opiates conversation, I don't remember reading anything about the meth epidemic in the past on HN.

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

#137

Post by amigoingtodie »

gozur88 wrote: post #24
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…

>Contrast to the crack cocaine epidemic in the 80s: fuck'em, throw them all in prison. That's overly reductive to the point of being wrong. There was never a particularly strong feeling that crack addicts should be thrown in prison any more than other types of addicts. People were strongly in favor of throwing crack dealers in prison because they were turning neighborhoods into war zones as they fought for lucrative…

I would downvote you if I could.

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

#138

Post by curun1r »

betenoire wrote: post #26
sharpercoder wrote: post #25

An addiction tries to replace a void in someone's life. Chances are big the environment of the addicted played a role in cerating the void.

That's not helpful at all. Yes, addiction is "filling" "something" "broken". Now what?

You focus on the actual problem rather than the previous false causes of addiction. In the past, we've blamed the addict's moral character and will power and, more recently, we've tried to look at addiction through a purely physiological lens where we believed we only needed to break the dependence. Guess what happened...most people relapsed or fell into some other self-destructive behavior. Human beings are just not able to live in a mostly-detached state.

Our improved understanding recognizes the need for human-to-human connection. We're realizing that substances are serving as substitutes for people who are lacking that genuine connection in their lives. Just removing the substance will create a void that will quickly get refilled, either by a relapse, another substance or something else that isn't productive.

And it's a mistake to think of this as solely a substance abuse problem. There are many other ways that people self-medicate. Television, the Internet and smartphones are all "relationships" that we lean on when we're not getting enough of the genuine kind that we crave. We like to blame this opioid epidemic on overprescription of these drugs, but we're making a huge mistake if we ignore everything about our society that has created so many human beings who are so detached from each other that they become addicted to these things.

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

#139

Post by wu_tang_chris »

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…

> Now that the opioid crisis is a problem for white people

a lot more people die from opiods than crack. most crack users are white.

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

#140

Post by wu_tang_chris »

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.

Your comment reminds me of this video: https://www.youtube.com/watch?v=ao8L-0nSYzg
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