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Drug addiction: choice vs. disease model.

I hate that it is called a "disease". Cancer is a disease. AIDS is a disease. Addiction is not a disease. It is a disorder. There is a key difference there. And it being a "disorder" instead of a "disease" does not minimize the destructive and uncontrollable impact addiction can have in ones life. It is simply a more appropriate term.

And there's some choice involved, like the choice to try heroin (not that everyone who tries or does opiates becomes addicted) or the choice to seek help. But you do not choose to become addicted and while addicted you certainly don't choose if you are going to get your DOC that day. You just do whatever you can to make it happen. There's no choice involved in it, other than "Ok, I'm quitting today" and hours later being like "fuck, I feel so shitty, there is no way I'm going to be able to do this, holy shit I'm in my car already on the way to the spot, how did that happen?", which is really no choice.
 
People don't actually BELIEVE that drug addiction is a "disease"? Right...?

It really is just a load of non-sense. First off, until you actually decide to use a drug, you will never crave it. And once you have used, it really just boils down to self-control. I'm sorry but that is it, and if you think otherwise you are weak minded.

Ever addict at one point or another made the decision and said, "fuck it, show me how to shoot this dope" to their shooter friend after months/years of insufflating. Every addict decided to try crack/meth/heroin after using a weaker form of drugs in it's same class (coke, amph's, opiate pills). People knowingly cross a line because they are greedy, they now want to feel "great" from the drug like they have before, or they want a most intense version of the high.

Occasional use is one thing, but eventually they lose all self control and are using ever single day. This doesn't happen instantly, this happens from year of using "once in a while", and it is completely and fully their own fault. They have made every decision that they have on their way to becoming a crackhead or junkie fully knowing that they were crossing a line, and that they crossed MANY lines to get there.

Disease my ass, I'd love to see you explain your disease to the kid that has cancer.
 
I was reading a blog and I stumbled upon this little entry:

http://www.junkysays.blogspot.com/2010/11/know-so-many-ppl-who-have-been-consumed.html

But this isn't the first time I have seen this, I have heard this saying many times, including on TV on shows like intervention. Maybe experts just make it up so that addicts can feel more at peace with the destruction they have caused to themselves and the people around them, as if it "isn't their own fault", even though it is but yea... If you even google "drug addiction a disease" or something along those terms I'm sure you will get tons of bullsh*tters preaching about how it's a disease lol.
 
Any thought for the people out there who are legitimately prescribed addictive medication?
Especially if their doctor doesn't warn them of the risks?

I was addicted to alprazolam (not because I wanted to get high, I suffer from panic attacks), and I tell you what, waking up every morning in withdrawal sure felt like a disease.
 
Cutting and pasting from another thread on the same subject:

I agree absolutely that addiction can be defined as a disease. A self-inflicted one of course, but an opiate addiction has a very real neurological mechanism behind a very real physical dependency that responds to medical interventions designed to treat that dependency, an absence of opiates causing the body and brain to get seriously out of balance with normal functioning seriously compromised so in that regard it qualifies. Disease as mental illness is entirely seperate but equally valid. Take away the opiate crutch from an addict and the psychological effect of that is very real, in a way that manifests itself physically. It's not just 'all in your head.'
 
^That doesn't just apply for opiates.

Sorry for the wikipedia quote, I don't have time to find a proper study. http://en.wikipedia.org/wiki/Physical_dependence

Drugs that cause physical dependence

All µ-opioids with any (even slight) agonist effect, such as (partial list) morphine, heroin, oxycodone, buprenorphine, nalbuphine, methadone, and fentanil, but not agonists specific to non-µ opioid receptors, such as salvinorin A (a k-opioid agonist), nor opioid antagonists or inverse agonists, such as naltrexone (a universal opioid inverse agonist)

All GABA agonists and positive allosteric modulators of both the GABA-A ionotropic receptor and GABA-B metabotropic receptor subunits, of which the following drugs are examples (partial list):

barbiturates such as phenobarbital, sodium thiopental and secobarbital
benzodiazepines such as diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax) (see benzodiazepine dependence and benzodiazepine withdrawal syndrome)
nonbenzodiazepines (z-drugs) such as zopiclone and zolpidem.
ethyl alcohol (alcoholic beverage) (cf. alcohol dependence, alcohol withdrawal, delirium tremens)
gamma-hydroxybutyric acid (GHB) and 1,4-butanediol
carisoprodol (Soma) and related carbamates (tybamate and meprobamate)
baclofen (Lioresal) and its non-chlorinated analogue phenibut
chloral hydrate
glutethimide
clomethiazole
methaqualone (Quaalude)

Gabapentin (Neurontin) and pregabalin (Lyrica), calcium channel modifiers that affect GABA
Antiepileptic drugs such as valproate, lamotrigine, tiagabine, vigabatrin, carbamazepine and oxcarbazepine, and topiramate
Possibly neuroleptic drugs such as clozapine, risperidone, olanzapine, haloperidol, thioridazine, etc.
Commonly prescribed antidepressants such as the selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) (cf. SSRI/SNRI withdrawal syndrome)
Tobacco (but not nicotine alone)
Blood pressure medications, including beta blockers such as propanolol and alpha-adrenergic agonists such as clonidine
Androgenic-anabolic steroids
Glucocorticoids
Click to expand...
 
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^Quite. Opiates are just one example, but anything causing a physical dependency on a substance the absence of which has objectively measurable physical effects would count equally well.
 
I get angry when people describe it as a disease, as well. It gives the user a sense of "It's okay, I have a disease, this is not my fault" when in fact, it is very much their own fault. People choose to get high, but a cancer patient doesn't choose to have cancer. Any withdrawal symptoms is a direct result of the individual choosing to ingest a substance to such an extent that it causes his or her body to need it. It's a choice, no matter how bad physical symptoms become.
 
No. Whether it's cancer or addiction is irrelevant. Doesn't matter how the cancer or the habit came to exist in the first place, the fact that they do so now and require specific medical treatments in an attempt to eradicate them is all that matters. It is to all intents and purposes a disease of the mind and body once established requiring a number of specific but very different treatments with very different emphases.
 
The same logic in the OP could apply to any mental disorder. "Sociopaths don't have a disease [read: medically recognized illness], they just need to exercise enough self control not to strangle the nanny!"

It's empirically proven that some people have genetic dispositions to addiction. Sometimes people need help to get and stay clean.
 
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some of these posts display a fundamental ignorance of the subject matter.

while addiction obviously involves the choice to start using drugs, once addicted, the addict can not change their behaviour even if they want to. to suggest otherwise - i.e. to dismiss addiction at this stage as a choice - is a misunderstanding of addictive disorder.

loss of control in addicts is due to permanent physical neurological changes in the brain. comparing it to cancer for the purposes of belittling the chronic nature of addiction is not only lazy, it's flawed.

alasdair
 
Sepher said:
No. Whether it's cancer or addiction is irrelevant. Doesn't matter how the cancer or the habit came to exist in the first place, the fact that they do so now and require specific medical treatments in an attempt to eradicate them is all that matters. It is to all intents and purposes a disease of the mind and body once established requiring a number of specific but very different treatments with very different emphases.
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I don't view it as that. It's all choices. A person chooses to receive medical treatment. It's a choice, a wise choice, and sometimes needed to overcome an addiction, but nonetheless a choice. The only time such treatment is absolutely needed is when the withdrawals have the possibility to kill. Otherwise, the person can overcome it on their own, through cold turkey withdrawal. I did so myself, no reason somebody else can't do it.

I'm not trying to downplay the severity of an addiction, its very much a horrible thing to experience, but I don't see it as a disease. A person chooses to use said drug, thus choosing to take the risk of becoming addicted. If they become dependent on it, that is their own fault. Similar to how a person who is doing well chooses to relapse. That's not chosen for them, no, that is a decision the individual makes on their own terms, usually coupled with tons of rationalizing thoughts and ultimately guilt. But that's getting off topic.

Edit: Some of you people are too fucking sensitive. It seems like any time I disagree with you guys, which is very often, you blow a fuse and get all sensitive about it. Kiss both sides of my behind :p
 
OK, yes, you can cold turkey an opiate withdrawal with no additional medicinal help, relying on the body / brain to repair itself sufficiently to return to normal functioning. It is exactly analogous to what happens with a virus for the sake of argument. The attack on the body causes disruption to normal function until such time as the body produces enough of the required response to put an end to the attack. How is that different to the requirement the body restart endorphin production following the withdrawal of the opiate sufficiently to bring it back into balance? It's not.
 
^ not only that but it's known that some people are genetically predisposed to addiction and some aren't.

you can view it any way you want, j wallace - whatever helps you sleep better - but there's an increasingly large body of scientific evidence that addiction is a disease. you're free to disagree, obviously.
J.Wallace said:
Edit: Some of you people are too fucking sensitive. It seems like any time I disagree with you guys, which is very often, you blow a fuse and get all sensitive about it. Kiss both sides of my behind :p
Click to expand...
you're the only one who's blowing a fuse in this discussion.

alasdair
 
Valiumpirate said:
Any thought for the people out there who are legitimately prescribed addictive medication?
Especially if their doctor doesn't warn them of the risks?

I was addicted to alprazolam (not because I wanted to get high, I suffer from panic attacks), and I tell you what, waking up every morning in withdrawal sure felt like a disease.
Click to expand...

I can pretty much guarantee you that your subscription was 2-4 weeks max and your doctor DID for-warn you to most likely ONLY use in cases of severe anxiety episodes, and to attempt to not use daily. I guarantee you at some point or another you began to use daily even when not experiencing such severe anxiety. Regardless, I'm rather certain benzo scripts are not ever prescribed for daily use, and if they are, not for long periods of time so your phsyical addiction I'd bet was almost entirely your own doing.

And you'd have to be a moron to not question the drugs your doctor is prescribing you, and not do your own research on the side as well. Don't blame the doctor, if you are popping pills from a prescript every day you better damn well not try to play the ignorant card. We aren't in the 1980's anymore, their is something called the internet, which is your 1 stop instant answer to about every question you've got.

To the mod talking about how very real opiate physical withdrawals are, yes they are real, but they didn't start from one use. The user crossed a line, several times over, until they became physically addicted. They simply didn't have the self control to limit themselves in a manner that would prevent physical addiction.

And I'm really not aiming this thread at people that are actually FOLLOWING their prescript to the que for medical reasons, and are not abusing any extra then that. I'm more talking about heroin shooters, meth smokers and coke heads that binge day after day and blame their "disease", that they some how have come to believe that they have after years of being addicts, completely self inflicted.
 
Sepher said:
OK, yes, you can cold turkey an opiate withdrawal with no additional medicinal help, relying on the body / brain to repair itself sufficiently to return to normal functioning. It is exactly analogous to what happens with a virus for the sake of argument. The attack on the body causes disruption to normal function until such time as the body produces enough of the required response to put an end to the attack. How is that different to the requirement the body restart endorphin production following the withdrawal of the opiate sufficiently to bring it back into balance? It's not.
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Yes, but it is SELF INFLICTED. And not like smoking with cancer, where it is a gamble and you may or may not wind up with lung cancer. When you are using opiates every day, because you have no self control, because your are ADDICTED, and you fully know that after your 4th day or whatever of using in a row you will begin to experience physical withdrawals shall you quit cold turkey, you can't possibly blame this on a "disease". Their is a line you are knowingly crossing, making you an addict. You are being selfish, fulfilling your own selfish needs, that is it.

You are an addict, this is not a disease don't kid yourself. Just like kids that sit on the computer all day playing world of warcraft to achieve whatever levels or items or whatever they are getting because it gives them satisfaction, and yet they ruin their social lives, playing 12-14 hours a day. Don't kid yourself this is all PERSONAL choice, if you used WILL POWER, you could break it instantly. Addiction CAN be broken, with a little something called man'ing the fuck up. Let me think of all the other diseases I can cure with that.

Oh that's right, zero. So I guess I better go take my dose of man'ing the fuck up to not do a line of coke today.
 
While pretty much everything you've said there is true, it also happens to be completely irrelevant in the main. You are spectacularly missing the point. Not sure if it's possible to even enlighten you further as to why that is if previous posts on the thread haven't made sense to you.

As for it being all a matter of will power, again not if you think it through logically. You're saying all that's required is the balls to stop and then you're cured. If that was the case the brain would repair itself immediately, as soon as the decision to not be an addict is made. Clearly that does not happen. The addiction and the symptoms resulting from it exist independently of the will.
 
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pbuilder said:
I can pretty much guarantee you that your subscription was 2-4 weeks max and your doctor DID for-warn you to most likely ONLY use in cases of severe anxiety episodes, and to attempt to not use daily. I guarantee you at some point or another you began to use daily even when not experiencing such severe anxiety. Regardless, I'm rather certain benzo scripts are not ever prescribed for daily use, and if they are, not for long periods of time so your phsyical addiction I'd bet was almost entirely your own doing.
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When I was 17 I was prescribed xanax 3x daily. The doctor told me to take the first pill in the morning to prevent any panic attacks before they start, and to take the other two as needed. I was younger then, and didn't think to do much research on the drug. All I cared about was getting a good nights sleep for the first time in 3 months, since my anxiety had been so bad that I was up all night reading psychology books about what could be wrong with me, and also driving myself to the hospital when I had very bad panic attacks that were impossible to tell apart from heart attacks.
And you'd have to be a moron to not question the drugs your doctor is prescribing you, and not do your own research on the side as well. Don't blame the doctor, if you are popping pills from a prescript every day you better damn well not try to play the ignorant card. We aren't in the 1980's anymore, their is something called the internet, which is your 1 stop instant answer to about every question you've got.
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I didn't even know what withdrawal was when I was first prescribed the xanax. I just read the pamphlet that came with the prescription. I was 17, and I trusted the doctor. Nowadays I do research on anything I may take, but back then I didn't really think to.

To the mod talking about how very real opiate physical withdrawals are, yes they are real, but they didn't start from one use. The user crossed a line, several times over, until they became physically addicted. They simply didn't have the self control to limit themselves in a manner that would prevent physical addiction.
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There are plenty of chronic pain patients that are prescribed opiates daily for long term treatment. Most of them 'cross the line' without knowing it. Also, I have the self control to limit myself to prevent physical addiction most of the time. Psychological addiction is completely different though. When I took 3-4 month breaks at a time, I was still thinking about when I would finally get high again. I removed myself from the 'people, places, and things' that had to do with drugs, yet drugs were still a big part of my life even when I wasn't using.

And I'm really not aiming this thread at people that are actually FOLLOWING their prescript to the que for medical reasons, and are not abusing any extra then that. I'm more talking about heroin shooters, meth smokers and coke heads that binge day after day and blame their "disease", that they some how have come to believe that they have after years of being addicts, completely self inflicted.
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The way that I look at it is nobody in their right mind would do half the things that addicts do, so there is clearly something wrong with them. I've seen people go from million dollar houses to the streets. At that point, their addiction is influencing all of their decisions, and I don't think that it is all a matter of self control.

You are an addict, this is not a disease don't kid yourself. Just like kids that sit on the computer all day playing world of warcraft to achieve whatever levels or items or whatever they are getting because it gives them satisfaction, and yet they ruin their social lives, playing 12-14 hours a day. Don't kid yourself this is all PERSONAL choice, if you used WILL POWER, you could break it instantly. Addiction CAN be broken, with a little something called man'ing the fuck up. Let me think of all the other diseases I can cure with that.
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Not all addicts are physically addicted. I did "man the fuck up" and stop using, but mentally I am still addicted. How do you explain that? I have done all the right things (stopping use, moving away, getting new hobbies, friends that don't use) yet I still think about drugs all the time. I'm still an addict, whether I'm using or not. That's why I view it as a disease, or at least a disorder.
 
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