Drug addiction: choice vs. disease model.

[woamotive]

http://www.hbo.com/addiction/

I went to the library yesterday and checked out a 4 disc DVD set called 'Addiction' from HBO. It talks about this very issue, 'Addiction as a disease'. Before watching this I was kind of on the fence regarding my position on this topic. It really presents some good arguments/metaphors/comparisons that help explain the position that 'Addiction is a disease'. I suggest you (all) watch this mini series! It has great ideas... I'm not going to bother summarizing the material, just check it out.

 

[max_]

Nobody forces obese people to eat. Obesity is a desease.
Nobody shoves their fingers down a bulimic throat but themselves. Bulimia is a disease.
Nobody forces people to work until they get a burnout. Burnout is a medical condition.

 

[pbuilder]

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.


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.



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.



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.



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.

Most of your responses are in re-guard to abiding by prescriptions for legitimate medical problems, which I said was a different issue and wasn't really what I was talking. As I pointed out, I am talking about smack/crank/crack homeless junkies. Quick question, how long was your xanax prescription?

For the last part, mental addiction can be targeted to anything... I want to eat poutine and chicken wings as my only meals, and if I could I would they are my favourite foods and when i'm hungry they are the foods I think about... So what am I mentally addicted to these foods? Do I have a disease because I crave those foods? Once again, self control has to be used with everything in life.

 

[Renz Envy]

I have related my own previous drug addiction to a disease of the mind.

But is it truly a disease?

No, Drug addiction is a lifestyle.

 

[Tommyboy]

Most of your responses are in re-guard to abiding by prescriptions for legitimate medical problems, which I said was a different issue and wasn't really what I was talking. As I pointed out, I am talking about smack/crank/crack homeless junkies. Quick question, how long was your xanax prescription?

No, the bulk of my post was about my opiate addiction. I was just giving an example of how people can get addicted to things like prescription benzos. I took them as directed and didn't take any extra because I needed it to last all month. I was prescribed xanax for 5 years, and then I went to a different doctor to taper off it using valium.

For the last part, mental addiction can be targeted to anything... I want to eat poutine and chicken wings as my only meals, and if I could I would they are my favourite foods and when i'm hungry they are the foods I think about... So what am I mentally addicted to these foods? Do I have a disease because I crave those foods? Once again, self control has to be used with everything in life.

There are people that can't control those cravings, which leads to obesity. If you think about poutine and chicken wings several times a day, and calculate how much of your earnings you can spend on poutine and chicken wings to just get by, then yes, I would consider that an addiction.

 

[alasdairm]

...because you have no self control...

if you used WILL POWER, you could break it instantly.

well, do they or don't they? you can't have it both ways...

Addiction CAN be broken, with a little something called man'ing the fuck up.

this single sentence demonstrates that you simply do not understand the concept - your comments come from a place of ignorance.

it's not clear why you (and j. wallace for that matter) are so angered by this issue? while speculating might generate a few interesting theories it wouldn't really be that helpful or relevant

as is often the case in discussions like this, your comments say a lot more about the subject than they do about the object...

alasdair

 

[pbuilder]

How was the contradictory, I said that they can't break it because they have no self control / will power, where as if they did have self control / will power it would never have gotten to that pathetic, junkie stage. Make all the excuses you want for being a junkie, go ahead. If it makes you sleep better at night, blame it on an imaginary disease.

 

[pbuilder]

No, the bulk of my post was about my opiate addiction. I was just giving an example of how people can get addicted to things like prescription benzos. I took them as directed and didn't take any extra because I needed it to last all month. I was prescribed xanax for 5 years, and then I went to a different doctor to taper off it using valium.



There are people that can't control those cravings, which leads to obesity. If you think about poutine and chicken wings several times a day, and calculate how much of your earnings you can spend on poutine and chicken wings to just get by, then yes, I would consider that an addiction.

Do you not get my point...? You are saying obese people NEVER had a chance to be skinny? They were always doomed to be fat? Addicts are always doomed to be addicts? So you are saying that you, and those other people don't actually have control over their life? Their life is on auto-pilot and they can't do anything about it?

Please stop being such an ignorant moron, I don't care if you use drugs (as do i), but please don't try to blame it on a "disease" lmao. You do drugs because they feel good (which is fine, once and a while), and you are addicted because you personally don't care enough about the negative side effects enough to use them in moderation. Simple as that.

 

[Tommyboy]

Did you miss the parts where I said that I have taken several 4 month breaks from using, and currently I don't use that often and am not dependent? I said that I think about using drugs a lot, not that I actually do so. Being addicted does not mean that you are dependent, although the two often go hand-in-hand. I am addicted, but not physically dependent. Not all addicts are living on the streets scheming and committing crimes to get there next fix. I graduated college while being an addict, and have had good jobs while being an addict. I still consider myself an addict because although I have been successful in many aspects, have a lot of friends that don't use, and am not in the 'drug scene,' I am still preoccupied with the notion of getting high again, even if it is months apart. I just don't act on these cravings as often as others, but they are still there, and very real.

I graduated college to get a good job so that I could afford to get high a few times a month. The thought of being able to get high was part of my motivation during all of this, and like I said, I don't get high too much because I don't want my tolerance to be high, and I don't want to become dependent, because I want to be able to better enjoy the occasional high.

I'm not saying that obese people never had a chance to be skinny, but more likely they didn't realized they had an issue until it was too late. From there it becomes a cycle of losing weight, gaining weight, feeling bad about not being able to lose weight, getting depressed about it, eating more, repeat. The only 'reward' that they get is from eating, so they eat more because it is the only thing that fills the void they are missing. It is not a healthy way of dealing with the core issue, but it's what they have come to know.

I'm not 100% on board with the disease model, but I think that addiction is a lot more complex than just an issue of will power. I would probably agree with it being a disorder rather than a disease, but both are conditions that are brought about by biological factors that are out of the persons control.

 

[pbuilder]

That's the problem, your mind set isn't to get clean indefinitely, but rather your current motivation in life is the next time you will get high. How about you actually put a decent effort in permanently stopping and finding other fulfilling, healthy activities rather than shift of blame off your self, and onto a "disease" lmao?

You are constantly thinking about drugs because you always plan to use again, that is your goal apparently, to be successful drug user. How can you ever rid yourself of that mindset if you don't actually wish to quit drugs. Here's news for you, if you actually had self control and quit all together eventually you would no longer crave drugs. But you have the mind-set of an addict because you have no will power.

 

[verso]

Please stop being such an ignorant moron, I don't care if you use drugs (as do i), but please don't try to blame it on a "disease" lmao. You do drugs because they feel good (which is fine, once and a while), and you are addicted because you personally don't care enough about the negative side effects enough to use them in moderation. Simple as that.

whoa! Who the hell are you? Tommyboy's posts have always been solid; he's one of this board's most active members, and an "ignorant moron" he most definitely is not. You, on the other hand, haven't exactly brought up any fascinating, new points. You're an armchair expert, but, unfortunately for you, this board has actual experts for members who will be more than happy to put you in your place and explain to you just exactly how addiction is, in fact, a disease. You won't understand, of course, because it appears that you've got your head in your ass, but please just know that the joke will be on you -- albeit at the same time lost on you.

Oh, and I'm merging this thread with another one that we already have.

 

[verso]

Here's news for you, if you actually had self control and quit all together eventually you would no longer crave drugs. But you have the mind-set of an addict because you have no will power.

Are you fucking kidding me?

 

[Renz Envy]

We're arguing opinionated, subjective viewpoints now.

No one has a good answer as to what addiction is.
Obviously it is vastly dependent on the substance you are using.

From a Harm Reduction point of view, Addiction should be treated as seriously as a disease.

From a realistic point of view, addiction is addiction. Just as people are tempted to have sex to please themselves, or eat junk food, drug-users will continue burying themselves in a hole of substance abuse until it becomes almost impossible to get out of.

Are the first few injections of heroin or puffs from the dope pipe because the person is addicted? No. They did it because it was fun, or it eased the pain of real life.

So perhaps addiction is a symptom of a more serious issue with you.

There is no point in saying drug addiction is "not your fault".

Addiction should be treated as seriously as a disease.

 

[Tommyboy]

That's the problem, your mind set isn't to get clean indefinitely, but rather your current motivation in life is the next time you will get high.

You summed up addiction quite beautify right there. Your posts are supporting the disease model more and more without you realizing it. You don't see something mentally wrong with people that have this mind set, perhaps something like a mental disorder or disease?

How about you actually put a decent effort in permanently stopping and finding other fulfilling, healthy activities rather than shift of blame off your self, and onto a "disease" lmao?

I do plenty of healthy, fulling things in my life. I'm not going to list all of my hobbies, interests, and activities right now, but I assure you that I have plenty of healthy activities in my life, more so than a lot of people that are not drug addicts. If I get high twice a month, that doesn't mean that I am sitting around on my ass the other 28 days only thinking of getting high. Getting high is not my motivation in life, although it may sometimes be my motivation to work a few extra hours so that I can buy some drugs without tapping into my regular pay. I didn't mean before that I went to school only so that I could get a good job to be able to get high. It was more so that I can have the money to continue pursuing my hobbies and interests, while still being able to buy drugs if I want.

You are constantly thinking about drugs because you always plan to use again, that is your goal apparently, to be successful drug user. How can you ever rid yourself of that mindset if you don't actually wish to quit drugs. Here's news for you, if you actually had self control and quit all together eventually you would no longer crave drugs. But you have the mind-set of an addict because you have no will power.

The part of your post that I bolded pretty much agrees with the disease model. The mindset of an addict? That would mean that addicts have a different brain chemistry that causes these thoughts to occur, thus verifying addiction to be a mental disease, or disorder. You can't really control all of the thoughts that come into your head, but rather can only control what you do with them. The thought of getting high pops into my head almost everyday, but I don't get high each time it does. When I didn't get high for over a year, I still had these thoughts. There are recovering addicts that stopped doing drugs for 40+ years until the day they died, and they still thought about a lot.

Will I view my life as a failure if I get high on oxycodone a few times a month after taking care of all of my other responsibilities at the time? No. Does it suck to be an addict and have the thought of getting high run through my head regularly? Yes.

Saying that I have no will power is a pretty big assumption to make, especially when you don't know what other things I do with my life, and how will power may apply to those things.

 

[verso]

I'm offended that anyone would even go so far as to suggest that if only you kick the drug, you'll no longer crave it. I mean, that's an unbelievable thought, a ridiculous idea. If that were truly the case, and if it really were that easy, then we wouldn't have all the people, all the facilities, the infrastructure, really, surrounding addiction and treatment. There would be no NA/AA meetings. Treatment would become merely abstaining from taking whatever substance, and voila, all better. But that's not the case; the cravings persist, and there in lies the disease.

Take a substance like alcohol, for example; there are those people, the majority of people, who can and do indulge without experiencing the cravings. They simply do not have that thing, that gene, that chemistry, that would allow them to drink in such a way without becoming dependent. And then there are those others who find such refuge in drinking that their brain ask for it. The brain says, "this is it, man, you've found what we've been missing all this time, so please, keep doing it!"

It's not an excuse, but its an explanation. It explains addict behavior. I'm sure that anyone, addict or otherwise, who is even the least bit rational would agree that to deny oneself food, clothing, shelter -- the very necessities -- in order to continue using a substance does not make sense. And yet, addicts do this. Emaciated and living on the streets, addicts do this. That, for me, is decisive enough proof to convince me that, "hey, something else is going on here, and it goes far beyond mere will-power and self-control."

 

[pbuilder]

Thank you, you have now cleared up the issue for me.

I hope I didn't anger anyone to much.

BTW, by mind-set, I more so meant "out-look"

And I still believe that time heals all wounds, and that your brain will actively restore itself back to normal, before it became dependent on chemicals, even if it may take years upon years. I by no means was implying that after a month you would magically stop craving, think of it more like a mellow slow down ward that goes on for a long long time, but eventually you outta get back to the ground or "normal". Where the high will simply be a distance memory, and the cravings, a faint itch.