Russell Brand: Addiction is an illness not a crime

[effie]

Agreed. That's why I thought 33hz's point was a good one. It's more of a symptom than an illness.

It certainly can be a symptom of mental illness, and drug use (or even abuse) is not an illness, I agree. However, addiction makes changes in your brain which alters the way it functions and this, to me, indicates that it is a disease process once it reaches this stage.

There is an interesting article about the biological aspect of addiction in the Other Drugs directory (The Basic Biology of Drug Addiction) and also a paper about it which was published in the journal "Science" - you need free registration to the website to read it, I think. Here is an extract:

Not only does acute drug use modify brain function in critical ways, but prolonged drug use causes pervasive changes in brain function that persist long after the individual stops taking the drug. Significant effects of chronic use have been identified for many drugs at all levels: molecular, cellular, structural, and functional (6,7). The addicted brain is distinctly different from the nonaddicted brain, as manifested by changes in brain metabolic activity, receptor availability, gene expression, and responsiveness to environmental cues. Some of these long-lasting brain changes are idiosyncratic to specific drugs, whereas others are common to many different drugs (6, 7, 8, 9). The common brain effects of addicting substances suggest common brain mechanisms underlying all addictions (5, 7, 9, 10).

Addiction particularly affects the reward pathways in the brain.

I don't see how it is any less of an illness than, say, diabetes brought on by eating lots of fatty foods and becoming obese. Yes, lifestyle choices initiated it, but that does not exclude it from being classified as an illness. There are genetic factors involved too - some people are more likely to become addicts (or diabetic) than others - and just like diabetes, addiction is a chronic illness with potentially severe consequences. I wish more money would be spent trying to prevent and treat it, rather than criminalising people for taking drugs

I'm not trying to medicalise addiction - I think you need to address the whole spectrum; psychological issues, social factors, and the biological side. Methadone/bupe maintenance is not for everyone but at least it allows people to stabilise and work on the social and psychological factors that triggered and perpetuated their addiction. I agree that there are probably better drugs that they could be on, however. For anyone tapering though you want something long-lasting - this is why diazepam is ideal for benzo tapers.

Equally, cold turkey/rapid detox aren't for everyone, and neither is abstenance. Russel Brand does make some good points and I agree with a lot of what he says, but one-size-fits-all is not an appropriate way to look at treating addiction.

And you're right, no one will listen to him anyway

 

[charlie clean]

Yeah, but he's Russell Brand, isn't he? He could give me one anytime .....

Doesn't he insist the girlies must shower and clean their teeth before they come near him?

Better, I suppose, than fellow entertainer Cheryl Cole, whose concubines must shave their pubic hair.

Who are these people? A singer who can't sing and a comedian who isn't funny. Anyone who thinks anything they do or say is important must be on drugs.

 

[33Hz]

It certainly can be a symptom of mental illness, and drug use (or even abuse) is not an illness, I agree. However, addiction makes changes in your brain which alters the way it functions and this, to me, indicates that it is a disease process once it reaches this stage.

I see what you're saying, but I dunno, I kinda think labeling addiction as a stand alone illness may be oversimplifying things a little and could actually be counterproductive in some ways in cases where there's more going on that meets the eye. Let's say you've been vomiting for days, for instance, and you go to see your GP to find out what was wrong with you. There are numerous possibilities for why this could be happening, right? So we treat it as a symptom, not the illness itself, in order to get to the root cause. If the GP just said something along the lines of "oh you have a case of the vomits" you'd probably be pretty pissed off at him/her for not finding out what was actually causing it. I mean, you could have anything ranging from a run of the mill bacterial infection to something a lot more serious. I think it's better to apply that same sort of logic when it comes to addiction, whether that's to drugs, food, sex, gambling, or whatever really. With the over eating thing, I could take it back further and say that an abnormality in serotonin levels (for which could be due to a number or reasons) leads to increased cravings for complex carbohydrates to help raise serotonin levels in the brain which in turn causes the person to put on excess weight. The excess weight then increases the risk of developing diabetes. 8( Is it purely a life style choice that lead to this person developing diabetes, or was this person unwell to begin with? I'm in no way saying that addiction isn't part of an illness, just that focusing in on individual things can stop us from be able to see the bigger picture (if there is one).

 

[Disco Doctor]

He's a smart man. The shabby vest and the seemingly pointless jokes actually turned his appearance into something that would be buried on page 2 to multiple page leads across all the papers. He got his message out loud and clear.

 

[effie]

I see what you're saying, but I dunno, I kinda think labeling addiction as a stand alone illness may be oversimplifying things a little and could actually be counterproductive in some ways in cases where there's more going on that meets the eye. Let's say you've been vomiting for days, for instance, and you go to see your GP to find out what was wrong with you. There are numerous possibilities for why this could be happening, right? So we treat it as a symptom, not the illness itself, in order to get to the root cause. If the GP just said something along the lines of "oh you have a case of the vomits" you'd probably be pretty pissed off at him/her for not finding out what was actually causing it. I mean, you could have anything ranging from a run of the mill bacterial infection to something a lot more serious. I think it's better to apply that same sort of logic when it comes to addiction, whether that's to drugs, food, sex, gambling, or whatever really. With the over eating thing, I could take it back further and say that an abnormality in serotonin levels (for which could be due to a number or reasons) leads to increased cravings for complex carbohydrates to help raise serotonin levels in the brain which in turn causes the person to put on excess weight. The excess weight then increases the risk of developing diabetes. 8( Is it purely a life style choice that lead to this person developing diabetes, or was this person unwell to begin with? I'm in no way saying that addiction isn't part of an illness, just that focusing in on individual things can stop us from be able to see the bigger picture (if there is one).

I see what you are saying too

My point though is that biologically and medically speaking, addiction is an illness. Whether it is a good idea or not to use that label is a different matter - it doesn't change the fact that if you look at it objectively, it fits under the umbrella of "disease".

Looking at the over-eating/diabetes example - I don't believe that is purely a lifestyle choice, either. Some people gain weight easier than others, and some people are genetically predisposed to developing diabetes - so out of all the people who eat a lot, some go on to become obese, and out of those, a few develop diabetes. With addiction, out of everybody who drinks or shoots up heroin or gambles or whatever, only a small percentage become an addict. Of couse this is partly related to external factors, but there does seem to be a genetic component as well.

I am a big believer in looking at the whole picture for any illness. Throwing pills at anything without considering other factors (social, psychological etc) is not a good idea.. I also don't believe labelling is generally a good idea either - things are too complex for that, especially when you are thinking about psychiatric disorders. However, calling addiction a disease isn't just semantics, and you can't say it isn't a disease because you don't think it would be productve to call it one.. It is a disease as far as I am concerned, based on the literature I have read, and I think it is important that society recognises this.. Not so we can ignore all the other factors, of course they are important, but so addictrs can get proper treatment and not be treated as scum.

There is an interesting article published in the Behavioural Science journal available here covering the basis of addiction as a disease. It quotes some figures from the Institute of Medicine in the US stating that "32 percent of people who try tobacco become dependent, as do 23 percent of those who try heroin, 17 percent who try cocaine, 15 percent who try alcohol and 9 percent who try marijuana.". There are obviously social and psychological factors that determine whether people become addicted or not, but there is an increasing amount of evidence for a genetic basis to it. This article in the American Psychological Association's website states that research has found that at least half of a patient's susceptibility to addiction has a genetic basis.

I agree that doctors need to look into what lies behind the addiction, and even if genetic factors are responsible, it is clear that social and psychological aspects are hugely significant in perpetuating the addiction. This is the case for pretty much any mental illness, however. Good doctors should be aware of how common dual diagnosis (having an addiction as well as another psychiatric illness) is and in fact it has it's own distinct branch of psychiatry. I accept that sadly not all doctors are good, however, and there is a definite lack of knowledge about addiction amongst the medical profession

 

[Pale Rider]

I am a big believer in looking at the whole picture for any illness. Throwing pills at anything without considering other factors (social, psychological etc) is not a good idea.. I also don't believe labelling is generally a good idea either - things are too complex for that, especially when you are thinking about psychiatric disorders. However, calling addiction a disease isn't just semantics, and you can't say it isn't a disease because you don't think it would be productve to call it one.. It is a disease as far as I am concerned, based on the literature I have read, and I think it is important that society recognises this.. Not so we can ignore all the other factors, of course they are important, but so addictrs can get proper treatment and not be treated as scum.

Nicely put, i don't always agree with labeling as it can mask the real underlying issue for an individual, but it does have its place and if it helps the general public understand more about addiction then this has to be a good thing...

 

[StoneHappyMonday]

Human beings are designed, seemingly, to enact repetitive behavioural patterns. All over the world people are doing the same things at the same time each and every day. When this behaviour conflicts with the dominant ideology (ie drugz are bad mmkay) we label it 'addiction'. When behaviour falls into place with the dominant ideology (ie rampant unnecessary consumerism) we label it as 'normal'.

I know people whose lives fall apart briefly if their favourite newspaper/chocolate bar etc is not available. Should we label these people 'diseased' too? For surely they have changes in their brain patterns that affect their behaviour.

Addiction is normal. We are programmed for repetitive behaviour. Only when this behaviour falls out of sync with 'the rules' (the dominant ideology) do we label it an illness/disease.

 

[5StarSquatHotel]

'Addiction is an illness not a crime'

Bollocks. I agree it's not a crime but it is sure not a illness imo. What other ilness is self inflicted?

 

[StoneHappyMonday]

'Addiction is an illness not a crime'

Bollocks. I agree it's not a crime but it is sure not a illness imo. What other ilness is self inflicted?

Diabetes type 2.

I do agree with your premise, just think you picked on a bad example to prove your point.

 

[5StarSquatHotel]

Diabetes type 2.

I do agree with your premise, just think you picked on a bad example to prove your point.

Yeah but not everyone who eats sugar will get diabetes where as taking drugs you know you are heading for addiction. It's a bit like chopping your arm off and calling the loss of a limb a illness but yeah I get what you are saying.

 

[effie]

Human beings are designed, seemingly, to enact repetitive behavioural patterns. All over the world people are doing the same things at the same time each and every day. When this behaviour conflicts with the dominant ideology (ie drugz are bad mmkay) we label it 'addiction'. When behaviour falls into place with the dominant ideology (ie rampant unnecessary consumerism) we label it as 'normal'.

I know people whose lives fall apart briefly if their favourite newspaper/chocolate bar etc is not available. Should we label these people 'diseased' too? For surely they have changes in their brain patterns that affect their behaviour.

Addiction is normal. We are programmed for repetitive behaviour. Only when this behaviour falls out of sync with 'the rules' (the dominant ideology) do we label it an illness/disease.

Interesting, SHM I think from a medical or scientific point of view, if people are addicted to their chocolate bar or newspaper to the point where their mesolimbic reward pathways were noticably altered, and it was having an impact on their functioning, then yes - they would be classed as having an illness. I wonder if the genetic factors extend to this too - if people are reaching that point, then I think they would - as you point out, it is no different to any other addiction.

However, all this brings us neatly back to 33Hz's point about whether it is helpful to label these people. While I do believe addiction is an illness, and I don't think that line of arguing is a reason not to classify addiction as an illness, I do think that this point is correct. The most important thing in any case is what is right for the person. Not all illnesses need medical treatment, and not all patients want any treatment. In the case of the chocolate bar and newspaper, treatment is clearly not appropriate. In some cases of drug addiction, treatment may not be appropriate or even wanted, and that is absolutely fine.

The lines between "illness" and "normal" are artificial and can be pretty blurry. I still stick to my position - from a biological/medical perspective addiction is an ilness - but I appreciate what you guys are saying and I am enjoying this debate!

Darkinthepark, many illnesses have a self-infliced component. Emphysema/lung cancer from smoking. Type II diabetes from eating too much sugar and fatty foods and becoming obese, as SHM pointed out. Osteoarthritis in the knees from running. Cirrhosis of the liver from drinking alcohol. There is a genetic influence too, and other variables play a role - but this is also true in the case of drug addiction, which is believed to have a strong genetic component.

 

[missing old pills]

This is a great debate especialy for me as I'm attending treatment to abstain.
Could we be confusing illness with obsession?
As for me I have to agree with SHM's point of choice.
It was always my choice to take drugs, yea there was a little peer pressure in the early days but no one put a gun to my head.
Also it's my choice to seek assistance to abstain.

It was one of the hardest things I've ever done to walk in that centre and ask for help especialy as I have some pretty entrenched views on drugs after taking them for over 20 years.
One thing I've noticed is that no one is forcing me to attend in fact it took three sessions until my worker as satisfied that I wanted to engage.
I'm not ill but it's nice to see both sides of my behaviour instead of just the one I've come used to for so long now.

Don't worry I won't turn out like an ex smoker who complains about smoke in a 100m radius of me but my harm reduction views will be more on my agena as I go through this therapy.

My views on professional use of drugs will probably shine through, not that I'm judging people as who am I to judge, but I feel there are some very important medicines that are being restricted and held back due to abuse that could be put into better use rather than used for fun.

I just feel if we all practised delayed gratification rather than instant we would be in a better place right now.

 

[charlie clean]

'Drugs' are illegal. Do they hope to legislate away illness?

'Illness' is something you may claim to escape the legal prohibitions a sick society imposes on a lifestyle choice.

 

[effie]

MOP, perhaps you aren't one of the % of people who develops a biological response to taking drugs? Not everyone does, figures vary but most find that less than 50% of people exposed to a drug develop addiction - whether this be for external or genetic reasons..

Thought it might be interesting to add this - the ICD-10 criteria for addiction/depedence. You need 3 or more criteria.
(ICD-10 = International Classification of Diseases vol 10 - used by UK psychiatrists to classify psychiatric disorders; the Americans use the DSM-IV)

(a) a strong desire or sense of compulsion to take the substance;

(b) difficulties in controlling substance-taking behaviour in terms of its onset,
termination, or levels of use;

(c) a physiological withdrawal state (see F1x.3 and F1x.4) when substance use has
ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome
for the substance; or use of the same (or a closely related) substance with the
intention of relieving or avoiding withdrawal symptoms;

(d) evidence of tolerance, such that increased doses of the psychoactive substances
are required in order to achieve effects originally produced by lower doses (clear
examples of this are found in alcohol- and opiate-dependent individuals who may
take daily doses sufficient to incapacitate or kill nontolerant users);

(e) progressive neglect of alternative pleasures or interests because of psychoactive
substance use, increased amount of time necessary to obtain or take the substance
or to recover from its effects;

(f) persisting with substance use despite clear evidence of overtly harmful
consequences, such as harm to the liver through excessive drinking, depressive
mood states consequent to periods of heavy substance use, or drug-related
impairment of cognitive functioning; efforts should be made to determine that the
user was actually, or could be expected to be, aware of the nature and extent of
the harm.

Iinterestingly it lumps the "psychological" addiction in with the physical dependence, when actually the two are different things - you can be physically dependent but not "addicted" - for example pain patients, who are not taking the drug to get high - and you can also have the "psychological" additction without dependence, for example addiction to amphetamines. Only opioids, benzos, barbituates, alcohol, other GABAergics such as GBL, phenibut etc and a handful of other things like Soma/carisoprdol produce dependence.

I just feel if we all practised delayed gratification rather than instant we would be in a better place right now.

I absolutely agree with this.

Still think addiction is a disease though It was a smoker's choice to smoke. Emphysema is a result of the effects of smoking on the lungs. An addict chose to take drugs. Addiction is the effect of drug use on the mesolimbic reward pathway and dopamine levels in the brain. Not every smoker gets emphysema, and not every drug user gets these changes,

Loving this discussion I respect all the points of view, definitely (as long as you can defend your position )

edit: did anyone read the link to the thread that I posted - Basic Biology of Drug Addiction? It's an attachment in the thread and it's not long I promse! Wondered if anyone had any comments about it?

 

[parttime crackhead]

Yeah but not everyone who eats sugar will get diabetes where as taking drugs you know you are heading for addiction. It's a bit like chopping your arm off and calling the loss of a limb a illness but yeah I get what you are saying.

What a load of shite. Out of all my close friends I am probably the only one who has any sort of drug addiction (& that is just a psychological dependency on weed, hardly a proper addiction), yet almost all of my close friends regularly take drugs. None of them are heading for addiction.

Charlie Clean & SHM are making the most sense in this thread by a fucking mile. Effie might be as well but a lot of it is a bit over my head really lol.

 

[StoneHappyMonday]

'Illness' is something you may claim to escape the legal prohibitions a sick society imposes on a lifestyle choice.

I am hoping that by turning to God that He can turn me away from this horrible affliction - m'Lud.

 

[Mr Smokes Blunts.]

They only want to label addiction as an illness so that it becomes a medical/health issue rather than a criminal one.

However if you look at the dictionary definition of illness:
ill·ness/ˈilnis/
Noun:
A disease or period of sickness affecting the body or mind.

I would classify addiction as "A period of sickness affecting the body and mind", especially the mind. I don't doubt you can become addicted to almost anything. One of the most addictive things, that I think we'll begin to see the ramifications of over the next decade or two, is computer games. There are a lot of people who have given up their jobs and their familiy to play World of Warcraft every day.

 

[effie]

What a load of shite. Out of all my close friends I am probably the only one who has any sort of drug addiction (& that is just a psychological dependency on weed, hardly a proper addiction), yet almost all of my close friends regularly take drugs. None of them are heading for addiction.

Charlie Clean & SHM are making the most sense in this thread by a fucking mile. Effie might be as well but a lot of it is a bit over my head really lol.

Haha :D I agree with what you say, definitely. It was what I was trying to say about there being a genetic (or whatever - something biological) component. Not everyone who eats lots of sugar becomes diabetic; not everyone who takes drugs becomes an addict, Yes, there is the behavioural component - without eating sugar/taking drugs you won't become diabetic/addicted - but without the genetics or biological aspect, you won't either. It takes a combination of the two.

I disagree with those saying addiction is not an illness, but I agree with that part, and I respect their point of view and I do appreciate what they are saying. I can see both sides, but I stand by what I have said (sorry for going over your head, this is a particular interest of mine :D)

 

[parttime crackhead]

Ha, no worries. If I hadn't just woke up & half my brain power wasn't being used trying to figure out where my next joint is coming from (ahh god, this terrible disease lol) I could probably have read your posts a bit better & understood them.

 

[missing old pills]

Thanks for that effie. Interesting read.
The part about continuing to use a drug while knowing the harm interests me greatly.
It's very hard to make a concrete conclusion on a particular drug due to the following factors.
1- how much research has been done.
2- mis-information on the drug.
3- pre-existing medical factors.

On point 1 a drug that has been around for years isn't necessarily safer than a brand new one it's just you have more information on side effects in itself can cloud your subjective experiance.

On point 2 my favourite story of when the DEA tried blocking MAPs application for FDA approval on trials with MDMA for people with treatment resistant PTSD.
They spent alot of money using a govenment scientist that administered MDMA on monkeys. His results clearly showed monkey brains with dead areas or 'holes' as they put it.
The pictures were plastered all over newspapers all over the world and was a figure head for the war on xtc.
A few years later he retracted his research admitting that he had administed methamphetamine by mistake. Not good reading considering meth is FDA approved in America for treating kids with ADHD.

On point 3 I have only recently found out that speed can cause glaucoma. Scared me a little as my father has this problem.
Also another FDA approved medicine.

So my position is now whether legal or illegal, tested or untested, researched or unresearched I'd like to as much as I can move away from all chemicals unless I am in real need of anything i.e a serious illness.
Even then I am concerned of the safety of the material as I feel profits will always come first rather than safety.