Drug addiction: choice vs. disease model.

[hobhead]

I think it's both. First you make poor choices and then acquire the addiction disease.

word !

 

[eon_blue]

We choose to use, but for some of us (addicts) that choice feels and seems like the only option there is.

Addiction is a disease but that doesn't absolve someone of the responsibility of their actions. I also refuse to believe that 'once an addict, always an addict'...the brain is capable of rewiring itself. Sure, I'll never forget what it feels like to IV dope but a 13 months after I last used, the cravings are MUCH easier to deal with (and fewer and farther between) than they were in the beginning. I know it'll only get easier.

EveryStar, I remember reading your posts from way back when you were first getting into IV'ing coke and thinking you were done for. I'm really happy for you for getting help Hate to sound cliche but life really is better when you're not living for a fix.

 

[Khadijah]

Lacey, I am not saying that it's not possible to re-rewire the brain, but I don't see how you can say that you are an example since you are on methadone. Thats not the only reason, the other reason being that in your other post in the thread about "the idea of being clean" you said that the methdone is just pretty much balancing out the chemicals in your brain to make you feel normal. I know it's for pain too, but how can you say that you beat addiction yet you need the methadone to keep your brain level so that you don't want to do dope to feel better. Also, can it be a blockade effect that is making you not want to use? I am not that familiar with methadone, or the dose that you are at. I know that when I was on suboxone I said and truly felt that even if I had a pile of 80mg OC's (my DOC) in my hand that I would throw them out. That blockade effect really worked on me and re-wired my thinking, but I can't say that it lasted forever after I weaned off of them. So IMO the methadone is pretty much the medication that you are prescribed to treat your addiction.

I gotta call it like I see it, and the two posts seem to contradict somewhat. I know your interested in this topic, otherwise I woulda let it slide.

i was pointing out to him that I have used and stopped, and the thing is, I known many, many addicts on methadone who would use "just once" and then go all out. and in the past when i was on methadone and sub before, i was still maintained like i am now, but i would do that same old shit and go out of control after just wanting to get high a few times, and ended up back in the addiction bullshit.

My point was that he was saying addicts lose their judgement, that they cant trust themself not to keep using and go back all-out into the addict behavior. And u asking if I think my ability to not be that way comes from the fact that I am on methadone. So I am saying, no i dont think it does, becuz first off I seen plenty of people on meth get kicked out the clinic etc, for using and using on top of the meth and just like binge out, they get on a run and just cant stop. And also myself, when i was on meth and sub before, and was not able to control my use like i am now.

So i feel like even if you on methadone, the junkie tendencies can still be there or not there. It also counts the shit that is in your mind. And like i said before, it aint just the done, people on sub, feens who will stop the sub for a few days to get high, plan to go back on sub but then they end up on a 5 month dope run just gettin high and livin crazy every day. being on maintenance does figure into it, but a person who is in "feen mode" will be actin that way whether or not they on MMT or SMT. And a person who has broke thru "feen mode" and is free from that mentality, will be that way whether they off any maintenance or on MMT/SMT. the maintenance drugs does have some kind of place in the whole equation dont get me wrong Im just sayin, its alot more about your mentality and where your head at than simply if you on or off maintenance. Otherwise the people who on maintance would be able to control their use just like I have explained i been able to. It aint just the drug, its much more than that.

I should also say that when i was on Sub i was not able to do that like I am now. I wasnt ready mentally and i was still in feen mode. I would go off my sub all the time to get high, on the regular and binge out without planning to one day would go into another and another. I risked my freedom, everything, doin this nonstop and just could not trust myself to control it, it didnt work. I was that person , that addict that just goes balls to the wall, fuck-it, dont care if i die, from one little shot that was just supposed to be getting high for one day, that ends up as a weeks or months long run that you get sucked up in and carried along like a strong-ass current on a river, hopeless to break free out of it. Thats how i was then, and that was on a maintenance drug just like i am on maintenance now.

So i feel that the part of you that is the junkie inside, the addict with the obsesion and compulsive behavior, that is there whether or not you are on maintenance. it depends on where your HEAD is at. and that is calling the shots on whether or not u are gonna be able to use in moderation or not.

Like I said before, I wanted to mention that I been on MMT once before, a few years ago. and I used while on the methadone and didnt have the same feelings like I do now. I was still a junkie, still wanted to get high at the expense of everything else. still functioning, living, thinkin , actin like a feen. doin that whole feen thang day in and day out, did not have the emotional control or the ability to even WANT to control it, i just wanted to keep gettin high til i died. So you can see if u compare the past meth experience, the sub experience and my current methadone use, it aint the drugs that was allowing me to use once and then forget about it for another 2 or 3 months. the difference was where i was at, mentally.

its simple--The first time i was on meth, I was not controllin my urges. i wanted to use all the time, I was a total feen for the shit. I was the kind of person that dokomo was describing, the addict that could not just use and control it, that could not trust their own judgement about whether or not they can control it, and the person who will always just go all out the second they start using, it just snowballs into a bigger and bigger binge everytime.

when i was on Sub i was the same. i would stick to it for a little while but then i would just use 'just for today' and then end up 3 weeks later still using, like okay, thats it im getting back on the sub tomorrow, etc.

That lasted for about 2 years and it took until I got my mentality correct, and really got my head right, for it to 'click.' Bein on the methadone DOES help, but i could easily stop taking it and get high, go on another run, get back into that junkie life, if i wanted to. If I still had that junkie feen mentality, each time that I got high in the past however many months, would have ended up as being weeks of using instead of a day of using, and thats exactly how it happened in the past. But now it aint like that.

When I did get high I would not dose for about 36 hours and then use so that i didnt get blocked. Then get high for my day, the next day go back on the Meth, and it never turned into a binge or a run or nothing , just a one shot deal. So there is a difference, but the maintenance drug I was on was the same. So I feel like its pretty safe to say that it definately came more from being inside of me and the way that my mind has changed, not chemically or physically but emotionally, the ways that I broke out of that addictive MINDSET.

Obviously having the methadone makes it easier to use, then stop using, since there aint no threat of gettin sick and goin thru the w'ds and all that, but the thing is, in the past, the methadone didnt stop me from feening out and goin all crazy with it. You feel me?

Obviously it is something more, not JUST the methadone. Becuz in the past the meth alone was not enough. It took changing my brain and the way i thought and really realizing and understanding where I was at and TRULY RECOGNIZING that i COULD NOT keep livin that way if i wanted to stay alive and stay out of jail, in combination with the Done that let me become a different person with the ability to use recreationally once in a while.

Like I said, i dont even do that now, and I aint using at all even once in a while. but Im just saying that I aint givin the done all the credit for this. I hope that my post explains it better but if u got more questions plz ask. I dont mind

 

[double ewe]

i'm in the "a little of both" camp.

your choices influence the progression of the disease, and your ability to recover from it. there are definitely genes that make someone more likely to develop an addiction. of course there are also choices that increase that likelihood as well.

in terms of treatment, i think it's the same way. you need to be stable physically and psychologically to take on an addiction, and at that stage i think the disease model works best. it doesn't do any good to talk to a heroin addict in withdrawal about their crappy choices. however, once you're through that phase, you also need to recognize that choices are what will determine the success of a recovery. the focus on being "powerless" really bothers me - it may be comforting, and it may be true for some of the most severe cases, but i just really disagree with the idea of a person accepting that they can't do anything to influence their lives or regulate their behavior.

 

[Znegative]

So i feel like even if you on methadone, the junkie tendencies can still be there or not there.

yeah, I agree with this 100%, which is why it's unfair to take credit away from people that are improving there lives with MMT. When I was on methadone my drug use stayed at least as bad, and possibly got worse because I started shooting coke like a madman on top of it all.

There is no miracle drug out there that will take away your urges without you having to do any work.

 

[love2party]

Even if the junkie tendencies are not there, while on methadone doesn't mean your home free. When I was on methadone I was doing really good. Had a good paying job and was making money. Taking my meth as directed. I thought my mindset had changed and thought I could detox. Boy, was I wrong. I'm not saying everybody is the same but first detox off of methadone and then tell us how your doing.

 

[ados]

I wouldn't say drug addiction is really a choice, it might be partly, but most people don't want to actually become addicted to drugs. I wouldn't say its a disease either though. I think drug addiction is a mental disorder, like anxiety, or depression. I don't consider that a disease, and I think its kind of insulting to people who have real diseases.

 

[Khadijah]

Even if the junkie tendencies are not there, while on methadone doesn't mean your home free. When I was on methadone I was doing really good. Had a good paying job and was making money. Taking my meth as directed. I thought my mindset had changed and thought I could detox. Boy, was I wrong. I'm not saying everybody is the same but first detox off of methadone and then tell us how your doing.

Why detox? There aint no need to do that. Honestly, I dont care how long Im on this. It helps fix a problem. I am satisfied with that solution. its simple enough to me. Anyways....There is a big change in my life....It aint just my well being I am lookin out for...Soon Ima be a mom and let me tell you that gettin high aint even close to bein on the list of priorities no more. If it was just about me thats one thing but I dont think its likely that Ima have a problem with goin back to those old ways now that Ima have another life to take care of. That, added to the changes in how I feel over almost the past yr of MMT and bein off dope is enough reassurance for me, and thats the only thing ima worry about. if someone else dont think it will work out that is on them but it aint gonna bother me.

 

[deez_nuggs]

Diseases stem from bacteria or viruses in the body..neither of which are yielded by drug abuse. Addiction is a word. As was stated before, I feel as though its a disorder like manic depression or PTSD. The "once an addict, always an addict" fallacy has been around far too long and is backed solely by those that are naive enough to go along with it. Sure you can have an addictive personality, but the state of mind and physical setting that an addict chooses to spend his or her time under the influence of is far more powerful than any chemical reaction in ones brain. Personally, if someone were to ask me what drugs ive done, i'd inform them that acetominophen and weed brownies are the extent of my usage. It's totally possible to experience the anxiety, depression, and cravings, however, that come with any drug use, if your reality is centered around always getting high.

 

[love2party]

Why detox? There aint no need to do that. Honestly, I dont care how long Im on this. It helps fix a problem. I am satisfied with that solution. its simple enough to me. Anyways....There is a big change in my life....It aint just my well being I am lookin out for...Soon Ima be a mom and let me tell you that gettin high aint even close to bein on the list of priorities no more. If it was just about me thats one thing but I dont think its likely that Ima have a problem with goin back to those old ways now that Ima have another life to take care of. That, added to the changes in how I feel over almost the past yr of MMT and bein off dope is enough reassurance for me, and thats the only thing ima worry about. if someone else dont think it will work out that is on them but it aint gonna bother me.

I'm not saying you should detox. I just get this vibe from your posts, that you seem to think like you conquered your addiction. In reality methadone is just a band-aid. It's still an opioid and a powerful one. You won't know how your mindset is really until you come off all opioids. I'm just saying don't declare victory until you have really kicked all opiates.

congratz on your new baby. You seem like a good person Lacey, I'm sure you will be a good mother.

http://forum.opiophile.org/showthread.php?t=1419 Here a poll on opiophile about people on meth and addiction. You might find it interesting.

 

[Khadijah]

I do feel that way and aint nothing gonna change my mind, methadone or not. I know my self better than i ever have in my life, Im sayin ever ever. Even if i was off methadone I know, i know that goin back to bein a dope head aint a option. And like i have said before, i dont believe that if a person uses here and there once in a while (meaning, once every few months, not a few times a week or some shit like that) That they are successful in beating their addiction. The idea is to beat the addiction not the drug use. So Im saying that I absolutely aint got no doubts about whether or not I would go back to bein addicted if I got off the Done.

I aint sayin that to argue with you or nothing but i think that we just got different beliefs on wat it means to "conquer your addiction." To me how I am livin is the definition of that regardless of if i am on done. Ima always be on something most likely considerin that the reasons I am prescribed it instead of at a clinic is b/c of pain management, so I aint worryin about if its "really" "conquered" , you feel me, becuz for different people there is a different meaning to wat it means to beat ur addiction. So I think we can Agree to disagree. Also, thanks for ur other kind words

 

[hobhead]

Lacey K,
What are the consequences of methadone crossing into your fetus's system ?
Are the social workers at the methadone clinic advising you to continue maintenance while you are carrying if, in fact, they are aware of it ?

 

[Escher's Waterfall]

What I dislike about the disease model is that it frequently treats drug abuse as the disease.

I don't think that the reason why some people are addicted is solely due to biology.

The people I know with addiction problems tend to have some underlying mental health issue.

 

[Sweet P]

Even if the junkie tendencies are not there, while on methadone doesn't mean your home free. When I was on methadone I was doing really good. Had a good paying job and was making money. Taking my meth as directed. I thought my mindset had changed and thought I could detox. Boy, was I wrong. I'm not saying everybody is the same but first detox off of methadone and then tell us how your doing.

I hope you don't make a habit of calling your methadone "meth".

Could cause a lot of confusion...

 

[nativenick]

i think its all your choice. at most i think maybe a person with an addictive personality maybe has a slightly different brain then the average person the same way they say a homosexuals brain is different from a heterosexuals but even thats a stretch too since that whole gay thing has never really been scientifically proven. life is more stressful then ever its really hard to get out of a bad habbit when sometimes it seems like thats all you have really to look forward too. it takes some sort of intervention or for you to realize all the problems your vice is causing you and even still its a fuckin hard road

 

[Khadijah]

Lacey K,
What are the consequences of methadone crossing into your fetus's system ?
Are the social workers at the methadone clinic advising you to continue maintenance while you are carrying if, in fact, they are aware of it ?

Yes of course my Dr. knows. aint at a clinic tho, at a dr. office. anyways,
Methadone is absolutely safe to use while pregnant. it is actually extremely, extremely dangerous NOT to take methadone while you pregnant, if you already on it.

Meaning, if you get OFF it before you get pregnant that is ok. But if you are on it and then find out you pregnant, you should NEVER get off it.

Even REDUCING your dose by 5 mg a WEEK can cause bad effects to the baby.

You cant just stop takin it cold turkey, but you also cannot slowly taper or detox. It can cause a miscarraige or birth defects, and deprive your babys brain of oxygen.

For the women who for some crazy ass reason insists that they just gotta get off methadone while they pregnant , which every doctor who knows jack shit will STRONGLY advice them not to, they have to do it in a intensive monitored inpatient setting becuz the danger to the fetus is so high, even on a medically monitored slow taper.

I dont go to a clinic. I get the Done prescribed by a Dr. for pain management. they know that i am on it. there aint been no issues.

Any clinic that finds out you are pregnant will do anything they can to make you understand that you need to stay on the methadone. I seen mad pregnant girls when i was at the clinic back in the day when i first went to a clinic to try and get clean years ago.

Methadone been used to treat pregnant women for almost 30 yrs now. It aint somethin that you would want to START taking if you hadnt been on it and you pregnant. but if you already on it and you find out you are it is a billion trillion times safer to stay on it than it is to try and get off it. Withdrawals can be fatal to the baby. it would be safer to do heroin than to go into severe full blown withdrawals that is how dangerous WD is when you pregnant.

Hope that answer ur questions. i know it is a off topic post but i wanted to reply to u in this thread becuz there is A LOT of people who is very educated abotu drugs but when it comes to methadone and pregnancy they are misinformed and think that it is bad to be on it, that u should detox, etc. its natural to think "Drugs plus pregnant=BAD" and assume that u should get off all drugs while pregnant. it makes sense to assume that. but when it comes to Done and pregnancy it is a relatively safe drug to be on. there aint no recognized birth defects that it causes. Some babies who get born to methadone dependent mothers have lower birth weights, and maybe dependent on it when they get born, but actually not even all babies who are the kids of methadone patient moms even come out addicted. some of them actually aint dependent on it at all, its just the luck of the draw. even tho most of them will have some level of bein dependent on the done, the doctors will treat them with low dose Diluted Opium Tincture over a few weeks to make sure they dont withdraw and then taper them down til they comfortable and safe and then thats it, it aint no thing.

Somethin that a lot of people dont understand is that Opiates alone, aint tertogenic which means toxic to a fetus. For example alcohol IS tertogenic. many drugs will DIRECTLY CAUSE birth defects just becuz of the way they act on the body.

But OPIATES, by themselfs, do not cause damage. the reason that alot of heroin addicted mothers have fucked up kids is becuz their lifestyle. they dont eat enough, they dont take prenatal vitamins, they dont get no type of prenatal care, they using un safe IV techniques, sharing needles, gettin infections, not living a good life to support a baby developing inside them you feel me. so alot of times if the baby has a problem its becuz it was mal nourished, didnt get the proper vitamins and shit that it needed to develop right, also alot of addicts also smoke cigarettes and use other drugs which can also effect the baby.

But if you are JUST taking opiates, and u medically supervised and otherwise you livin good, eating healthy, takin your vitamins, gettin the right prenatal care n all that, the opiates really dont cause no major defects or problems. it might be a smaller baby, and shit like that, but in general it aint a real negative dangerous drug to take like some other drugs are during pregnancy. I aint saying "hey everybody its safe to use opiates while you pregnant , so get high if ya wanna!" I am just sayin in a case like this where a woman is on methadone and she is pregnant it aint a dangerous thing to be ont he methadone, its getting OFF that is a problem.

 

[FcL30]

I went into rehab in 06, mostly because my ex phoned my parents and told them that i was a coke junkie (which he was just too willing to be as well by the way).
So i went into a programme and did the whole fellowship thing. three meetings a day, sponsor, stepwork, service the whole lot... for three years. it worked well... i grew up a lot... and got to take care of my mom before she died. six months after her passing i picked up again. but rehab told me "if you pick up you'll die' so i was so scared... turns out i didnt die. and it turns out that i am not the junkie i thought i was. in fact, most of the time i am well aware that i have the choice to either pick up or not...
i think certain programmes are really helpful, but i dont trust the ppl. they are all there for clean time and keyrings... and they are all, in my experience, full of themselves... junkie pride "i did this and that - that's how hardcore i am"... when my mom died, not one single person called or checked in with me. my sponsor disappeared and i'd rather swallow razorblades than go back.
just my opinion.

 

[deez_nuggs]

FcL, I'm sorry to hear about your mom. I can't imagine what that does to a persons outlook on life. And I was a little surprised to hear your testimony of the rehab you did. Was this NA? Are you still doin coke? I've always been skeptical of the twelve step program or whatever, and I firmly believe addiction stems from behavioral patterns that manifest a powerful psychological and often physical dependence. If youre a recovered addict, I feel that what so many have come to believe is that your very consciousness is diseased. If I were to have cancer as an adolescent, and get fully treated, recover, etc. should I claim 40 years down the road that I'm still a cancer patient??

 

[FcL30]

Deez,
i believe that the 12 step programme has a place and meaning for people who struggle with what is called the 'disease' of addiction. It is a spiritual guide... and it certainly helped me to rebuild my self confidence and self respect. I was out of control - but then again, what's rock bottom to one person is peanuts to another...
I dont regret doing AA and NA... the basic principles are great... ON PAPER... but in practice, you're basically dealing with people.. who are inherently full of themselves, looking for excuses and affirmations... I got tired of going to meetings and hearing ppl either blowing smoke up their own asses or telling everyone how hardcore they used to be. Other times a person would be sitting with serious problems... spouses, death, financial issues etc, and you'll get some a-hole sharing about how his or her housemate in the rehab keeps leaving the tap running.... In my opinion, I met ppl who were constantly torn between narcisism and insecurities... a very dangerous combination.
I saw ppl coming back after relapses and "old timers" rolling their eyes and doing everything except 'helping the still suffering addict'. Its hypocritical... on the one side they tell you to help those who cant help themselves and on the other they tell you to stay away from dangerous or 'iffy' ppl. So what's the deal then?
The steps do work... i had the opportunity to make amends to my mom and she did to me, she was 15 years sober when she passed... she died seeing me sober and clean...
Am I using again? Yes. Do i feel guilty about it? No. Because i know i'm not the 'horrible junkie' everyone in meetings kept on saying i would be as soon as i pick up. I own my own business, am a stepmom, have a wonderful partner and thanks to the three years of abstinence, I grew up enough to go into my 30s with more brains and self respect.
The thing i hate the most about the 'fellowship'? the slogans... the platitudes, the constant reminder that every person there is ill and have character defects. Defects... if you sit around talking about how defective you are, you eventually believe it and live your life in guilt and shame... and after some clean time...that guilt changes into arrogance.

Again... just my experience and my own opinion.

 

[hobhead]

rational recovery profoundly loathes the 12 stepping and the 'defect' model of an addict .

that said, most everyone knows people that consider NA/AA to be what has kept them away from chemical abuse .