foreword; i'm enjoying our discussion so don't think i'm getting upset or anything ok, and i hope the same applies to you.
Of course, I love a good debate, and those can only happen with people you disagree with
But I do understand if the mods are concerned about this dragging the thread off topic, and would be fine with the discussion being moved into a separate venue.
No your wrong. The research of Dr Mark Hutchinson and Professor Watkins has proven without a doubt exposure to stress hormones during pre and post natal development is responsible for priming individuals to drug addiction. This research has been independent validated by that of Dr Gabor Maté who has long argued that exposure to stress during pre-natal development causes brains structures to develop differently.
But to clarify this position and the fact that opiate, alcohol and amphetamine addiction appear to have similar causes (considering that their all getting ibudilast trials), and that the withdrawal affects are actually inflammation responses I would direct you to the below which shows this isn't just some made up shit on my part but that some serious research has proven.
Its paradigm shifting:
1.
The “Toll” of Opioid-Induced Glial Activation: Improving the Clinical Efficacy of Opioids by Targeting Glia
2.
Exploring the Neuroimmunopharmacology of Opioids: An Integrative Review of Mechanisms of Central Immune Signaling and Their Implications for Opioid Analgesia
3.
Opioid activation of Toll-Like receptor 4 contributes to drug reinforcement
4.
Glia as the “bad guys”: Implications for improving clinical pain control and the clinical utility of opioids
5.
Evidence that intrathecal morphine-3-glucuronide may cause pain enhancement via toll-like receptor 4/MD-2 and interleukin-1β
I'm not disagreeing with any of this, I'm simply saying it's not the only factor. I never disagreed with the idea that some people are "primed" for addiction, just that that "priming" process isn't an unalterable life sentence. And I'm not seeing anything in any of what you link which claims that it is.
Yes i've had stressful moments in my life. What I'm saying is that the stress hormone my body produced, caused my TLR4 to activate at greater levels then if I wasn't afflicted by the deformity that occurred during pre-natal development. Ergo I felt more pain then a normal person which explains why when I used pain killers, the relief was far greater, far more palatable.
Which is, I imagine, the experience for almost every addict out there. It doesn't mean that that they're stuck with the choice of either living in pain or self medicating, that's an absolute false dichotomy.
I've escaped that situation long ago. You need to use someone else as an example if you want to go down this path.
I was just going off what you posted - my impression was that you were discussing more recent events.
Really? Who, what are their names? Where is the research that shows large scale Large-scale observational epidemiology studies on groups of people who after being rabid junkies have gone on to being clean all their life?
To start with, I don't follow the published research to the degree that you do, so I don't have any piles of bookmarked studies to back my points up. I imagine I can look them up if you insist, but I really don't feel that it's necessary. A simple glance at the public sphere will show plenty of people who were once active addicts to the point of severe dysfunction and yet are now no living fulfilling lives without constant self medication. Authors, musicians actors, assorted other celebrities, politicians, harm reduction activists, etc etc, even posters here on bluelight and other HR forums. I'd rather not trot out a "who's who of celebrity junkies," but again, I absolutely can if you want.
rabid junkies have gone on to being clean all their life?
I want to address this point in particular, because it ties into your next few paragraphs - I don't feel that it's necessary for someone to become completely and perpetually "clean" for the pursuit of self improvement via. escaping from addiction to have merit.
What matters is that someone is happy, satisfied and functional. So what if somebody relapses after being sober for a decade or two? That's still a decade or two in which they managed to stay drug-free, and hopefully live a more fulfilling and productive life for it (if they didn't, then that's a whole other issue), and I feel that if someone can stay sober for a decade once, then all that proves is that they can do so again. Relapse happens, that's life, but people can (and do) choose to get up on their feet and keep striving to improve, to become the best possible version of themselves.
The reality is that, especially in our current social setting, increased consumption of opiates (and amphetamines, alcohol, etc. for that matter) is associated with a whole slew of social and psychological dysfunctions and physical ailments. For the majority of people, attempting to reduce their consumption of these substances is going to result in an increased ability to live a fulfilling and meaningful life.
And there are, on the flip side, people who have the exact same problems as addicts - in utero stress hormone exposure, environmental stressors, psychological trauma, physical pain - and yet they never become addicts themselves, even if only because they never have the chance. The connection between these things simply isn't as clear cut and one-way as you're portraying it.
This isn't a moral issue - if someone's optimal state of happiness is genuinely getting high every day, then good for them. But for most people, that simply isn't the case, and addiction is an attempt to self medicate external environmental stressors and internal psychological dysfunction from past trauma. But it isn't the case that drug addiction is the only (or even most effective) way to deal with these.
I'm sorry but its not true. Like I said before I was talking to a senior Addiction Medicine specialist who said that they used to believe that but when they started getting people in their 50s and 60s coming for help to treat their addictions they realised the idea that people who have "quit" drugs in their early life were really just ticking timebombs, waiting for a series of terrible events that would see them end up using again.
I suspect another reason is the huge crack down on doctors on prescribing opiates. See in the 60s, 70s, 80s and even 90s doctors would hand out to older patients powerful opiates with little to no regulation or control. This meant that huge swathes of our older population were basically getting cheap subsidised dope.
But with the crack down of the last 16 years, and the death & retirement of the older baby boomer doctors, these older patients are no longer getting access to their legal opiates. Hence why their now swarming drug addiction services.
See above.
So on one hand you accept my argument and then you go, without any evidence to argue that a person can somehow (but you don't describe how) reduce the pain created by inflammation cytokines.
How exactly? Good diet? Exercise?
I don't know about the specifics of inflammation cytokines, but it's absolutely possible for people to go from a state of active addiction into a state of, if you will, remission.
Diet and exercise would be a great start, but I don't think they would be generally sufficient in themselves. But throw in medication (both in the context of treating psychological ailments and in managing dependence and the withdrawal process), psychotherapy, CBT, the support of people around them, meditation/mindfulness/other self development practices, and, most of all, determination and motivation, and I think they stand a pretty fucking good chance.
I think people are deluded into thinking that once they've "quit" using heroin, and gotten past the first 1-5 years that there in the clear. Life I've discovered has an ability to throw at people some fucked up events that make it difficult to eat healthy, exercise regularly and all the other things that you'd imagine might help mitigate your bodies response to inflammation.
But at the end of the day lets not pretend we live in la-la land.
Again, see above. I would just restate my point that if someone can go 1 - 5 years without heroin once, then they can absolutely do it again. Maybe they'll relapse a few times in their life. Hell, maybe they'll relapse every 5 years like clockwork. But that doesn't mean they should just throw in the towel.
Well actually there are several countries that have prescribed heroin, Canada being the latest one. There are also several countries that have either decriminalised or are looking to decriminalise all drugs. Its only a logical step to legalisation/clinic prescribed heroin programs from there.
SO no i don't think its a fantasy to believe that one day legalised heroin will be available in Australia.
Considering we have suboxone and methadone I would argue that we're 1/3 of the way already there.
I'm aware of the programs you're referring to, and a strong supporter of them. But I think there are two points to be made here.
The first is that no matter how great things might be in Canada (which actually isn't that great - their program is highly limited in scope and they still have a massive problem with addicts using street heroin and illicit pharmaceuticals) or Switzerland (which, from what I can tell, actually is pretty damn great in relative terms, but definitely not perfect), or wherever else, we're not talking about those places.
"Well, some addicts have access to legal heroin in some other countries, and it will probably happen here too in the next few decades if the current trend continues" is not a satisfactory answer to someone from Australia who comes to this thread (in, you know, the Australian sub-forum) saying "I'm addicted to heroin and it's ruining my life, what do I do?" All it is is an abdication of responsibility.
The second is that still isn't enough for some people. I'm sure there are people who are perfectly happy going to a clinic every day, shooting up, and then going about their life, but that's not the case for everyone. It should absolutely be an option, but it isn't a blanket solution to the issue of opiate addiction (and of course, there's also the issue of addiction to all sorts of other drugs where pharmaceutical supplies or substitutions are even less viable).
The third point I want to touch on is the one Spacejunk articulated earlier in the thread. I can't speak for everyone, obviously, but it's been my experience, and my observation from watching those around me dealing with addiction, that the self medication aspect of addiction has the effect of causing a very real type of arrested development.
For some people it may be the case that the pain which causes them to seek out relief in drug use is simply unalterable, that's an unfortunate fact. But it's also the case that for many people, the pain caused by poor living situations and psychological trauma can be articulated, processed and either eliminated or more effectively managed through a variety of therapeutic modalities.
If someone makes the decision to simply self medicate the surface manifestations of these problems, then they generally do that at the cost of the opportunity to address the root of the issue. And that's their decision, but not everybody is going to choose to simply coast along relying on chemicals to feel comfortable with life, and I think it's important that we acknowledge that it's both possible, and a valid desire, to unwrap the cause of addiction in any given case and address that cause.
Ok i never said anything about Benzos but outside of people with Kidney issues opiates are extremely non-toxic. Look at the LD50 50 mg / KG / 10M. Gastro dysfunction as I said boils down to constipation which can be mitigated through all sorts of measures.
This isn't about toxicity, this is about side effects that many people experience from opioid use even at optimized doses. Your "all sorts of measures" in reality boils down to spending a lot of time and money on imperfect treatments which have to be continually administered and very often come with their own side effects and long term damage. It's just not possible for some people, and it's not desirable, I would imagine, for very many at all.
The phase 2 and 2b trials for ibudilast have proven it to be an effective agent in reducing tolerance (which only goes to reinforce my argument that heroin and drug addiction, tolerance and "withdrawals" in general is caused by an inflammation response).
Once ibudilast is available you'll be able to take it with your heroin, which means;
- no more gram a day habits
- being able to quit with little to no opiate induced sickness.
- improved analgesic effect from opiates.
This sounds more like "la la land" to me.
So we're not only holding out for Australia to institute a Swiss-style heroin clinic program (which still causes severe lifestyle restrictions), we're also holding out for an experimental drug which isn't even available yet to be integrated into the treatment protocol on the hope, based on a few early clinical trials, that it will remove all of the negative effects of opioid dependence and withdrawal without causing yet more problems of it's own?
Look, if that happens, I'll be the first to applaud, but until it does, we have to live in the real world, and in the real world, tolerance exists, withdrawals exist and side effects exist.
I saw the movie.
Only the uneducated who fail to follow appropriate Harm minimisation and IV best practice end up with fucked up veins. There are thousands of people out there who have to inject non narcotic substances. I myself have been using for good on 6 years (like every day) and had only one adverse vein event (which was easily solved by rotating a little earlier then normal). I had several creams that I used that would quickly help heal the wounds.
It takes practice and care. But shit here is the thing. Heroin legally costs like $20 per gram. At that price you could simply drink, snort or shove it up your ass. You don't need to inject it so its a false choice to claim that in a fantasy world of cheap and accessible heroin that a person couldn't use regularly (because their veins would collapse).
My argument as i've expressed else where is that herion would be made available from clinics and approved chemists where patients would be required to be certified on best IV/ROA practices, be required to dose at clinics if they were dysfunctional whilst functional users would get takeways from their clinic/chemist. (just like with suboxone/methadone).
The events I'm describing were cut out of the movie adaption, if I remember correctly, but my point was more related to the tolerance issue than the vein one (although realistically, not everyone is going to practice ideal HR when it comes to veins, and this has to be factored in).
I'd like to reiterate the author as an example of someone who had an extreme heroin addiction and yet managed to cease using the drug and then lead a productive life, because he's an example both of what would be lost (in the form of a gifted author and poet) if everyone gave into the kind of neurochemical determinism you're espousing, and because he's an example of exactly what I've been saying, that there are real people out there who were once severely addicted to drugs, and then managed to escape their addiction without living in constant misery and pain. Even if he relapsed tomorrow, returned to his old lifestyle and never wrote another thing, I'd argue that his literary output during the 20+ years he's spent sober was worth the effort of his ceasing his drug use.
huh but that's my point. Without drugs your exposed to pain and stress. The problem is in glia damaged individuals this pain is magnified because your glia and the TLR4 are far more hyperactive when activated. Causing greater levels of cytokines.
My point is that even if you take varied levels of "glial damage" out of the picture, everyone who exists on this planet experiences suffering, pain and dissatisfaction. It's the human condition. You're over-pathologizing one of the fundamental tenets of reality - that nobody is happy all the time.
Lol
Your choosing to deny science because you think i'm unhappy? How do you know i'm unhappy? Because i worked alot 5 years ago. I like my life. I'm having a good time. Nothing going on here. Really. I've got a good job, pays wells. I work from home 3-4 days a week. I get to see my kids far too much and i've got far too many animals. No one is dying yet and apart from the odd issue no one fights or yells. In fact I barely even fight with the wife these days.
I used an older example to explain the pain and anxiety I used to feel and how that (and I wasn't even using then) it was insanely bad.
I'm not denying science, I'm denying your personal and extremely one-sided interpretation of a certain set of studies.
As for the rest - if you use old examples without qualifying that they're no longer relevant to your life situation, don't complain that people make statements based on those examples. If you're happy now, that's awesome.
No what i get upset about is when people come onto harm minimisation sites and make it sound like the only option is to quit drugs, and that (edit) its all about being "clean".
I've never said anything of the sort.
A drug addict is going to try and get through his or her life without using but considering the fucked up past most of us have had (the ones that have faced physical and sexual abuse) we're fucking sponges of pain. Everyone has their breaking point and when it happens and they end up up using again they'll read your words and think fuck if Crankinit can quit drugs then what sort of person am I who fails.
First of all, I've yet to actually quit drugs, technically speaking, so I might not be the best example
I have made substantial progress in terms of reducing my overall intake of drugs and my exposure to the damaging effects they cause, in reducing my dependence on drugs as a method of dampening emotional turmoil (which I think is probably a fairly good defintion of "addiction" in my personal case) and in understanding and addressing the emotional turmoil and physical pain which lead me to self medicate with drugs in the first place.
And I want to reiterate, because I think it's important, that it was only once I managed to stabilize enough to stop the constant self medication that I managed to make significant progress in the last part of that.
But even if I never make a step of progress beyond where I am now, I still think it was worthwhile.
My answer to your question from this hypothetical poster would be that they're human, that any process of healing and self development is an ongoing one, with periods of progress and periods of setback, and that just because they're currently in the latter doesn't mean that they can't get back into the former. That, in fact, the periods of setback are part of the process, and that everybody goes through them.
One of the problems here is the language we use. We talk about "relapse" as though it means an instant dive back into the worst of the individual's addiction. Maybe it's just a "glass half full/empty" situation, but if somebody ceases their drug use for a week after months of non-stop use, only to use the drug again at the end of the week, then I'd say it's just as accurate (and far more productive) to view that as "progressing from using seven days a week to using one day a week" instead of viewing it as "progressing to being clean for a week then regressing back to addiction." Any kind of positive self change is a process of taking steps forward and steps back - what matters is doing your best to make the steps forward outnumber the steps backward.
Personally, I think your neurochemical determinism is orders of magnitude more harmful to people in that situation, because it will just lead them to ask why the fuck should they even try to improve their lives if their brain is permanently damaged by something they had no control over and as a result any attempt to scale back their addiction will result in nothing but suffering?
I read countless stories of people quitting. Shit I was like that 16 years ago. I quit heroin. I said the same words you said crankinit. But I came back to my real wife and it was weird because at the time I didn't even realise how stressed I was.
It was only in retrospect when I had that shot again, thinking that I could control this bucking bronoc, only use once a a fortnight, (and then once a week, and then only weeks, and then only fridays and weekends and so on) that I realised that I had never quit.
First of all, that's bullshit. You did quit. Even if it was only temporary, you managed to go for a period of time without using drugs.
What you didn't do is address the underlying cause of your drug use, which is why being re-exposed to environmental stressors resulted in your resumption of heroin use.
I don't have fatigue, indigestion or constipation from suboxone (well my stomach was always pretty slow so its no bother to me). I don't take Benzo's so I really can't comment on that. Re hormones I find the number one issue that dictates hormone levels is physical activity. I like to think i keep myself busy enough. I definitely noticed higher hormone levels when i've been doing a lot of stuff.
Which is great for you, but it's an undeniable scientific fact that a certain portion of the people taking a drug will experience the side effects of that drug.
There is nothing wrong with suboxone
Maybe for you personally, and if that's the case, all the more power to you for making it work. I'm not ripping on suboxone here - it did a lot of good things for me in terms of helping me understand the process of craving, relapse, withdrawal, etc. It provided some stability and craving relief when I needed it, and relief from physical pain when I also needed it. But I no longer need those things as badly as I need to be rid of the side effects and restrictions suboxone brings into my life.
That's me personally, but I'm not the only one. That's the point I'm trying to make. Not passing moral judgement, not claiming that pure sobriety is the ideal state for everyone, not passing moral judgement on people's drug use or lack thereof, simply pointing out that eternal self medication or maintenance is neither desirable nor sustainable for everybody.
I've used for over 23 years. I've had breaks sure but i've always come back to it. Even when I was confident that i had fixed the issues in my life, made breakthroughs with therapy, and reduced my stress levels. Even when I told people I had quit and that quitting, the withdrawals, the desire to get high was beaten i guess my cockiness came and bit me on my ass.
I only recently stumbled upon the research that I linked above, and its taken me a good 1-2 years to understand a fraction of it. It's clear that the drug addiction world is utterly in the dark to the ramifications of it. Users, doctors and the public seem to want to believe that drug addiction is something that can be solved with gumption and hard work.
There is no care or consideration given to the fact drug addicts are born deformed. I know its a brutal awful truth but if you think a good diet, no stress and exercise is all you need to quit drugs then i'm sorry but your deluding yourself.
No one quits being a drug addict.
I think you're indulging in false categorization here, with this idea that people born with over a certain level of in utero stress hormone exposure are addicts by definition and will be so for all of their lives, and that people born without that exposure get off free and live their lives in some completely different manner to the addicts, just cruising through without worrying about pain or suffering or trauma.I don't buy it. The reality is lot messier and a lot more complicated than that. We are products of far more than the chemicals we were exposed to in the womb, and addiction is far too complicated a phenomenon to boil down to something as simple as stress hormone levels.
In the end, "drug addict" is a label for people who indulge in a certain set of behaviors. We can argue about the meaning of that label, what it does or doesn't apply to, all we want, but at the end of the day, what it boils down to for me is that people have far more power over their lives, their bodies and their destinies than you seem willing to give them credit for. It's not fast and it's not easy and, as you've pointed out, it's not always permanent, but people can absolutely work to become happier and healthier and to reach a more meaningful place in their life.
