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Truth behind addiction? How do you know what to believe?3

deuce85

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Hello everyone. I have been sober for four years from opiates. They were my crutch. They damn near killed me. Oxycontin i specifically. While I was in rehab they stressed how addiction is a chronic progressive disease and that if i did not go to AA/NA I would die. So this automatically put a high level of fear in me. So iI never went to AA/NA and a year after rehab I got off of Suboxone. This was the toughest time of my life. SO many feelings and I guess subtle cravings. But I got through it. During this time I researched addiction and found many conflicting views. The overwhelming majority though believes addiction is a chronic progressive brain disease, but I always wanted to believe it was not. I don't know but I guess I just wanted to vent and see what people think on this. How do you know what to believe as an addict? I read some great things on this site. And I appreciate everyone for their commitment and help. What a wonderful site.
 
There are some stickies on exactly this subject. Like the Brain and Addiction one. You'd probably enjoy that.

Whatever addiction actually is is far less important for those with a history of problematic drug use than their actual history (especially if it is ongoing) of problematic drug use. Getting wrapped up in that question is interesting, but more often than not pretty fruitless - especially in the moment. For someone with a history of problematic drug use, it's only really productive in hindsight.

Plus, it's not exactly a self-evident subject. For you addiction is almost certainly going to have a different (if not radically different) character than me or the next person - take someone with problems eating, using alcohol and using heroin (e.g. an addiction to something all humans need to do, an addiction to something socially acceptable, and an addiction to something taboo). There will be some things in common. These are probably what you're getting at. Parsing them is not the simplest thing in the world.

Modern medical/accepted definitions all address addiction as problematic drug use in the past - e.g. a problematic history of drug use - and how it impedes one's functioning (as in a psychiatric disorder; over the last decade we've seen more cognitive and neurosciences approaches, but they follow from the definitions that became popularized in the 1980s). I personally find the sociological components of addiction much more pressing, as well as the broader philosophical implications any definition or understand of addiction inevitably has.

When I first saw this thread I was a little put off reading the opening post. Most people seem to understand Addiction as pretty much a mirror images of their own experience of addiction - they have a hard time understanding how it can be radically different for even very similar people under very similar circumstances. Extrapolating too much from anecdotal evidence, especially when it comes to addiction, can be particularly dangerous given the overwhelmingly "self-help" or non-professional nature of addiction treatment (particularly in the US).

So I was a little nonplussed at first. But it is an interesting subject which I too continue to explore. There are some really good books about this out there, from Chasing the Scream to The Birth of Heroin and the Demonization of the Dope Fiend to more scholarly works like Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control (on of my favorites). There are also good research papers out there, like the International Journal of Drug Policy (for instance, http://www.ijdp.org/article/S0955-3959(13)00010-8/abstract).
 
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There are a lot of theories-from NA/AA's allergy to some genetically mediated predisposition. One theory I've heard from addictionologists is individuals with the predisposition actually receive some sensation or benefit that is different from the standard response and that sensation creates the mental addiction. Normies don't react the same way-yes, they can become physically dependent or get high, but the craving to use at all costs isn't there. Plus add in the individual factors, including various forms of mental illness and it become pretty tough to untangle.

I don't have the source for this but some research in the mid 90s supposedly found women, who had a family history of addiction and a history of both depression and an encounter with abuse were at the highest risk for prescription drug abuse. I don't know if I agree with any of that but that is the information I received.
 
It's pretty well settled that there must be a biopsychosocial definition when it comes to addiction. If genetics play a role, which they almost certainly do, they only play part of that role, and the role genetics play we already know is incredibly complex - there isn't going to be anything like Gattaca anytime soon. The whole allergy thing is pure analogy, a product of a time before there was any agreed upon definitions in medicine.

The distinction between "normie" and addict persists, especially within 12-Step culture, although there is growing appreciation in broader society that addiction isn't black and white, an either/or matter. Even the DSM-5 now labels addiction as a "spectrum" disorder, appropriately so. The addict/normie distinction is a deeper human psychologically urge to lump those we perceive like and unlike us into separate groups in service of our own sense of self, and is ironically counter productive in actually appreciating the nature of Addiction.
 
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deuce85 said:
While I was in rehab they stressed how addiction is a chronic progressive disease and that if i did not go to AA/NA I would die. So this automatically put a high level of fear in me. So iI never went to AA/NA and a year after rehab I got off of Suboxone. This was the toughest time of my life.


There is no doubt in my mind it is progressive. EVery time I thought things couldn't get worse, they inevitably did, until I finally managed to wreck my marriage and my finances and found
myself quite alone in the world. I'm a big believer in 12 step, but I don't cram it down peoples' throats. And sometimes meetings suck. But if I didn't have my AA family, I wouldn't have anyone. That said, it isn't impossible to quit on your own. My alcoholic father just managed to stop and could never understand why I couldn't. But I don't think he had the underlying depression, anxiety and panic issues I do.

toothpastedog said:
If genetics play a role, which they almost certainly do, they only play part of that role


I can attest to that. Alcoholism was rampant on both sides of my family. But my mother, seeing the havoc that her father's alcoholism wreaked on the family has been a lifelong teetotaler, so there definitely is a psychosocial aspect of addiction. But had she drank, who knows what would have happened?
 
There have been some remarkable twin studies that demonstrate that there is a genetic component to addiction (to alcohol in particular).
 
most people seem to understand addiction as pretty much a mirror images of their own experience of addiction - they have a hard time understand how it can be radically different for even very similar people under very similar circumstances. Extrapolating to(o) much from anecdotal evidence, especially when it comes to addiction, can be particularly dangerous given the overwhelmingly "self-help" or non-professional nature of addiction treatment (particularly in the us).

.

qft.
 
This is both a nature and nurture problem. My whole family is full of alcoholics and drug addicts. That gene is within me that causes me to crave another hit.

Here is a reading that I think you may find fascinating Toothpastedog. I know I certainly did...it explains a lot of th reason why some people can have one drink and stop and others cannot.THIQ Production in the brain of alcoholics(THIQ is also created by opiates and benzodiazepines)

Cocaine and stimulants on the other hand rewire your reward center in your brain. Most real rewards of dopamine take time to get, ie: growing a garden, developing a relationship, cleaning your house..etc. However cocaine and other stims flood your brain with dopamine immediately and almost creates a feedback loop that causes you to continue chasing that immediate reward feeling.

I also had a strong nurture role to my addiction. My father injected cocaine, morphine and drank. I witnessed this growing up. I learned by my environment that this is how adults have fun and blow off steam. As I grew up I got into using substances quickly, not only because of genetic predisposition, but also positive reinforcement. (Dad came home angry from work and was abusive, but after he went into the bathroom and used he came out loving and accepting.)

This is a chronic and progressive disease in the sense that the ultimate end, if not treated chronically, is death...even if it is losing your life to the prison system or psychiatric hospital.

We are slowly catching up from the recovery models thrust on us in the 50's-80's. People are becoming more accepting of addiction as not a moral failing, but a mental health issue. I don't know if I should say fortunately, or lament the fact it has gone this far...but a lot of policy changes have been coming because addiction has touched the families of so many of our lawmakers. Use Jeb Bush's daughter as an example.
 
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^I actually put very little faith in any theory that suggests a pharmacological culprit to addiction. Plus, well, I'm always a bit wary of "research" publishes or distributed by treatment centers.
 
-^-Having been through inpatient treatment, I can say I think the treatment industry is a sham that counts on repeat business. I relapsed in pretty short order after leaving treatment. Again, I'm not trying to cram 12 step down anyone's throat because my alcoholic father didn't need it to quit, but stopping didn't really take until I took it seriously and got a hardass sponsor. I look around the rooms and see people that all they needed to quit was to take AA seriously, and that is an inspiration to me.
 
Again, I'm not trying to cram 12 step down anyone's throat because my alcoholic father didn't need it to quit, but stopping didn't really take until I took it seriously and got a hardass sponsor. I look around the rooms and see people that all they needed to quit was to take AA seriously, and that is an inspiration to me.

Of course, it is a normal, literally everyday occurrence to see people in the rooms that only needed to take AA seriously to quit. And if seems like as you need is to take AA serious to quit, so that kind of reinforcement makes sense it would work well for you.

A hardass sponsor was probably one of the more harmful strategies I tried. I have become so much happier, healthier and more successful since I got away from 12 step culture. Different strokes for different folks.

It's a really rare thing for someone to just need the 12 steps in order to be successful in their recovery. But obviously there are still lots of people for who it does work well out there.

----------------------------------------

On another note, one of the biggest reasons I find discussing like this about the roots of addiction to be off putting is due to all the misinformation out there. People aren't just really narrow minded and stubborn in their understanding about addiction, the vast majority of info out there surrounding addiction is very, very impoverished.
 
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A hardass sponsor was probably one of the more harmful strategies I tried. I have become so much happier, healthier and more successful since I got away from 12 step culture. Different strokes for different folks.

I've learned there is a difference between a hardass sponsor and an unreasonable one. I would have characterized my first NA sponsor as a hardass. Now instead I see he was an unreasonable dick in that he wanted me to quit taking my psych meds.

toothpastedog said:
It's a really rare thing for someone to just need the 12 steps in order to be successful in their recovery. But obviously there are still lots of people for who it does work well out there.

12 step is just one component of my recovery. I see an addiction psychiatrist regularly, in addition to a psychotherapist. Considering that alcohol basically left me friendless, I would be completely isolated from other people were it not for AA, which would leave me inside my own head. That's not a place I need to be right now without adult supervision.
 
Yea, it seems like 12 step stuff works best for those who need a significant social component to their recovery. Like who's social life revolved around the bar previously or something. Nothing wrong with that.

I'm a bit more introverted and my use was distinct from my social life. Turns out I didn't need an explicitly social component that's as regimented as something like AA is.

There is nothing wrong with my head, my mind isn't broken and I'm not crazy. I really value my ability to be a thoughtful person. Some people on BL have helped remind me of what I have to offer the world.
 
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It's pretty well settled that there must be a biopsychosocial definition when it comes to addiction. If genetics play a role, which they almost certainly do, they only play part of that role, and the role genetics play we already know is incredibly complex - there isn't going to be anything like Gattaca anytime soon. The whole allergy thing is pure analogy, a product of a time before there was any agreed upon definitions in medicine.

The distinction between "normie" and addict persists, especially within 12-Step culture, although there is growing appreciation in broader society that addiction isn't black and white, an either/or matter. Even the DSM-5 now labels addiction as a "spectrum" disorder, appropriately so. The addict/normie distinction is a deeper human psychologically urge to lump those we perceive like and unlike us into separate groups in service of our own sense of self, and is ironically counter productive in actually appreciating the nature of Addiction.

This is something that intrigues me. Alot of people beleive in the normie/addict distinction when it is decidedly more complex. Everyone has coping mechanisms for life whether good,bad or a mixture. And theres so many different levels of users, functional addicts, full blown addicts, partiers,etc. Nothing is black and white, but it seems to me most people fail to understand that.
 
Precisely.

The link to the paper I posted earlier, Post-humanism, addiction and the loss of self-control: Reflections on the missing core in addiction science, particularly the second to last section (although the entire paper is marvelous), address this issue: http://www.ijdp.org/article/S0955-3959(13)00010-8/pdf

So post-humanism is the answer, just don't try going and explaining it to the average lay person at a meeting :)
 
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that truly was a good read, especially the part about drug policy. It is amazing that newer findings in addiction diagnosis and sociological findings take such a far backseat when drug policy is being created. We are still using ideas from the seventies on how to deal with addicts.

Each person is different....my addiction is different than your addiction is different to his addiction, and the treatment of addiction should be tailored to the individual. It totally is not degeneracy but rather conditioning and how it relates to something corporeal we experience.

I also liked the part about the difference between the street addict, and the person that becomes dependent due to doctors. The street addict "knows/understands" what will make them feel better through experience...whereas the person dependent because of surgery, or prescription from doctors generally doesn't have an idea that the feelings they are having are a result of the medication or lack thereof and don't necessarily become addicts.

there is so much more I want to say, but I have to get to work in the garden before it gets too hot out.
 
Off the topic of the original post but related to what a few people mentioned, what turned me off of AA was their direct implication that I was going to literally die without them. People get and stay sober without AA. People still relapse without AA. People get and stay sober with AA. People still relapse with AA.
And while I'm religious and had no problem with God being involved, I really don't expect him to solve my problems for me or "remove my defects of character", he's got bigger fish to fry than whether I get drunk.
I just felt immense pressure to fit into their idea of what a recovering alcoholic should be and that I should be spending all my time with other recovering alcoholics and they couldn't accept that you can have friends that are understanding of your problems and want to spend time with you just grabbing coffee or watching a movie. There's more to me than being an alcoholic which is the good thing about recovery, your life is no longer about your disease but with AA it feels like you're stuck with your alcoholism following you around begging for your attention.
 
Informative, great thread

I myself was amazed how progressive I found it to be....I stopped using IV heroin for years, then relapsed, and within a couple weeks was using like I had never stopped. It was one of the moments of clarity for me. Anyway, really good stuff in this thread.
 
Off the topic of the original post but related to what a few people mentioned, what turned me off of AA was their direct implication that I was going to literally die without them. People get and stay sober without AA. People still relapse without AA. People get and stay sober with AA. People still relapse with AA.
And while I'm religious and had no problem with God being involved, I really don't expect him to solve my problems for me or "remove my defects of character", he's got bigger fish to fry than whether I get drunk.
I just felt immense pressure to fit into their idea of what a recovering alcoholic should be and that I should be spending all my time with other recovering alcoholics and they couldn't accept that you can have friends that are understanding of your problems and want to spend time with you just grabbing coffee or watching a movie. There's more to me than being an alcoholic which is the good thing about recovery, your life is no longer about your disease but with AA it feels like you're stuck with your alcoholism following you around begging for your attention.

I know just what you mean. There are times that I find myself needing the fellowship of others that share my common problem though. There are certain things that someone that has never been in love with the needle just wouldn't understand...like walking down the street and seeing an orange cap on the ground and getting the taste of cocaine in the back of your throat, and how that can send your mind spiraling in all directions. However, I do believe that if I go back to using, I am going to have problems...lots of problems and I would rather have that tool in the belt than not. Everyone is different, I remember I went to a few AA meetings and there were some in the meeting that didn't understand when I was talking about how I had to use to feel normal, and drink to party. Whenever I had to tell my story I had to give a trigger warning that my story contains lots of drug use. I dunno...every addict is different and they get there for their own reasons...if you need the rigid structure of AA to save your life then go there, if you are like me and only go when you need some help that only another addict can understand, than do that. If you believe some modern mysticism that some benevolent deity of your choosing is going to keep you sober than use it. The end result is the same....our problematic using patterns are diminished while we work on ourselves.

Meditation, medication, and therapy is what works for me...
 
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