4 ms·

> people can self-medicate themselves in times of crisis. I cringe reading that as a child of parents who spent their lives self-medicating through drugs and a

> people can self-medicate themselves in times of crisis. I cringe reading that as a child of parents who spent their lives self-medicating through drugs and alcohol rather than seeking outside help... > How many lives has that saved? I don’t know how many it’s saved, but I can tell you that it’s severely damaged and nearly ruined the lives of at least a handful of innocent bystanders.

freehunter 8y ago
There's a big difference between having a beer after a hard day at work and actual alcohol dependency. One is harmless (and possible harm-reducing), the other destroys lives and relationships. We need to be able to differentiate between the two without conflating them.
- hobs 8y ago
  The GP clearly notes they are an alcoholic, so I wouldn't say the responder is conflating anything.
  - barking 8y ago
    So what's an alcoholic? Seems to me that almost all drinkers are, seeing as how most of them find it nicer to keep drinking.
    - finaliteration 8y ago
      If we shouldn’t conflate having a single drink with alcohol-dependency then we also shouldn’t conflate the occasional drinker with those who are struggling with alcohol-dependency.
      - barking 8y ago
        When I started smoking I used to smoke other people's cigarettes. Then I started buying my own out of embarrassment. I wasn't a tobacco addict in my own mind at that stage, I just like smoking. It was only when I wanted to quit I found it really hard to stay off for long periods. Eventually I managed it. The level I smoked at was about 10-15 a day. I know a man who smokes 60 a day. He is probably more addicted than I was but it's a matter of degree rather than me being able to look down on him as an addict as compared to my moderate level of smoking.
    - francisofascii 8y ago
      It is best measured on continuum, rather than a binary.
    - DanBC 8y ago
      Harmful drinking covers a wide range of behaviors and levels of drinking. https://www.nice.org.uk/guidance/cg115 https://www.nice.org.uk/guidance/cg115 Someone can be doing harm to themself well before they reach dependent-drinking levels. > Harmful drinking is defined as a pattern of alcohol consumption causing health problems directly related to alcohol. This could include psychological problems such as depression, alcohol-related accidents or physical illness such as acute pancreatitis. In the longer term, harmful drinkers may go on to develop high blood pressure, cirrhosis, heart disease and some types of cancer, such as mouth, liver, bowel or breast cancer. Alcohol-dependency is marked by > craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking). Alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders. Although alcohol dependence is defined in ICD-10 and DSM-IV in categorical terms for diagnostic and statistical purposes as being either present or absent, in reality dependence exists on a continuum of severity. However, it is helpful from a clinical perspective to subdivide dependence into categories of mild, moderate and severe. People with mild dependence (those scoring 15 or less on the Severity of Alcohol Dependence Questionnaire; SADQ) usually do not need assisted alcohol withdrawal. People with moderate dependence (with a SADQ score of between 15 and 30) usually need assisted alcohol withdrawal, which can typically be managed in a community setting unless there are other risks. People who are severely alcohol dependent (with a SADQ score of more than 30) will need assisted alcohol withdrawal, typically in an inpatient or residential setting. In this guideline these definitions of severity are used to guide selection of appropriate interventions.
- finaliteration 8y ago
  > There's a big difference between having a beer after a hard day at work and actual alcohol dependency. I’m not saying they’re the same thing and that having a beer ruins lives. I certainly have a glass of wine from time to time and don’t feel it’s having an impact on anyone around me. But, at least to me, “self-medicating” implies far more consumption than just one drink.
- DanBC 8y ago
  A beer a day is definitely not harm-reducing. One beer a day could be one 330 ml bottle of beer at 5%. That's 11 uk units a week, which is at the upper end of the maximum recommended level.
  - freehunter 8y ago
    Define harm, and explain maximum recommended level for what. (This is rhetorical)
frank_s 8y ago
>I cringe reading that as a child of parents who spent their lives self-medicating through drugs and alcohol rather than seeking outside help... I declared myself as an alcoholic in an effort to get outside help. It was a big mistake. I went from being the equivalent of a Jew in a ghetto to a Jew in a ghetto who had ever so helpfully just pinned a gold star on their chest in order to identify themselves more clearly to their persecutors. One of the problems your parents had, is that in you they had a child who clearly chose to 'admonish' and just feel self-pity. I don't blame you. My sister hated our alcoholic father and she still hates alcoholics. She's a Nurse Practitioner BTW. If you cared about your parents, you would have looked into the why's and wherefore's of drug addiction and if you cared about anybody else you would have moved heaven and earth to make sure nobody else should have to go through what you did as a child. To just say: Drugs are bad, mmmkay? That's a stuck record and about as bad as it gets and just ensures drug abuse persists and the broken lives with it. Which is basically what you and this study are promulgating. If you recognise you are an alcoholic you ultimately have 3 choices: 1) Carry on as you are with the inevitable consequences of a slow unpleasant & painful death but also significant damage to those who love you: family & friends. 2) Own up to your addiction. See comments above. BTW, the medical profession will like you no more than the rest of society ie. Not at all. If you recover, it's going to be largely due to your own efforts & if you're lucky enough, supportive loved one(s). 3) Suicide. ASAP. I think that's known as a classic Hobson's choice.

freehunter 8y ago

There's a big difference between having a beer after a hard day at work and actual alcohol dependency. One is harmless (and possible harm-reducing), the other destroys lives and relationships. We need to be able to differentiate between the two without conflating them.

hobs 8y ago
The GP clearly notes they are an alcoholic, so I wouldn't say the responder is conflating anything.
- barking 8y ago
  So what's an alcoholic? Seems to me that almost all drinkers are, seeing as how most of them find it nicer to keep drinking.
  - finaliteration 8y ago
    If we shouldn’t conflate having a single drink with alcohol-dependency then we also shouldn’t conflate the occasional drinker with those who are struggling with alcohol-dependency.
    - barking 8y ago
      When I started smoking I used to smoke other people's cigarettes. Then I started buying my own out of embarrassment. I wasn't a tobacco addict in my own mind at that stage, I just like smoking. It was only when I wanted to quit I found it really hard to stay off for long periods. Eventually I managed it. The level I smoked at was about 10-15 a day. I know a man who smokes 60 a day. He is probably more addicted than I was but it's a matter of degree rather than me being able to look down on him as an addict as compared to my moderate level of smoking.
  - francisofascii 8y ago
    It is best measured on continuum, rather than a binary.
  - DanBC 8y ago
    Harmful drinking covers a wide range of behaviors and levels of drinking. https://www.nice.org.uk/guidance/cg115 https://www.nice.org.uk/guidance/cg115 Someone can be doing harm to themself well before they reach dependent-drinking levels. > Harmful drinking is defined as a pattern of alcohol consumption causing health problems directly related to alcohol. This could include psychological problems such as depression, alcohol-related accidents or physical illness such as acute pancreatitis. In the longer term, harmful drinkers may go on to develop high blood pressure, cirrhosis, heart disease and some types of cancer, such as mouth, liver, bowel or breast cancer. Alcohol-dependency is marked by > craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking). Alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders. Although alcohol dependence is defined in ICD-10 and DSM-IV in categorical terms for diagnostic and statistical purposes as being either present or absent, in reality dependence exists on a continuum of severity. However, it is helpful from a clinical perspective to subdivide dependence into categories of mild, moderate and severe. People with mild dependence (those scoring 15 or less on the Severity of Alcohol Dependence Questionnaire; SADQ) usually do not need assisted alcohol withdrawal. People with moderate dependence (with a SADQ score of between 15 and 30) usually need assisted alcohol withdrawal, which can typically be managed in a community setting unless there are other risks. People who are severely alcohol dependent (with a SADQ score of more than 30) will need assisted alcohol withdrawal, typically in an inpatient or residential setting. In this guideline these definitions of severity are used to guide selection of appropriate interventions.
finaliteration 8y ago
> There's a big difference between having a beer after a hard day at work and actual alcohol dependency. I’m not saying they’re the same thing and that having a beer ruins lives. I certainly have a glass of wine from time to time and don’t feel it’s having an impact on anyone around me. But, at least to me, “self-medicating” implies far more consumption than just one drink.
DanBC 8y ago
A beer a day is definitely not harm-reducing. One beer a day could be one 330 ml bottle of beer at 5%. That's 11 uk units a week, which is at the upper end of the maximum recommended level.
- freehunter 8y ago
  Define harm, and explain maximum recommended level for what. (This is rhetorical)

frank_s 8y ago

>I cringe reading that as a child of parents who spent their lives self-medicating through drugs and alcohol rather than seeking outside help... I declared myself as an alcoholic in an effort to get outside help. It was a big mistake. I went from being the equivalent of a Jew in a ghetto to a Jew in a ghetto who had ever so helpfully just pinned a gold star on their chest in order to identify themselves more clearly to their persecutors. One of the problems your parents had, is that in you they had a child who clearly chose to 'admonish' and just feel self-pity. I don't blame you. My sister hated our alcoholic father and she still hates alcoholics. She's a Nurse Practitioner BTW. If you cared about your parents, you would have looked into the why's and wherefore's of drug addiction and if you cared about anybody else you would have moved heaven and earth to make sure nobody else should have to go through what you did as a child. To just say: Drugs are bad, mmmkay? That's a stuck record and about as bad as it gets and just ensures drug abuse persists and the broken lives with it. Which is basically what you and this study are promulgating. If you recognise you are an alcoholic you ultimately have 3 choices: 1) Carry on as you are with the inevitable consequences of a slow unpleasant & painful death but also significant damage to those who love you: family & friends. 2) Own up to your addiction. See comments above. BTW, the medical profession will like you no more than the rest of society ie. Not at all. If you recover, it's going to be largely due to your own efforts & if you're lucky enough, supportive loved one(s). 3) Suicide. ASAP. I think that's known as a classic Hobson's choice.