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Based on the examples he gives, physicians seem to have a disappointingly unsophisticated response to the word “addiction” or to any signs that point in the dir
by mrosett 7y ago
Based on the examples he gives, physicians seem to have a disappointingly unsophisticated response to the word “addiction” or to any signs that point in the direction of it. Even if you are physically dependent on a drug and respond poorly to having it withdrawn, you’re not addicted in the clinical sense unless you’re engaging in problematic behavior. That nuance seems to be lost on far too many doctors amidst the current moral panic.
I wish that we could have a more nuanced response to the true horrors of the opioid epidemic. But perhaps even highly trained doctors aren’t capable of more discretion. To be pessimistic and reductionist, the only options are “make drugs harder to get across the board” or “make them easier to get” and we’ve chosen the former. That may help with the opioid crisis, but it has its own costs.
- chongli 7y agoBased on the examples he gives, physicians seem to have a disappointingly unsophisticated response to the word “addiction” That's because the incentives are not in proportion to the disincentives. Doctors are highly trained, yes, but they adjust their level of discretion in response to liability risk. If the current legal regime treats addiction like the black plague then doctors are going to avoid enabling addicts like the plague, even if that means leaving a lot of legitimate patients in severe pain.
- deleted 7y ago[deleted]
- nullc 7y agoHumans sometimes draw conclusions which are overly reductive. "This person is an addict" is a very tidy and convenient explanation for a multitude of symptoms which would otherwise be vexing to analyze and treat, and it also is a not-that-improbable answer in terms of the base rate. Keep in mind that these examples are cherry picked failures. Actually, when you consider that they're presumably the worst cases the author personally knew of-- they're surprisingly not that bad. None of them featured the patient being killed by police officers as a result of misdiagnosis of addicition and especially poor handling by the hospital... Even if we had chosen "make them easier to get" you'd still probably be able to find examples of laughably false addiction diagnoses resulting in poor care...