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How to know if you’re addicted

190 points by openknot 5y ago

goldcountry 5y ago
Can we finally stop calling it "drugs and alcohol" and just acknowledge that alcohol is a drug?
- openknot 5y ago
  From the perspective of academic psychologists, this is true: "Substance use disorders (SUDs), as described in DSM-IV, are part of a class of disorders (substance-related disorders) that are “related to the taking of a drug of abuse (including alcohol)” [1 p. 175]. Although the transition from DSM-IV to DSM-5 involves changes at multiple levels for SUDs, this basic definition remains unchanged [1,2]." However, most likely readers of the article are likely unaware of the distinction (or may resist it), so the usage of the colloquial and informal definition of "drug" that excludes alcohol would help more people with alcohol use disorder find the article and learn about its main points. [0] https://www.ncbi.nlm.nih.gov/books/NBK519702/ https://www.ncbi.nlm.nih.gov/books/NBK519702/
- deleted 5y ago
  [deleted]
- clpm4j 5y ago
  I think the fact that they're grouped logically is enough, for the most part. It seems widely acknowledged that alcohol is not good for you, but there is a psychological distinction between doing shots at your local dive bar and a glass of Pinot with dinner. I think the spectrum of alcohol use is just broader than most other drugs except for maybe cannabis and psilocybin.
  - mushbino 5y ago
    There isn't a chemical distinction that separates alcohol from other drugs, only social constructs.
    - clpm4j 5y ago
      Right, and social constructs carry more weight in cultural/societal norms which is why I doubt anyone will ever say I'll have a glass of drugs with dinner tonight even though a lot of people know there isn't a technical, chemical distinction.
      - dns_snek 5y ago
        Nobody says "I'll smoke some drugs" either, closest thing you'll hear people say is that they're going to smoke some weed. "Alcohol and drugs" is a harmful distinction when we're talking about substance use, abuse, or harm reduction because it automatically implies that alcohol is categorically different from (and less harmful than) other drugs, thus reinforcing the misinformation and antiquated beliefs.
    - dns_snek 5y ago
      You're being downvoted even though you're absolutely right. I'm assuming that arbitrary distinction makes it a lot easier to rationalize drinking alcohol while they stigmatize or demonize people who say, smoke weed or eat psychedelic mushrooms (or any other drug, really) in reasonable quantities, even if they are extremely productive members of society.
sumosudo 5y ago
Remove the offending substance and see how long or to what extent you would go to get it back.
- hprotagonist 5y ago
  the fortitude saving throw T-break is a good idea, once in a while.
- grvdrm 5y ago
  It's interesting to try it this way. Did it in the past with alcohol because I was curious how long it take to eliminate the urge (regardless of strength) to drink. Got through two months without any drinks and I'm not sure that the urge ever really went away. But I got used to tamping it down.
  - freedom2099 5y ago
    I really can’t relate… I drink but I never feel the “urge” to drink… I can simply stop and alcohol doesn’t even cross my mind for weeks.
    - exdsq 5y ago
      That’s good! That is how a healthy relationship with alcohol should be.
    - grvdrm 5y ago
      That's interesting. I've suspected it was two things: 1. Some chemical addiction - hard to understand but may contribute to the "urge" 2. Some component of taste - in other words, I like the taste of bourbon. I don't really care to be drunk but it obviously happens sometimes. But the goal is not to be drunk but instead to enjoy the taste of bourbon. I'm sure that desire manifests itself chemically in the body as well. Yet, I think of them as different pathways to the outcome. So day to day, what I feel like I'm fighting is the desire to taste something I really enjoy, rather than the desire to be drunk, if that distinction makes sense.
monkeybutton 5y ago
I've had a couple of dreams where I'm chopping up lines even though its been almost a decade since I've done hard drugs. The dreams were very disorienting because they never go further than the prep before suddenly waking up. Like falling and never hitting the ground.
- rjbwork 5y ago
  A huge part of addiction is the rituals surrounding the use of the addicting stimuli, not just the immediate gratification of the stimuli. I recently watched a video of a decades long heroin addict describing his life. He said that he came home from rehab once and just the smell of heroin in his house was enough to make him nauseous and craving it.
sleepingadmin 5y ago
Recently gave cannabis a break. Been using for years as a medical user. If flower, I would smoke < 0.3g a day. If vape, maybe 5-10 hits. Barely any compared to so many others Felt like I wasn't anywhere near overdoing it, but when looking at cannabis withdraw symptoms... can confirm. Certainly had a problem. Still wondering if i can even go back.
- rajin444 5y ago
  I’m similar I think. I generally smoke similar amounts daily. I’ve taken a break a few times now and aside from some weird dreams initially and my eyes being less dry, I didn’t really notice much. I took a 2 month break not too long ago and the only benefit I found was from “doing something” - ie a mental boost from setting a goal and accomplishing it. I’ve only ever used weed to relax when all the other stressors in my life are under control, which might have something to do with it.
  - sleepingadmin 5y ago
    Ive occasionally taken breaks but I think I didn't do it long enough. This time at like day 3-4 I was triumphantly saying there was no withdrawals, but for some reason I was unusually angry. I dont deny anger, I almost denied that I was angry. Normally I absorb the emotion and analyze why I was this way. I couldn't really do that, I couldn't really justify why I was angry. I even woke up angry with no apparent cause. The next day I lost control and raised my voice out of anger for a moment. Something I generally don't do. I tried questioning this anger again but found no answers. I believe at this time I still didn't believe cannabis was addictive or for that matter I was having withdrawals. Let alone this was just the beginning. Took over a week for problems to really peak. The bigger problem, I was using medically... without it... that original problem also started to come back. Just making it all that much worse.
- bengale 5y ago
  I found it hard to regulate but easy to quit. I was probably smoking more than you from the sound of it, but I found myself smoking more during the work day when I started working from home, tried to put some limits on it and then found myself breaking the rules. So I stopped cold, worst of it was probably the desire to smoke while winding down, more of a craving than a compulsion though and no physical symptoms.
GenZRiseUp 5y ago
That is a really beautifully designed website. I was addicted to pornography. The way I knew was by trying to stop for at least a week, if I could accomplish that, then it wouldn't be a problem. I couldn't make it past one day. I thought, maybe access was the issue - so I deleted my browsers, and within a day was reinstalling them just to watch porn. I was watching during classes, and I would go late to events just so I could finish watching a particular scene, or explore a pornstar's catalogue. It was only after confiding in somebody that I realised how deep I had sunk (watching and paying for snuff and gore), and it was extremely tough to come out of that. I still get the urge when opening a browser to muscle memory type in a site, and it's constant vigilance and self-discipline that has held me at bay, but the pull has never went away.
- rmbyrro 5y ago
  I wonder if the dopamine doses associated with the activity is what causes the addiction on the area.
  - Mezzie 5y ago
    My ancedotal evidence says yes. I've never had a porn problem (I'm a homosexual female, I'm not sure there's enough material for me to sustain a porn problem...), but I've had other psychological addictions and one interesting thing I've noticed is that if I take modafinil when I'm trying to break one that my cravings/desires are much less. I think it's dopamine (as opposed to the other nts modafinil is theorized to work on) because a changing short half-life SNRI dose does nothing (so it's not serotonin or norepinephrine making the change), caffeine does nothing (so not adenosine), and histamine modifiers also do nothing.
    - beaconstudios 5y ago
      That's interesting because that's the opposite effect to me - I used to smoke (still do rarely but try to avoid it) and when I took modafinil I often had a strong urge to chain-smoke, just like after a few drinks.
aurbano 5y ago
Is it just me or it's actually hard to find an answer "how to know if you're addicted" in the article? I skimmed the article and thought I found it when I got to the section titled "Key points – How to know if you’re addicted", in the middle of the article; but again this section didn't give a list of things to look out for... Maybe I missed it?
- IAmGraydon 5y ago
  > Addiction can be defined as a persistent, compulsive need to use a substance, despite the negative consequences to you or others. If that describes you, you likely have an addiction.
  - aurbano 5y ago
    I feel like the definition should just be "Addiction can be defined as a persistent, compulsive need to use a substance". Surely one can be addicted even if it doesn't have negative consequences right?
    - Mezzie 5y ago
      Yeah, this is a major omission and it is also why you see so many functional addicts who don't think they have a problem. Also it means that who is considered an 'addict' is partially socially constructed: Some people have jobs that will randomly drug test for weed, so if they smoke daily and lose their job, they're addicts, but since my job is remote and doesn't care, I could be high as a kite most nights and not be an 'addict' since it didn't cause issues.
      - leetcrew 5y ago
        I mean yeah, different jobs come with different obligations. showing up high to a construction site is a problem in a way that being high during your shift at a dispensary is not. I dunno if that's "socially constructed"; it seems like a very real safety issue to me. it's unfortunate that we can't test for acute cannabis intoxication the way we can with alcohol, but I'm sure we'll get there in time. more generally, I would push back on the idea that someone isn't experiencing consequences just because they manage to hold a job. spending all your nonworking time intoxicated is not usually the path to a fulfilling personal life. the consequences are there whether the person sees them or not.
gareiner 5y ago
Beautiful website, beautiful content. I have learned and taken account into considerations in facing addiction.
JimWestergren 5y ago
Why such a focus of substances and no mention of the more common addictions such as video games, porn and social media?
- Cthulhu_ 5y ago
  Probably because they're considered less harmful to your physical health and society as a whole.
  - JimWestergren 5y ago
    Yes, ok. But such an article with such a title should at least mention them I think. Otherwise some people keep thinking it is normal spending hours daily on social media, or checking their phone 50 times a day. We should speak up and say that it is NOT normal.
    - openknot 5y ago
      It may be a writing constraint or decision by the editor to keep the article focused on alcohol and drug use, as addiction to "video games, porn and social media" may have different treatment approaches or signs of addiction (and would thus significant broaden the article's scope), though I agree with your last two sentences. For example, consider the criteria used to describe the signs of addiction: "You need an increasing amount of alcohol or drugs to feel a buzz or high. You feel an urgency to get the first drink or drug of the day. You experience a loss of interest in other activities and an increased desire to get ‘high’ or ‘buzzed’. You try to quit or cut down on the use of alcohol or drugs but can’t. You will do almost anything to get the drug or alcohol." You might feel an urge for these other addictive habits at the start of the day; experience a loss of interest in other activities; and try to cut down but can't. For the pull to experience an "increasing amount" of the activity for a high, that is plausible for porn (for some users, it's a want for more extreme content), but less so for video games and social media. It's also not immediately obvious—especially when compared to drugs and alcohol—that a user of video games, porn, or social media would "do almost anything" to satisfy the urge. The bottom line is that these behaviours, while addicting, have significant differences when compared to alcohol and drugs. Speaking from past writing experience, these would require the article to significantly broaden its scope, which may not have been possible due to editorial constraints (e.g. word count). It's also plausible that the original article may have been, "The first steps to respond to a potential alcohol or drug addiction," but the editor shortened it to a catchier "How to know if you're addicted."
throwawayweed 5y ago
In my mid twenties, I had two addictions - pornography and Marijuana. The first was significantly harder to kick than the later. Maybe I'm merely a weak person, but I felt I slowly succumbed to these things after years of casual use and some major relational setbacks in my life post college. I got psychological help but was not encouraged to stop doing these things, just to practice moderation. Ultimately, I was forced by circumstance to have to stop and realized I was a lot happier. I think a lot of people don't want to acknowledge that they are addicted to stuff like this and rationalize it away. I find myself thinking we should set up better societal guard rails about these things, but avoid making them illegal. Neither of these are hard addictions to kick anyway, but they do cost you a lot of time and money.
- axiosgunnar 5y ago
  > I was forced by circumstance to have to stop Could you elaborate?
  - throwawayweed 5y ago
    I took a contracting job where I'd travel for two or three weeks at a time, often working long hours. This would usually take me from a spot where weed was recreationally available and ubiqutous to impossible and impractice to get. The two vices ran together for me. After sobering up while away, I realized how much of a drag these things had been on my well being and resolved to just give them up, or at least try.
anonymouse008 5y ago
I’d like to throw this out there to see what comes back; has anyone thought about coding and development being an addiction? In my experience, it has fit all of the characteristics of a deeply addictive loop… There’s a strong period of hard effort for variable reward - and much of the time that reward is just the dang thing compiling. I know without a doubt I’ve hurt myself doing this more than I should and am currently struggling with the potential long term benefit vs. the current pains.
- mikepurvis 5y ago
  I would agree with this, but I think for me it's more of an undiagnosed ADHD thing, where I have periods of fabulous productivity where I'm up all night for days riding an endless wave of dopamine, and then other times where it's weeks of feeling stalled and unmotivated even when the next steps should be fairly clear.
- granshaw 5y ago
  Broadly I think society only considers “harmful” activities as addictive - drinking, porn, your usual If you can’t stop doing something that’s societally acceptable or even lauded, you’re just “passionate”
- deleted 5y ago
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- nunez 5y ago
  I think this viewpoint is really interesting, especially when one considers how massively incentivized this addiction is (by way of high-paying jobs with generally-great benefits and working environments).
- empthought 5y ago
  Science and the Compulsive Programmer (1976) https://www.sac.edu/AcademicProgs/Business/ComputerScience/Pages/Hester_James/HACKER.htm https://www.sac.edu/AcademicProgs/Business/ComputerScience/P...
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andrewmcwatters 5y ago
> Addiction can be defined as a persistent, compulsive need to use a substance, despite the negative consequences to you or others. This is a really poor definition, because you can be addicted to things that have no negative consequences to you, and you still don't want to do them. "An inability to stop" is probably more succinct.
pdenton 5y ago
The worst of the bunch is tobacco. The effect is basically nothing, but it hurts ones health and wallet. I've done cocaine, marijuana, mdma, speed, xtc pills, and some research chemicals. Protips: don't smoke, and never combine any two drugs. If you really want a certain substance, do at least the first session with someone sober to keep an eye on you. Never accept drugs from strangers and don't give in to peer pressure (which can be pretty tough at times when self-confidence is lacking).
- psyclobe 5y ago
  Vaping is worse. Wrapped in a nebulous belief that it is probably a lot safer then the leaf form, it is mighty hard to give up. Mostly because you can vape anywhere and everywhere, constantly, making your body expect dopamine 24/7.
- sjcoles 5y ago
  Nicotine is a useful tool though. The latest round of tobacco free pouches are great and reduce risk to basically zero.
  - mrtranscendence 5y ago
    A useful tool for what? I haven't used nicotine in a long time, but from what I recall the impact was basically zero unless I hadn't smoked in a while.
    - deleted 5y ago
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    - sjcoles 5y ago
      It's a stimulant. It helps me concentrate and seems to help my working memory (which is already poor due to ADHD).
- wpietri 5y ago
  For some costumes, I have held an unlit cigar in my teeth. The effect for me is noticeable and strong, like caffeine but more so. I really liked it! Which is why I will never take up regular use of it.
temp0826 5y ago
I serve Kambo (which is the poisonous secretion derived from a particular Amazonian tree frog) to people. It has been my savior for breaking out of addictive patterns. It's definitely not for everyone (not just considering the contraindications; it's an extremely rough experience in general). It can feel like a physiological and psychological "reset" (note, only speaking anecdotally as there is not a lot of proper research around it). Quite a breath of fresh air after being in a rut or just looking to make changes in your life.
- mikepurvis 5y ago
  Looks like a bit of a mixed bag: https://en.wikipedia.org/wiki/Kambo_cleanse https://en.wikipedia.org/wiki/Kambo_cleanse
  - temp0826 5y ago
    Yah... I won't try to paint a pretty picture of it, but that article (as well as any other "alternative treatment" on wikipedia) portrays it pretty negatively. There definitely have been a couple of studies and papers (on both kambo and on some of the individual constituent peptides in the secretion), but the article states otherwise. In the traditional context, Kambo wouldn't ever be called a "cleanse". Traditionally, it's used by a few Amazonian tribes to remove what they call "panema" (which is essentially bad luck, mostly in regards to hunting. Not being able to bring back food has consequences for the community), to increase strength and stamina, and as sort of a "vaccine" (immunity booster). The "removal of toxins" or whatever is a hard western woo spin on it.
dasKrokodil 5y ago
Funny how they keep writing 'drugs OR alcohol'
- openknot 5y ago
  Sounds like the inclusive or [0] from the context. [0] https://english.stackexchange.com/questions/63998/inclusive-or-in-speech https://english.stackexchange.com/questions/63998/inclusive-...
- bananamerica 5y ago
  Many readers will not include alcohol in the group drugs, so it needs to be mentioned explicitly, even though it actually is part of the "drugs" group.
jagger1345 5y ago
It doesn't always get a ton of notice when addiction is brought up but addiction to anabolics is an interesting phenomena in itself. I started using anabolics years ago and slowly added more compounds over time. It eventually got to the point where I started to experience increasingly negative sides that I had trouble managing so would add further pharmaceuticals to the stack to mitigate the side effects of the anabolics. What is interesting about anabolic use is that if abused for long enough or heavily enough (blast and cruise) going back to a state of non anabolics is actually difficult and can come with months/years of hormone / neurosteroid deficiency as you attempt to restart your HPTA. This is why most people are on replacement doses of testosterone for life after dabbling in this area which is interesting in terms of your typical reformed addict = quitting sense.
- shard 5y ago
  To save someone else a search, HPTA is, according to Wikipedia: The hypothalamic–pituitary–gonadal axis (HPG axis) refers to the hypothalamus, pituitary gland, and gonadal glands as if these individual endocrine glands were a single entity. Because these glands often act in concert, physiologists and endocrinologists find it convenient and descriptive to speak of them as a single system.
drewcoo 5y ago
Step 1: Self-Diagnosis! Somehow that doesn't seem like something a credible psychologist would say. And a skim through their other stories is in the same vein.
kosyblysk2 5y ago
admit powerlessness over your addiction and start reflecting upon yourself (shadow/feelings(anima)/etc) ...the wound is the cure
laurex 5y ago
I have more than a passing interest in neuroscience and psychology and I’m still on the fence a bit but truthfully I do think most descriptions of addiction make my relationship with my phone at least in the realm of applying the addict label. There’s the idea in neuroscience of not liking a behavior but still doing it compulsively with a unconscious hope of repeating a high that becomes harder and harder to access as tolerance builds up. I find myself with my phone in my hand as though by magic sometimes. And yes, I’m writing my comment on my phone right now.
- buscoquadnary 5y ago
  Honestly I am at that state right now with HN and Reddit.
- silicon2401 5y ago
  personally I think everyone's addicted to their phones, or at best has a horrible habit of being on their phones. I used to be the standard modern person, phone always in hand and finding something to do. Over the years I put in work to change that, and now I generally go to my phone if I need it, rather than being on it by default and finding something to do with it. It's incredibly liberating. IMO The experience of using a phone is incredibly cheap and shallow compared to almost anything else you can do, even watching the same videos but on a proper tv or monitor.
blobbers 5y ago
"Addiction can be defined as a persistent, compulsive need to use a substance, despite the negative consequences to you or others." What about things that are beneficial but unclear if they're healthy? Staying up late on the computer but then taking a sedative to fall asleep immediately so that you don't spend an hour staring at the ceiling. You get more sleep, but you're probably addicted to the sleeping pills. Without them, you don't get enough rest.
- openknot 5y ago
  Sleeping pills may be better than getting no sleep at all, but cognitive behavioural therapy for insomnia (CBTi) may be a better treatment approach than medication [0]. A problem with sleeping pills is that they reduce sleep quality, so you aren't as well-rested versus sleeping without them. From an interview with Matthew Walker, a professor of neuroscience and psychology [1]: "The quality of sleep that you have when you’re on these drugs is not the same as normal, naturalistic sleep. They’re classified as “sedative hypnotics,” so the drugs actually just sedate you — and sedation is not sleep." [...] "They don’t tend to increase sleep much beyond placebos. People may be fooled into thinking that they’re getting more sleep, but actually they’re not. This was not my conclusion — it was a committee of experts, who reviewed 65 separate drug placebo studies, and their conclusion was simple: There was no objective benefit of sleeping pills beyond placebo. Their summary was that the impact of sleeping pills was small, and of questionable clinical importance. "And my third problem: They are associated with a higher risk of death and cancer. "About that last point, in your book you do raise the possibility that it’s not sleeping pills that’s causing those things — it’s whatever is causing you to have trouble sleeping, which weakens your immune system. "Yeah, I think that would be the counterargument, and I think it’s a very reasonable one at this stage. But I think an equally reasonable, equally tenable explanation is that they do shorten your life and increase your risk of cancer. The answer is we just don’t know which of those two things it is.” [0] https://aims.uw.edu/nyscc/training/sites/default/files/CBTi%20Manual.pdf https://aims.uw.edu/nyscc/training/sites/default/files/CBTi%... [1] https://www.thecut.com/2017/10/the-vicious-cycle-of-insomnia-and-sleeping-pills.html https://www.thecut.com/2017/10/the-vicious-cycle-of-insomnia...
  - 5y ago
oceanplexian 5y ago
It’s a lot harder than you would think. I’m not a big drinker, not even a daily drinker, maybe once or twice per week.. and decided to do a month without drinking for fitness reasons. After two weeks it was hard to resist the urge every time I’d see people drinking on a TV show, or at the airport, or with dinner at a restaurant. While it may not be a full blown addiction it made me realize I’m much closer to addiction than I’d like to admit.
- kolla 5y ago
  Same here, I'm probably considered an alcoholic because of the ammount of liquour I drink per week/month but I can work out every single day and stay in great shape but come friday and saturday I do empty quite a few units. Stopping the weekend urge is hard.
  - at-fates-hands 5y ago
    Anecdotal evidence so take this as you will. I have alcoholism in my family. When my Dad finally went into a 30 day in-patient treatment, I was still a sophomore in college. I was very much like you. An athlete (played D3 soccer), so I was working out, and in great shape, but wouldn't touch alcohol during the week - when I first got to college, my drinking was all done on the weekends. Then when I was of legal drinking age (US 21 years) then it started to creep into Thursday, then eventually I was drinking Wed-Sat, drying out Sunday and then cramming all my homework and studying into three days just to get ready for the weekend again. One of the things they do is a screening. You fill out a long survey - How do you drink, when you drink? When do you drink? How often are you drinking, etc. I fill it out based on my current activity. Counselor sits me down, and starts telling me that I'm not an alcoholic YET, but I'm clearly heading that way. I do abuse alcohol on a regular basis and these are the behaviors they look for and she basically told me if I continue doing what I doing? I will be there in a few years. I was 22 or 23 at the time. I kind of shrugged it off. Dad continued in and out of rehab while I continued doing what I was doing. Then the wheels fell off for my Dad. Like really bad. Disappeared for a week, Mom couldn't find him, started getting worried. Found him in a shady hotel on the edge of town. He was trying to drink himself to death. We got there, got him into the psych ward and they forcibly detoxified him. He was basically under medical house arrest until he sobered up and vowed this was indeed the end. I finally had a front row seat to see what my future was. My mom pulled me aside that Christmas in the midst of our entire extended family at my parents house celebrating. She grabs my arm and pulls me into a room, looks me dead in the eyes and says, "If you want to put someone you love through what your father just put our family through these last two years? Then keep drinking, keep partying and doing whatever you're doing." and then just walked away from me. That was pretty much it. I decided a few weeks later to put a cap on it, I had a good run, but gambling with my future like that? No thanks. Been sober 14 years. Sure I have a beer here and there, but its only one (I'm a total lightweight now, so its no fun) and then that's it. And I never judge the people I'm around if they want to drink. I would tell you what the nurse told me. It sounds like you do abuse alcohol, and you're heading down that road. Is your future predetermined? I don't think so, but it took a litany of close calls and the one major episode with my Dad to make me realize what was happening and change course before it was too late.
MeinBlutIstBlau 5y ago
standardUser 5y ago
The most important thing for people to understand is that everyone is different, and different people can have very different experiences with the exact same substance. Some people can smoke cigarettes on the weekend for years and never get addicted, which sounds insane to someone like me who couldn't go for more than a hour without a cigarette for twenty years and went through hell for 6 months to finally quit. But I can binge cocaine for weeks on end (in college it was meth) and then stop when I get bored (or my nose hurts) and suffer no withdrawal beyond occasional thoughts of "it would be nice to get high!". Yet other people end up in rehab for using far less than I have. I drink absurd amounts of caffeine every day and will get a mild headache sometimes if I skip it, and I thought this was normal until a friend quit caffeine and described it the way I would describe quitting nicotine! It's all over the map. Wild variation is the norm, but a lot of our public health messaging and "conventional wisdom" ignores this entirely.
- simon1ltd 5y ago
  I just had a discussion with a friend about this last week. Some people (we call it addictive personalities, not sure if there’s a better term) seem to get hooked almost right away. Others, can stop whenever they want with little trouble. The problem is that you don’t know which of those possibilities applies to you without trying it, and then it’s too late. Since my immediate family members have had issues with substances, I assume I would be one of the people with a problem. That’s the message I’m trying to pass along to the next generation too. You might not have a problem, but you won’t know if you do until it’s too late. YMMV
  - standardUser 5y ago
    There's even hard data on this with regards to alcohol and cocaine that show that some people are predisposed to have a higher risk of addiction. With alcohol we know it's at least partially hereditary, so people with histories of alcohol abuse in their families are often told to be extra careful. I would love to see more research on this and even the ability to give individuals info on their own risk levels. The only thing that seems to be near-universally dangerous in terms of addiction are opioids. But even still, most people who try heroin or get prescribed oxycodone never become addicted.
kaycebasques 5y ago
Just started Urge: Our History Of Addiction yesterday! I am doing a sober February this month as an exercise in contemplating my own addictions and for the pure sake of challenge. No beer, no marijuana, etc. Not even caffeine! Caffeine is much harder for me than any other.
- MandieD 5y ago
  I give up alcohol for Lent every year. I tried giving up caffeine one year instead. I broke down after a week and went back to giving up alcohol instead.
entropicgravity 5y ago
Somewhere I read that an alcoholic was someone who always remembers their last drink whether it was an hour ago or a decade ago.
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nyc111 5y ago
Nice article but who is "you" here? It's very difficult to define who is addicted. In the case of sugar addiction, it is the sugar loving microorganisms that live inside the body. It is not the conscious mind who is addicted. And these microorganisms can control the behavior of the host, that is, the body, like making you go to where sweets are sold without you knowing it. I don't know how but these organisms have direct access to the motor nerveous system and can do things and make decisions without (or before) conscious mind realizes it. So the way we become aware of the hot surface we touched accidentally only after we retract our arm, we become aware of some decisions only after executing them to satisfy the desires of the microorganisms, our symbionts. So I'm sure addiction is not a mind issue but a gut issue.

190 points by openknot 5y ago

goldcountry 5y ago

Can we finally stop calling it "drugs and alcohol" and just acknowledge that alcohol is a drug?

openknot 5y ago
From the perspective of academic psychologists, this is true: "Substance use disorders (SUDs), as described in DSM-IV, are part of a class of disorders (substance-related disorders) that are “related to the taking of a drug of abuse (including alcohol)” [1 p. 175]. Although the transition from DSM-IV to DSM-5 involves changes at multiple levels for SUDs, this basic definition remains unchanged [1,2]." However, most likely readers of the article are likely unaware of the distinction (or may resist it), so the usage of the colloquial and informal definition of "drug" that excludes alcohol would help more people with alcohol use disorder find the article and learn about its main points. [0] https://www.ncbi.nlm.nih.gov/books/NBK519702/ https://www.ncbi.nlm.nih.gov/books/NBK519702/
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clpm4j 5y ago
I think the fact that they're grouped logically is enough, for the most part. It seems widely acknowledged that alcohol is not good for you, but there is a psychological distinction between doing shots at your local dive bar and a glass of Pinot with dinner. I think the spectrum of alcohol use is just broader than most other drugs except for maybe cannabis and psilocybin.
- mushbino 5y ago
  There isn't a chemical distinction that separates alcohol from other drugs, only social constructs.
  - clpm4j 5y ago
    Right, and social constructs carry more weight in cultural/societal norms which is why I doubt anyone will ever say I'll have a glass of drugs with dinner tonight even though a lot of people know there isn't a technical, chemical distinction.
    - dns_snek 5y ago
      Nobody says "I'll smoke some drugs" either, closest thing you'll hear people say is that they're going to smoke some weed. "Alcohol and drugs" is a harmful distinction when we're talking about substance use, abuse, or harm reduction because it automatically implies that alcohol is categorically different from (and less harmful than) other drugs, thus reinforcing the misinformation and antiquated beliefs.
  - dns_snek 5y ago
    You're being downvoted even though you're absolutely right. I'm assuming that arbitrary distinction makes it a lot easier to rationalize drinking alcohol while they stigmatize or demonize people who say, smoke weed or eat psychedelic mushrooms (or any other drug, really) in reasonable quantities, even if they are extremely productive members of society.

sumosudo 5y ago

Remove the offending substance and see how long or to what extent you would go to get it back.

hprotagonist 5y ago
the fortitude saving throw T-break is a good idea, once in a while.
grvdrm 5y ago
It's interesting to try it this way. Did it in the past with alcohol because I was curious how long it take to eliminate the urge (regardless of strength) to drink. Got through two months without any drinks and I'm not sure that the urge ever really went away. But I got used to tamping it down.
- freedom2099 5y ago
  I really can’t relate… I drink but I never feel the “urge” to drink… I can simply stop and alcohol doesn’t even cross my mind for weeks.
  - exdsq 5y ago
    That’s good! That is how a healthy relationship with alcohol should be.
  - grvdrm 5y ago
    That's interesting. I've suspected it was two things: 1. Some chemical addiction - hard to understand but may contribute to the "urge" 2. Some component of taste - in other words, I like the taste of bourbon. I don't really care to be drunk but it obviously happens sometimes. But the goal is not to be drunk but instead to enjoy the taste of bourbon. I'm sure that desire manifests itself chemically in the body as well. Yet, I think of them as different pathways to the outcome. So day to day, what I feel like I'm fighting is the desire to taste something I really enjoy, rather than the desire to be drunk, if that distinction makes sense.

monkeybutton 5y ago

I've had a couple of dreams where I'm chopping up lines even though its been almost a decade since I've done hard drugs. The dreams were very disorienting because they never go further than the prep before suddenly waking up. Like falling and never hitting the ground.

rjbwork 5y ago
A huge part of addiction is the rituals surrounding the use of the addicting stimuli, not just the immediate gratification of the stimuli. I recently watched a video of a decades long heroin addict describing his life. He said that he came home from rehab once and just the smell of heroin in his house was enough to make him nauseous and craving it.

sleepingadmin 5y ago

Recently gave cannabis a break. Been using for years as a medical user. If flower, I would smoke < 0.3g a day. If vape, maybe 5-10 hits. Barely any compared to so many others Felt like I wasn't anywhere near overdoing it, but when looking at cannabis withdraw symptoms... can confirm. Certainly had a problem. Still wondering if i can even go back.

rajin444 5y ago
I’m similar I think. I generally smoke similar amounts daily. I’ve taken a break a few times now and aside from some weird dreams initially and my eyes being less dry, I didn’t really notice much. I took a 2 month break not too long ago and the only benefit I found was from “doing something” - ie a mental boost from setting a goal and accomplishing it. I’ve only ever used weed to relax when all the other stressors in my life are under control, which might have something to do with it.
- sleepingadmin 5y ago
  Ive occasionally taken breaks but I think I didn't do it long enough. This time at like day 3-4 I was triumphantly saying there was no withdrawals, but for some reason I was unusually angry. I dont deny anger, I almost denied that I was angry. Normally I absorb the emotion and analyze why I was this way. I couldn't really do that, I couldn't really justify why I was angry. I even woke up angry with no apparent cause. The next day I lost control and raised my voice out of anger for a moment. Something I generally don't do. I tried questioning this anger again but found no answers. I believe at this time I still didn't believe cannabis was addictive or for that matter I was having withdrawals. Let alone this was just the beginning. Took over a week for problems to really peak. The bigger problem, I was using medically... without it... that original problem also started to come back. Just making it all that much worse.
bengale 5y ago
I found it hard to regulate but easy to quit. I was probably smoking more than you from the sound of it, but I found myself smoking more during the work day when I started working from home, tried to put some limits on it and then found myself breaking the rules. So I stopped cold, worst of it was probably the desire to smoke while winding down, more of a craving than a compulsion though and no physical symptoms.

GenZRiseUp 5y ago

That is a really beautifully designed website. I was addicted to pornography. The way I knew was by trying to stop for at least a week, if I could accomplish that, then it wouldn't be a problem. I couldn't make it past one day. I thought, maybe access was the issue - so I deleted my browsers, and within a day was reinstalling them just to watch porn. I was watching during classes, and I would go late to events just so I could finish watching a particular scene, or explore a pornstar's catalogue. It was only after confiding in somebody that I realised how deep I had sunk (watching and paying for snuff and gore), and it was extremely tough to come out of that. I still get the urge when opening a browser to muscle memory type in a site, and it's constant vigilance and self-discipline that has held me at bay, but the pull has never went away.

rmbyrro 5y ago
I wonder if the dopamine doses associated with the activity is what causes the addiction on the area.
- Mezzie 5y ago
  My ancedotal evidence says yes. I've never had a porn problem (I'm a homosexual female, I'm not sure there's enough material for me to sustain a porn problem...), but I've had other psychological addictions and one interesting thing I've noticed is that if I take modafinil when I'm trying to break one that my cravings/desires are much less. I think it's dopamine (as opposed to the other nts modafinil is theorized to work on) because a changing short half-life SNRI dose does nothing (so it's not serotonin or norepinephrine making the change), caffeine does nothing (so not adenosine), and histamine modifiers also do nothing.
  - beaconstudios 5y ago
    That's interesting because that's the opposite effect to me - I used to smoke (still do rarely but try to avoid it) and when I took modafinil I often had a strong urge to chain-smoke, just like after a few drinks.

aurbano 5y ago

Is it just me or it's actually hard to find an answer "how to know if you're addicted" in the article? I skimmed the article and thought I found it when I got to the section titled "Key points – How to know if you’re addicted", in the middle of the article; but again this section didn't give a list of things to look out for... Maybe I missed it?

IAmGraydon 5y ago
> Addiction can be defined as a persistent, compulsive need to use a substance, despite the negative consequences to you or others. If that describes you, you likely have an addiction.
- aurbano 5y ago
  I feel like the definition should just be "Addiction can be defined as a persistent, compulsive need to use a substance". Surely one can be addicted even if it doesn't have negative consequences right?
  - Mezzie 5y ago
    Yeah, this is a major omission and it is also why you see so many functional addicts who don't think they have a problem. Also it means that who is considered an 'addict' is partially socially constructed: Some people have jobs that will randomly drug test for weed, so if they smoke daily and lose their job, they're addicts, but since my job is remote and doesn't care, I could be high as a kite most nights and not be an 'addict' since it didn't cause issues.
    - leetcrew 5y ago
      I mean yeah, different jobs come with different obligations. showing up high to a construction site is a problem in a way that being high during your shift at a dispensary is not. I dunno if that's "socially constructed"; it seems like a very real safety issue to me. it's unfortunate that we can't test for acute cannabis intoxication the way we can with alcohol, but I'm sure we'll get there in time. more generally, I would push back on the idea that someone isn't experiencing consequences just because they manage to hold a job. spending all your nonworking time intoxicated is not usually the path to a fulfilling personal life. the consequences are there whether the person sees them or not.

gareiner 5y ago

Beautiful website, beautiful content. I have learned and taken account into considerations in facing addiction.

JimWestergren 5y ago

Why such a focus of substances and no mention of the more common addictions such as video games, porn and social media?

Cthulhu_ 5y ago
Probably because they're considered less harmful to your physical health and society as a whole.
- JimWestergren 5y ago
  Yes, ok. But such an article with such a title should at least mention them I think. Otherwise some people keep thinking it is normal spending hours daily on social media, or checking their phone 50 times a day. We should speak up and say that it is NOT normal.
  - openknot 5y ago
    It may be a writing constraint or decision by the editor to keep the article focused on alcohol and drug use, as addiction to "video games, porn and social media" may have different treatment approaches or signs of addiction (and would thus significant broaden the article's scope), though I agree with your last two sentences. For example, consider the criteria used to describe the signs of addiction: "You need an increasing amount of alcohol or drugs to feel a buzz or high. You feel an urgency to get the first drink or drug of the day. You experience a loss of interest in other activities and an increased desire to get ‘high’ or ‘buzzed’. You try to quit or cut down on the use of alcohol or drugs but can’t. You will do almost anything to get the drug or alcohol." You might feel an urge for these other addictive habits at the start of the day; experience a loss of interest in other activities; and try to cut down but can't. For the pull to experience an "increasing amount" of the activity for a high, that is plausible for porn (for some users, it's a want for more extreme content), but less so for video games and social media. It's also not immediately obvious—especially when compared to drugs and alcohol—that a user of video games, porn, or social media would "do almost anything" to satisfy the urge. The bottom line is that these behaviours, while addicting, have significant differences when compared to alcohol and drugs. Speaking from past writing experience, these would require the article to significantly broaden its scope, which may not have been possible due to editorial constraints (e.g. word count). It's also plausible that the original article may have been, "The first steps to respond to a potential alcohol or drug addiction," but the editor shortened it to a catchier "How to know if you're addicted."

throwawayweed 5y ago

In my mid twenties, I had two addictions - pornography and Marijuana. The first was significantly harder to kick than the later. Maybe I'm merely a weak person, but I felt I slowly succumbed to these things after years of casual use and some major relational setbacks in my life post college. I got psychological help but was not encouraged to stop doing these things, just to practice moderation. Ultimately, I was forced by circumstance to have to stop and realized I was a lot happier. I think a lot of people don't want to acknowledge that they are addicted to stuff like this and rationalize it away. I find myself thinking we should set up better societal guard rails about these things, but avoid making them illegal. Neither of these are hard addictions to kick anyway, but they do cost you a lot of time and money.

axiosgunnar 5y ago
> I was forced by circumstance to have to stop Could you elaborate?
- throwawayweed 5y ago
  I took a contracting job where I'd travel for two or three weeks at a time, often working long hours. This would usually take me from a spot where weed was recreationally available and ubiqutous to impossible and impractice to get. The two vices ran together for me. After sobering up while away, I realized how much of a drag these things had been on my well being and resolved to just give them up, or at least try.

anonymouse008 5y ago

I’d like to throw this out there to see what comes back; has anyone thought about coding and development being an addiction? In my experience, it has fit all of the characteristics of a deeply addictive loop… There’s a strong period of hard effort for variable reward - and much of the time that reward is just the dang thing compiling. I know without a doubt I’ve hurt myself doing this more than I should and am currently struggling with the potential long term benefit vs. the current pains.

mikepurvis 5y ago
I would agree with this, but I think for me it's more of an undiagnosed ADHD thing, where I have periods of fabulous productivity where I'm up all night for days riding an endless wave of dopamine, and then other times where it's weeks of feeling stalled and unmotivated even when the next steps should be fairly clear.
granshaw 5y ago
Broadly I think society only considers “harmful” activities as addictive - drinking, porn, your usual If you can’t stop doing something that’s societally acceptable or even lauded, you’re just “passionate”
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nunez 5y ago
I think this viewpoint is really interesting, especially when one considers how massively incentivized this addiction is (by way of high-paying jobs with generally-great benefits and working environments).
empthought 5y ago
Science and the Compulsive Programmer (1976) https://www.sac.edu/AcademicProgs/Business/ComputerScience/Pages/Hester_James/HACKER.htm https://www.sac.edu/AcademicProgs/Business/ComputerScience/P...

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andrewmcwatters 5y ago

> Addiction can be defined as a persistent, compulsive need to use a substance, despite the negative consequences to you or others. This is a really poor definition, because you can be addicted to things that have no negative consequences to you, and you still don't want to do them. "An inability to stop" is probably more succinct.

pdenton 5y ago

The worst of the bunch is tobacco. The effect is basically nothing, but it hurts ones health and wallet. I've done cocaine, marijuana, mdma, speed, xtc pills, and some research chemicals. Protips: don't smoke, and never combine any two drugs. If you really want a certain substance, do at least the first session with someone sober to keep an eye on you. Never accept drugs from strangers and don't give in to peer pressure (which can be pretty tough at times when self-confidence is lacking).

psyclobe 5y ago
Vaping is worse. Wrapped in a nebulous belief that it is probably a lot safer then the leaf form, it is mighty hard to give up. Mostly because you can vape anywhere and everywhere, constantly, making your body expect dopamine 24/7.
sjcoles 5y ago
Nicotine is a useful tool though. The latest round of tobacco free pouches are great and reduce risk to basically zero.
- mrtranscendence 5y ago
  A useful tool for what? I haven't used nicotine in a long time, but from what I recall the impact was basically zero unless I hadn't smoked in a while.
  - deleted 5y ago
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  - sjcoles 5y ago
    It's a stimulant. It helps me concentrate and seems to help my working memory (which is already poor due to ADHD).
wpietri 5y ago
For some costumes, I have held an unlit cigar in my teeth. The effect for me is noticeable and strong, like caffeine but more so. I really liked it! Which is why I will never take up regular use of it.

temp0826 5y ago

I serve Kambo (which is the poisonous secretion derived from a particular Amazonian tree frog) to people. It has been my savior for breaking out of addictive patterns. It's definitely not for everyone (not just considering the contraindications; it's an extremely rough experience in general). It can feel like a physiological and psychological "reset" (note, only speaking anecdotally as there is not a lot of proper research around it). Quite a breath of fresh air after being in a rut or just looking to make changes in your life.

mikepurvis 5y ago
Looks like a bit of a mixed bag: https://en.wikipedia.org/wiki/Kambo_cleanse https://en.wikipedia.org/wiki/Kambo_cleanse
- temp0826 5y ago
  Yah... I won't try to paint a pretty picture of it, but that article (as well as any other "alternative treatment" on wikipedia) portrays it pretty negatively. There definitely have been a couple of studies and papers (on both kambo and on some of the individual constituent peptides in the secretion), but the article states otherwise. In the traditional context, Kambo wouldn't ever be called a "cleanse". Traditionally, it's used by a few Amazonian tribes to remove what they call "panema" (which is essentially bad luck, mostly in regards to hunting. Not being able to bring back food has consequences for the community), to increase strength and stamina, and as sort of a "vaccine" (immunity booster). The "removal of toxins" or whatever is a hard western woo spin on it.

dasKrokodil 5y ago

Funny how they keep writing 'drugs OR alcohol'

openknot 5y ago
Sounds like the inclusive or [0] from the context. [0] https://english.stackexchange.com/questions/63998/inclusive-or-in-speech https://english.stackexchange.com/questions/63998/inclusive-...
bananamerica 5y ago
Many readers will not include alcohol in the group drugs, so it needs to be mentioned explicitly, even though it actually is part of the "drugs" group.

jagger1345 5y ago

It doesn't always get a ton of notice when addiction is brought up but addiction to anabolics is an interesting phenomena in itself. I started using anabolics years ago and slowly added more compounds over time. It eventually got to the point where I started to experience increasingly negative sides that I had trouble managing so would add further pharmaceuticals to the stack to mitigate the side effects of the anabolics. What is interesting about anabolic use is that if abused for long enough or heavily enough (blast and cruise) going back to a state of non anabolics is actually difficult and can come with months/years of hormone / neurosteroid deficiency as you attempt to restart your HPTA. This is why most people are on replacement doses of testosterone for life after dabbling in this area which is interesting in terms of your typical reformed addict = quitting sense.

shard 5y ago
To save someone else a search, HPTA is, according to Wikipedia: The hypothalamic–pituitary–gonadal axis (HPG axis) refers to the hypothalamus, pituitary gland, and gonadal glands as if these individual endocrine glands were a single entity. Because these glands often act in concert, physiologists and endocrinologists find it convenient and descriptive to speak of them as a single system.

drewcoo 5y ago

Step 1: Self-Diagnosis! Somehow that doesn't seem like something a credible psychologist would say. And a skim through their other stories is in the same vein.

kosyblysk2 5y ago

admit powerlessness over your addiction and start reflecting upon yourself (shadow/feelings(anima)/etc) ...the wound is the cure

laurex 5y ago

I have more than a passing interest in neuroscience and psychology and I’m still on the fence a bit but truthfully I do think most descriptions of addiction make my relationship with my phone at least in the realm of applying the addict label. There’s the idea in neuroscience of not liking a behavior but still doing it compulsively with a unconscious hope of repeating a high that becomes harder and harder to access as tolerance builds up. I find myself with my phone in my hand as though by magic sometimes. And yes, I’m writing my comment on my phone right now.

buscoquadnary 5y ago
Honestly I am at that state right now with HN and Reddit.
silicon2401 5y ago
personally I think everyone's addicted to their phones, or at best has a horrible habit of being on their phones. I used to be the standard modern person, phone always in hand and finding something to do. Over the years I put in work to change that, and now I generally go to my phone if I need it, rather than being on it by default and finding something to do with it. It's incredibly liberating. IMO The experience of using a phone is incredibly cheap and shallow compared to almost anything else you can do, even watching the same videos but on a proper tv or monitor.

blobbers 5y ago

"Addiction can be defined as a persistent, compulsive need to use a substance, despite the negative consequences to you or others." What about things that are beneficial but unclear if they're healthy? Staying up late on the computer but then taking a sedative to fall asleep immediately so that you don't spend an hour staring at the ceiling. You get more sleep, but you're probably addicted to the sleeping pills. Without them, you don't get enough rest.

openknot 5y ago
Sleeping pills may be better than getting no sleep at all, but cognitive behavioural therapy for insomnia (CBTi) may be a better treatment approach than medication [0]. A problem with sleeping pills is that they reduce sleep quality, so you aren't as well-rested versus sleeping without them. From an interview with Matthew Walker, a professor of neuroscience and psychology [1]: "The quality of sleep that you have when you’re on these drugs is not the same as normal, naturalistic sleep. They’re classified as “sedative hypnotics,” so the drugs actually just sedate you — and sedation is not sleep." [...] "They don’t tend to increase sleep much beyond placebos. People may be fooled into thinking that they’re getting more sleep, but actually they’re not. This was not my conclusion — it was a committee of experts, who reviewed 65 separate drug placebo studies, and their conclusion was simple: There was no objective benefit of sleeping pills beyond placebo. Their summary was that the impact of sleeping pills was small, and of questionable clinical importance. "And my third problem: They are associated with a higher risk of death and cancer. "About that last point, in your book you do raise the possibility that it’s not sleeping pills that’s causing those things — it’s whatever is causing you to have trouble sleeping, which weakens your immune system. "Yeah, I think that would be the counterargument, and I think it’s a very reasonable one at this stage. But I think an equally reasonable, equally tenable explanation is that they do shorten your life and increase your risk of cancer. The answer is we just don’t know which of those two things it is.” [0] https://aims.uw.edu/nyscc/training/sites/default/files/CBTi%20Manual.pdf https://aims.uw.edu/nyscc/training/sites/default/files/CBTi%... [1] https://www.thecut.com/2017/10/the-vicious-cycle-of-insomnia-and-sleeping-pills.html https://www.thecut.com/2017/10/the-vicious-cycle-of-insomnia...
- 5y ago

oceanplexian 5y ago

It’s a lot harder than you would think. I’m not a big drinker, not even a daily drinker, maybe once or twice per week.. and decided to do a month without drinking for fitness reasons. After two weeks it was hard to resist the urge every time I’d see people drinking on a TV show, or at the airport, or with dinner at a restaurant. While it may not be a full blown addiction it made me realize I’m much closer to addiction than I’d like to admit.

kolla 5y ago
Same here, I'm probably considered an alcoholic because of the ammount of liquour I drink per week/month but I can work out every single day and stay in great shape but come friday and saturday I do empty quite a few units. Stopping the weekend urge is hard.
- at-fates-hands 5y ago
  Anecdotal evidence so take this as you will. I have alcoholism in my family. When my Dad finally went into a 30 day in-patient treatment, I was still a sophomore in college. I was very much like you. An athlete (played D3 soccer), so I was working out, and in great shape, but wouldn't touch alcohol during the week - when I first got to college, my drinking was all done on the weekends. Then when I was of legal drinking age (US 21 years) then it started to creep into Thursday, then eventually I was drinking Wed-Sat, drying out Sunday and then cramming all my homework and studying into three days just to get ready for the weekend again. One of the things they do is a screening. You fill out a long survey - How do you drink, when you drink? When do you drink? How often are you drinking, etc. I fill it out based on my current activity. Counselor sits me down, and starts telling me that I'm not an alcoholic YET, but I'm clearly heading that way. I do abuse alcohol on a regular basis and these are the behaviors they look for and she basically told me if I continue doing what I doing? I will be there in a few years. I was 22 or 23 at the time. I kind of shrugged it off. Dad continued in and out of rehab while I continued doing what I was doing. Then the wheels fell off for my Dad. Like really bad. Disappeared for a week, Mom couldn't find him, started getting worried. Found him in a shady hotel on the edge of town. He was trying to drink himself to death. We got there, got him into the psych ward and they forcibly detoxified him. He was basically under medical house arrest until he sobered up and vowed this was indeed the end. I finally had a front row seat to see what my future was. My mom pulled me aside that Christmas in the midst of our entire extended family at my parents house celebrating. She grabs my arm and pulls me into a room, looks me dead in the eyes and says, "If you want to put someone you love through what your father just put our family through these last two years? Then keep drinking, keep partying and doing whatever you're doing." and then just walked away from me. That was pretty much it. I decided a few weeks later to put a cap on it, I had a good run, but gambling with my future like that? No thanks. Been sober 14 years. Sure I have a beer here and there, but its only one (I'm a total lightweight now, so its no fun) and then that's it. And I never judge the people I'm around if they want to drink. I would tell you what the nurse told me. It sounds like you do abuse alcohol, and you're heading down that road. Is your future predetermined? I don't think so, but it took a litany of close calls and the one major episode with my Dad to make me realize what was happening and change course before it was too late.

MeinBlutIstBlau 5y ago

standardUser 5y ago

The most important thing for people to understand is that everyone is different, and different people can have very different experiences with the exact same substance. Some people can smoke cigarettes on the weekend for years and never get addicted, which sounds insane to someone like me who couldn't go for more than a hour without a cigarette for twenty years and went through hell for 6 months to finally quit. But I can binge cocaine for weeks on end (in college it was meth) and then stop when I get bored (or my nose hurts) and suffer no withdrawal beyond occasional thoughts of "it would be nice to get high!". Yet other people end up in rehab for using far less than I have. I drink absurd amounts of caffeine every day and will get a mild headache sometimes if I skip it, and I thought this was normal until a friend quit caffeine and described it the way I would describe quitting nicotine! It's all over the map. Wild variation is the norm, but a lot of our public health messaging and "conventional wisdom" ignores this entirely.

simon1ltd 5y ago
I just had a discussion with a friend about this last week. Some people (we call it addictive personalities, not sure if there’s a better term) seem to get hooked almost right away. Others, can stop whenever they want with little trouble. The problem is that you don’t know which of those possibilities applies to you without trying it, and then it’s too late. Since my immediate family members have had issues with substances, I assume I would be one of the people with a problem. That’s the message I’m trying to pass along to the next generation too. You might not have a problem, but you won’t know if you do until it’s too late. YMMV
- standardUser 5y ago
  There's even hard data on this with regards to alcohol and cocaine that show that some people are predisposed to have a higher risk of addiction. With alcohol we know it's at least partially hereditary, so people with histories of alcohol abuse in their families are often told to be extra careful. I would love to see more research on this and even the ability to give individuals info on their own risk levels. The only thing that seems to be near-universally dangerous in terms of addiction are opioids. But even still, most people who try heroin or get prescribed oxycodone never become addicted.

kaycebasques 5y ago

Just started Urge: Our History Of Addiction yesterday! I am doing a sober February this month as an exercise in contemplating my own addictions and for the pure sake of challenge. No beer, no marijuana, etc. Not even caffeine! Caffeine is much harder for me than any other.

MandieD 5y ago
I give up alcohol for Lent every year. I tried giving up caffeine one year instead. I broke down after a week and went back to giving up alcohol instead.

entropicgravity 5y ago

Somewhere I read that an alcoholic was someone who always remembers their last drink whether it was an hour ago or a decade ago.

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nyc111 5y ago

Nice article but who is "you" here? It's very difficult to define who is addicted. In the case of sugar addiction, it is the sugar loving microorganisms that live inside the body. It is not the conscious mind who is addicted. And these microorganisms can control the behavior of the host, that is, the body, like making you go to where sweets are sold without you knowing it. I don't know how but these organisms have direct access to the motor nerveous system and can do things and make decisions without (or before) conscious mind realizes it. So the way we become aware of the hot surface we touched accidentally only after we retract our arm, we become aware of some decisions only after executing them to satisfy the desires of the microorganisms, our symbionts. So I'm sure addiction is not a mind issue but a gut issue.