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I provided the definition, and I also provided a paper by professors of psychiatry and neuroscience that point out the critical parts of the definition. All ex

I provided the definition, and I also provided a paper by professors of psychiatry and neuroscience that point out the critical parts of the definition. All except one (and even that one is arguable) take the user's state of mind and perception about their own life into account, and their lack of control. The practitioners even mention this in the abstract of that paper: > A definitive diagnosis entails confirming the presence of addictive behavior by identifying a preoccupation, compulsivity and relapse relative to the drug Preoccupation is a lack of control. Compulsivity(sic) is a lack of control. Relapse is a lack of control. In fact, the authors of that paper wrote a book about alcohol abuse[1] that is littered with quotes about control, like “These criteria reflect the loss of control over alcohol that is central to the diagnosis of alcoholism” or “The loss of control over the self and the alcoholic is present in the enabler as it is present in the alcoholic”, or my favourite: > The behavioral criteria describe the loss of control over alcohol that leads to the adverse consequences As to this claim by you: > Even if a doctor thinks you're capable of controlling your diet, it doesn't make their clinical diagnosis of obesity go away" They're not (or haven't been) capable of controlling their diet, that's why they're obese, and that's why they're getting help from a professional, but regardless, you've chosen a poor analogy. Someone with an addiction to eating or sugar would be much better, as obesity is a consequence of their actions, just as "Not managing to do what you should at work, home, or school because of substance use" would be an possible consequence of marijuana dependency. [1] https://books.google.com.au/books?id=NrHzBwAAQBAJ&q=control#v=snippet&q=control&f=false https://books.google.com.au/books?id=NrHzBwAAQBAJ&q=control#...

bumby 4y ago
I think you are just confirming my suspicion about arguing for its own sake. >I provided the definition, and I also provided a paper Yes, but did you notice that the paper you cited is from 1989? And that I cited the more modern DSM V, which did not exist when that paper was published? Also note that you keep using the term "dependence" and I'm using "substance use". This is because the terminology was deliberately changed in the DSM V. It was updated to combine both "use" and "dependence" and merged them into a the category of "substance use". This includes the criteria that are not specifically related to the locus of control. This is what I mean about drawing strong conclusions from a paper when you don't know the fuller context. I don't think you're understanding my point about control so I'll try one last time. I've already agreed that control is part of the definition; so I don't think we disagree there. But I am saying the definition goes beyond just the idea of control. I get the impression you also agree here because you’re couching your statements to now include the “critical” (I.e., non-exhaustive) elements. It's possible to have the capability of control, but not exercise that control or not have the other elements to get a specific outcome. That doesn't make the clinical diagnosis go away. Keeping with the obesity analogy, consider a sumo wrestler who is, by clinical definition, morbidly obese. They could very well have phenomenal willpower to control their diet, but choose not to because their chosen profession gets a benefit from being larger than their opponent. In some sense, they choose to be obese. A clinician will still say they have an obesity problem. (It seems like you're assuming that, by the nature of their diagnosis, they are trying to fix it. i.e. 'trying to get help from a doctor'. That's assumption is not included in the distinction I'm making.) Now transfer that to an addict. Many choose to chase a high at the cost of their family, career, and/or health. To them, it's a worthy tradeoff. And the way substances affect/change the manner that we decide those tradeoffs is very real. Even if they could stop cold-turkey, they still have a clinical substance abuse problem. Your assumption is that they want to stop because of those ramifications and can't. I'm saying that they may not want to stop. They're still addicts. That's the pernicious part of your definition; just because they're doing it willfully doesn't make the problem go away any more than legalizing drugs makes society's drug problems magically go away.
- brigandish 4y ago
  > I think you are just confirming my suspicion about arguing for its own sake. That would be very convenient for you so I'm glad I could help, I'd hate for you to challenge your preconceptions. I certainly wouldn't be able to think the same in return. How could it be so! As to your next paragraph about the DSM where you've criticised the cited paper yet ignored the provision of the actual DSM-5 criteria in the following comment. The updates you point to were made to improve the capture of abuse in the diagnostic criteria, and that does not downplay the control aspect or go beyond it (or whatever strange angle you wish to provide). The idea that dependence does factor in control but abuse doesn't is absurd. > This includes the criteria that are not specifically related to the locus of control There are no criteria that do not relate to control. > I don't think you're understanding my point about control so I'll try one last time. Again, so convenient, but I'm very happy to see the words one last time, we'll see if your self control reaches that far. > I get the impression you also agree here because you’re couching your statements to now include the “critical” (I.e., non-exhaustive) elements Is that your impression? I'm amazed at how all of these insights into my intentions always align with your convenience. Funny that! What a run you're on. Regardless, I started with the critical elements, you brought up the other elements, it makes no difference to my point either way. > It's possible to have the capability of control, Everyone without a pre-existing disorder has the capability of control. > …but not exercise that control So they're not in control then. > That doesn't make the clinical diagnosis go away. It wouldn't, because they're not in control. If they were, they wouldn't have a problem and wouldn't be able to meet any but one - if that - of the criteria on the list. Lack of control is a pre-condition. > Keeping with the obesity analogy, consider a sumo wrestler Here you repeat the faults of the previous attempt at this analogy, it's a restatement that does nothing to fundamentally improve it. > A clinician will still say they have an obesity problem Because obesity is a problem because of its negative health consequences despite any self control. A sumo's job is not affected, it is their job. It doesn't concern legal problems or wanting to stop etc, it concerns known health risks that they are (hopefully) aware of and decide to take on in full control. There's no compulsion from inside or out. An addict is *not in control*. They don't make a trade off as they unable to choose another path, there's no trade going on, hence why the criteria are what they are, and hence your analogy being incredibly poor. Your analogy would hold where someone with a known predisposition to some illness (mental or physical) or who has or had a illness decided to imbibe marijuana and this affect their health, like someone with COPD lighting up. But they wouldn't fulfil the marijuana dependence nor substance abuse criteria, they're in control. They'd still get a clinical diagnosis like that of the sumo but for their COPD, not substance abuse. > Your assumption is that they want to stop because of those ramifications and can't. I'm saying that they may not want to stop. How did you read my mind yet again? You didn't. Their desire to stop or continue are irrelevant, they can't stop. > Even if they could stop cold-turkey, they still have a clinical substance abuse problem They would possibly only fulfil one criteria (cravings and urges to use the substance), so no, they wouldn't. Objectively and according to the DSM, IV or 5. I believe my wish to convenience your faultless mental processes has reached its limit.

bumby 4y ago

I think you are just confirming my suspicion about arguing for its own sake. >I provided the definition, and I also provided a paper Yes, but did you notice that the paper you cited is from 1989? And that I cited the more modern DSM V, which did not exist when that paper was published? Also note that you keep using the term "dependence" and I'm using "substance use". This is because the terminology was deliberately changed in the DSM V. It was updated to combine both "use" and "dependence" and merged them into a the category of "substance use". This includes the criteria that are not specifically related to the locus of control. This is what I mean about drawing strong conclusions from a paper when you don't know the fuller context. I don't think you're understanding my point about control so I'll try one last time. I've already agreed that control is part of the definition; so I don't think we disagree there. But I am saying the definition goes beyond just the idea of control. I get the impression you also agree here because you’re couching your statements to now include the “critical” (I.e., non-exhaustive) elements. It's possible to have the capability of control, but not exercise that control or not have the other elements to get a specific outcome. That doesn't make the clinical diagnosis go away. Keeping with the obesity analogy, consider a sumo wrestler who is, by clinical definition, morbidly obese. They could very well have phenomenal willpower to control their diet, but choose not to because their chosen profession gets a benefit from being larger than their opponent. In some sense, they choose to be obese. A clinician will still say they have an obesity problem. (It seems like you're assuming that, by the nature of their diagnosis, they are trying to fix it. i.e. 'trying to get help from a doctor'. That's assumption is not included in the distinction I'm making.) Now transfer that to an addict. Many choose to chase a high at the cost of their family, career, and/or health. To them, it's a worthy tradeoff. And the way substances affect/change the manner that we decide those tradeoffs is very real. Even if they could stop cold-turkey, they still have a clinical substance abuse problem. Your assumption is that they want to stop because of those ramifications and can't. I'm saying that they may not want to stop. They're still addicts. That's the pernicious part of your definition; just because they're doing it willfully doesn't make the problem go away any more than legalizing drugs makes society's drug problems magically go away.

brigandish 4y ago
> I think you are just confirming my suspicion about arguing for its own sake. That would be very convenient for you so I'm glad I could help, I'd hate for you to challenge your preconceptions. I certainly wouldn't be able to think the same in return. How could it be so! As to your next paragraph about the DSM where you've criticised the cited paper yet ignored the provision of the actual DSM-5 criteria in the following comment. The updates you point to were made to improve the capture of abuse in the diagnostic criteria, and that does not downplay the control aspect or go beyond it (or whatever strange angle you wish to provide). The idea that dependence does factor in control but abuse doesn't is absurd. > This includes the criteria that are not specifically related to the locus of control There are no criteria that do not relate to control. > I don't think you're understanding my point about control so I'll try one last time. Again, so convenient, but I'm very happy to see the words one last time, we'll see if your self control reaches that far. > I get the impression you also agree here because you’re couching your statements to now include the “critical” (I.e., non-exhaustive) elements Is that your impression? I'm amazed at how all of these insights into my intentions always align with your convenience. Funny that! What a run you're on. Regardless, I started with the critical elements, you brought up the other elements, it makes no difference to my point either way. > It's possible to have the capability of control, Everyone without a pre-existing disorder has the capability of control. > …but not exercise that control So they're not in control then. > That doesn't make the clinical diagnosis go away. It wouldn't, because they're not in control. If they were, they wouldn't have a problem and wouldn't be able to meet any but one - if that - of the criteria on the list. Lack of control is a pre-condition. > Keeping with the obesity analogy, consider a sumo wrestler Here you repeat the faults of the previous attempt at this analogy, it's a restatement that does nothing to fundamentally improve it. > A clinician will still say they have an obesity problem Because obesity is a problem because of its negative health consequences despite any self control. A sumo's job is not affected, it is their job. It doesn't concern legal problems or wanting to stop etc, it concerns known health risks that they are (hopefully) aware of and decide to take on in full control. There's no compulsion from inside or out. An addict is *not in control*. They don't make a trade off as they unable to choose another path, there's no trade going on, hence why the criteria are what they are, and hence your analogy being incredibly poor. Your analogy would hold where someone with a known predisposition to some illness (mental or physical) or who has or had a illness decided to imbibe marijuana and this affect their health, like someone with COPD lighting up. But they wouldn't fulfil the marijuana dependence nor substance abuse criteria, they're in control. They'd still get a clinical diagnosis like that of the sumo but for their COPD, not substance abuse. > Your assumption is that they want to stop because of those ramifications and can't. I'm saying that they may not want to stop. How did you read my mind yet again? You didn't. Their desire to stop or continue are irrelevant, they can't stop. > Even if they could stop cold-turkey, they still have a clinical substance abuse problem They would possibly only fulfil one criteria (cravings and urges to use the substance), so no, they wouldn't. Objectively and according to the DSM, IV or 5. I believe my wish to convenience your faultless mental processes has reached its limit.