6 ms·

Its fucking wild that folks are advocating shame as a method for dealing with drug addiction in the year 2023. As if shame isn't one of the major contributing f

Its fucking wild that folks are advocating shame as a method for dealing with drug addiction in the year 2023. As if shame isn't one of the major contributing factors to the crippling opioid crisis to begin with. An astonishingly large number of people got hooked on legal prescription drugs which were pushed by billion-dollar pharma companies and the medical profession as a whole. Shame is what drives people away from admitting their addiction and seeking treatment towards illegal means of procuring a fix. The mind boggles at just how phenomenally stupid this thread is.

afpx 3y ago
Yeah, this shame angle is offensive. My 80 year mom, who was strongly against drugs, died an addict because the pharm industry got her hooked on pain killers. Because of shame, her kids didn’t even know until she was an addict until she was almost dead.
- cududa 3y ago
  This is shockingly common in the aging population, and no one really thinks to look at Grandma baking cookies as a potential addict quietly suffering
  - godelski 3y ago
    Ironically the shame is what hides this too. The Grandma trying to hide her shameful addiction. The part of her family that takes care of her shamefully hiding it from the rest of the family, for fear that they would not be seen as good care takers despite doing their best. The shame of the others that see it but pretend they don't, because they themselves don't want to admit that grandma is an addict. Justifying it away. No, the junkies on the street are different, they chose that life, but grandma is a victim. While yes, there can be people who made those poor choices, if grandma is a victim, then why should it surprise anyone that there are others. Others who are less fortunate, who's children aren't as responsible and loving as you. My mom died of cancer in her 40's. My mom also died an addict. Two of her sisters also had cancer, found because of her diagnosis. Both became addicts as well. I don't see how they couldn't have. Chemo is rough. It is a long and painful treatment that we _should_ be giving painkillers to those receiving it. But it is shame that makes it difficult for people to get treatment. It is shame that prevents people from even admitting they need treatment in the first place. The hard truth is that grandma is an addict and she needs to be unashamed of going to the methadone clinic.
    - cududa 3y ago
      Precisely. I grew up in an odd town on Lake Erie. On the coast there were the Cleveland Clinic millionaire surgeons, NFL, MLB, and NBA players. On the west side of town a Ford plant and some low income housing, same income and housing on the east side. Middle bit was mostly solid middle class with a couple small higher income enclaves (CEO of a Berkshire Hathaway division, for instance). So it was truly, truly all income levels interacting in our public schools (which are pretty highly rated). I graduated in 2009. Close to 10% of my graduating class (~400), all income levels, died of opioid overdoses or suicide. The shame of talking about our town's problem and wanting keep up appearances killed scores of people. BBC did a documentary on our town, called Smack in Suburbia, focussed on my age group. 30 minute watch, but, it really drives this point home https://www.youtube.com/watch?v=j7ynJ5S9c58 https://www.youtube.com/watch?v=j7ynJ5S9c58 All of this tragedy was the direct consequence of shame as public health policy.
- K0balt 3y ago
  I’m really sorry about your mom. Your story is a good example of how shame can be harmful, it may have kept her from seeking help. That is certainly a negative effect of shame as a behaviour moderating factor, and I’m sorry that it affected your family in the way that it did. I think your response is the only valid counterpoint I’ve seen here, since most people seem to think I was talking about shaming people or that shame would somehow prevent addiction… none of that was my point. But your story is a good example of how exactly what I was talking about can also have harmful effects, and that is an excellent point. People should never be led to believe that seeking help is shameful.
alienbeast 3y ago
For an example of how shame can be useful in discouraging bad choices, look at cigarettes. They're legal, but society and government have successfully campaigned to publicize their negative effects, to shame smokers and to praise quitters.
- mzmzmzm 3y ago
  I don't think it's been empirically demonstrated that shame-based public information campaigns contributed to the drop in smoking as much as tax increases, bans in restaurants and other semi-public spaces, and changing preferences (eg, adoption of ecigs and marijuana products). At least for personal health risks like drug addiction or obesity, pretty big mounds of evidence do exist that shame is mostly ineffective for changing behavior. Here's one analysis for example: https://www.sciencedirect.com/science/article/pii/S0272735818303167 https://www.sciencedirect.com/science/article/pii/S027273581...
  - godelski 3y ago
    What? You're telling me that you're denying the overwhelming evidence of the success of Nancy Regan's Dare program!? It's overwhelmingly uncommon to see anyone smoking weed, which we know is just a gateway drug to harder things like crack and heroin. Gen Xers and Millennials, who grew up under this program, are overwhelmingly known to be anti-pot and similarly just last week HN cheered about MasterCard's decision to deny service to dispensaries, which are also uncommon and no state would legally allow them. Similarly, you don't see the overwhelming evidence of abstinence based contraception? I mean how many Catholic girls get pregnant? Who needs a coat hanger abortion when you have Jesus? There is undeniable evidence that shame, fear based education, and harsh punishments stop these kinds of immoral behavior. (If for one moment anyone thinks I needed to add a sarcasm tag, please reevaluate your perception of the world. This is as obvious as it gets)
- 542354234235 3y ago
  It wasn't shame. It was age restrictions, banning smoking in most public spaces, addiction acknowledgement and smoking cessation resources, public health awareness campaigns, and increased taxation. "Shaming" smokers was just the cultural byproduct in the change in smoking, and arguably a negative one.
godelski 3y ago
> Its fucking wild that folks are advocating shame as a method for dealing with drug addiction in the year 2023. It's also extremely divorced from reality. Even if you've never met an addict and seen how many want to get off the drugs (maybe you've met someone who is addicted to something else, like food, alcohol, or bad habits), but that the very fact that people don't flaunt it is proof of that shame. Now maybe some are unabashed now, especially in big cities, but similarly if you call someone "a fatty" enough they'll either: fix themselves (lol), hide their eating while trying to show effort or justify their weight, or just stop giving a fuck. > people got hooked on legal prescription drugs I want to address this, not because I think you're making this argument (your wording suggests not), but because it can be common. Many people set up the situation as if there are one of two directional graphs. Drugs -> homelessness or homelessness -> drugs (with variations on paths and some other nodes). But the effect in reality is coupled. Both can be true. It's a clique to drink your sorrows away and everyone knows the call of a stiff drink after a hard breakup or the call to eat a tub of ice cream. Of course losing your livelihood and having difficulties putting it back together can lead to that kind of addiction. But similarly we've seen people go off the deepend and take a bender too far, so of course that can lead to losing your livelihood. Most things in the world are not DAGs. There's lots of complex and coupled phenomena with feedback loops and many paths to reach certain steady state solutions. The danger is oversimplifying it and pretending these are trivial to avoid or trivial to escape. But the nature of their existence is proof of the lack of triviality, while a single counter example is not proof that they are. Similarly it boggles my mind that a comment about shame is the solution. As if the Victorian times were well known for their safety and high prosperity. As if highly religious cultures have demonstrated exceptional prosperity (Christian, Muslim, Hindu, or whatever). That we're seeing similar comments about punishment, as if North Korea, Russia, and Iran are pinnacles of prosperity, wealth, and morality. How people are unabashedly hand waving away any nuance and pretending that the solutions are simple. But if they were then the examples before would be utopias, and that we'd speak of the many historical draconian eras in high regard.
K0balt 3y ago
Fwiw I actually wasn’t trying to advocate shaming people as a solution to drug addiction. At all. I’m not even addressing addiction, but rather the socially disruptive manifestations of drug addiction related activities that are becoming increasingly common, especially in the United States. Obviously my (now suppressed) comment was poorly written if it gave that impression. I was suggesting rather that the disruptive social circumstances that we are seeing in the USA surrounding drug addiction are partly a result of people not feeling that they need to keep disruptive behaviours to a minimum out of a sense of personal discretion. I have lived all over the world, and in many areas with serious addiction problems, but the kind of overt behaviour common in the last decade in the USA is uncommon in most of those cultures, and i posit that is a direct extension of the addicts themselves retaining a sense of personal dignity. The idea of personal dignity and it’s corollary, shame, seems to be conspicuously missing in the subcultures where these kind of problems are recently erupting compared to subcultures with similar base problems where the public presentation tends to be more benign. But that is just my empirical observation from living amongst different peoples and cultures. Furthermore, I think that replacing personal standards and self moderation with stronger regulations and reductions of civil liberties is a dangerous path that can jeopardise the functioning of a healthy democratic society. In summary, I see shame ( not being shamed by others, but rather feeling shame in oneself) is an undervalued component in the moderation of behaviour and has utility that we ignore at our peril. Some commenters have pointed out that shame sometimes prevents people from seeking help for addiction or other circumstances. I think that is an excellent example of where a usually useful thing can sometimes be tragically harmful. It’s an excellent counterpoint, though I never meant to suggest that shame was universally a good thing, only that it is often a useful thing. It’s definitely worth mentioning though, since my examples do tend towards being unreasonably rosy in that regard. Personally, I strive to be able to look back at my actions and words of 5 years ago and feel a deep sense of shame- this is an indication that I have grown as a person and have transcended behaviour that I earlier would have thought of as being nominal. That’s just one example of how I find shame to be useful in my own growth.

afpx 3y ago

Yeah, this shame angle is offensive. My 80 year mom, who was strongly against drugs, died an addict because the pharm industry got her hooked on pain killers. Because of shame, her kids didn’t even know until she was an addict until she was almost dead.

cududa 3y ago
This is shockingly common in the aging population, and no one really thinks to look at Grandma baking cookies as a potential addict quietly suffering
- godelski 3y ago
  Ironically the shame is what hides this too. The Grandma trying to hide her shameful addiction. The part of her family that takes care of her shamefully hiding it from the rest of the family, for fear that they would not be seen as good care takers despite doing their best. The shame of the others that see it but pretend they don't, because they themselves don't want to admit that grandma is an addict. Justifying it away. No, the junkies on the street are different, they chose that life, but grandma is a victim. While yes, there can be people who made those poor choices, if grandma is a victim, then why should it surprise anyone that there are others. Others who are less fortunate, who's children aren't as responsible and loving as you. My mom died of cancer in her 40's. My mom also died an addict. Two of her sisters also had cancer, found because of her diagnosis. Both became addicts as well. I don't see how they couldn't have. Chemo is rough. It is a long and painful treatment that we _should_ be giving painkillers to those receiving it. But it is shame that makes it difficult for people to get treatment. It is shame that prevents people from even admitting they need treatment in the first place. The hard truth is that grandma is an addict and she needs to be unashamed of going to the methadone clinic.
  - cududa 3y ago
    Precisely. I grew up in an odd town on Lake Erie. On the coast there were the Cleveland Clinic millionaire surgeons, NFL, MLB, and NBA players. On the west side of town a Ford plant and some low income housing, same income and housing on the east side. Middle bit was mostly solid middle class with a couple small higher income enclaves (CEO of a Berkshire Hathaway division, for instance). So it was truly, truly all income levels interacting in our public schools (which are pretty highly rated). I graduated in 2009. Close to 10% of my graduating class (~400), all income levels, died of opioid overdoses or suicide. The shame of talking about our town's problem and wanting keep up appearances killed scores of people. BBC did a documentary on our town, called Smack in Suburbia, focussed on my age group. 30 minute watch, but, it really drives this point home https://www.youtube.com/watch?v=j7ynJ5S9c58 https://www.youtube.com/watch?v=j7ynJ5S9c58 All of this tragedy was the direct consequence of shame as public health policy.
K0balt 3y ago
I’m really sorry about your mom. Your story is a good example of how shame can be harmful, it may have kept her from seeking help. That is certainly a negative effect of shame as a behaviour moderating factor, and I’m sorry that it affected your family in the way that it did. I think your response is the only valid counterpoint I’ve seen here, since most people seem to think I was talking about shaming people or that shame would somehow prevent addiction… none of that was my point. But your story is a good example of how exactly what I was talking about can also have harmful effects, and that is an excellent point. People should never be led to believe that seeking help is shameful.

alienbeast 3y ago

For an example of how shame can be useful in discouraging bad choices, look at cigarettes. They're legal, but society and government have successfully campaigned to publicize their negative effects, to shame smokers and to praise quitters.

mzmzmzm 3y ago
I don't think it's been empirically demonstrated that shame-based public information campaigns contributed to the drop in smoking as much as tax increases, bans in restaurants and other semi-public spaces, and changing preferences (eg, adoption of ecigs and marijuana products). At least for personal health risks like drug addiction or obesity, pretty big mounds of evidence do exist that shame is mostly ineffective for changing behavior. Here's one analysis for example: https://www.sciencedirect.com/science/article/pii/S0272735818303167 https://www.sciencedirect.com/science/article/pii/S027273581...
- godelski 3y ago
  What? You're telling me that you're denying the overwhelming evidence of the success of Nancy Regan's Dare program!? It's overwhelmingly uncommon to see anyone smoking weed, which we know is just a gateway drug to harder things like crack and heroin. Gen Xers and Millennials, who grew up under this program, are overwhelmingly known to be anti-pot and similarly just last week HN cheered about MasterCard's decision to deny service to dispensaries, which are also uncommon and no state would legally allow them. Similarly, you don't see the overwhelming evidence of abstinence based contraception? I mean how many Catholic girls get pregnant? Who needs a coat hanger abortion when you have Jesus? There is undeniable evidence that shame, fear based education, and harsh punishments stop these kinds of immoral behavior. (If for one moment anyone thinks I needed to add a sarcasm tag, please reevaluate your perception of the world. This is as obvious as it gets)
542354234235 3y ago
It wasn't shame. It was age restrictions, banning smoking in most public spaces, addiction acknowledgement and smoking cessation resources, public health awareness campaigns, and increased taxation. "Shaming" smokers was just the cultural byproduct in the change in smoking, and arguably a negative one.

godelski 3y ago

> Its fucking wild that folks are advocating shame as a method for dealing with drug addiction in the year 2023. It's also extremely divorced from reality. Even if you've never met an addict and seen how many want to get off the drugs (maybe you've met someone who is addicted to something else, like food, alcohol, or bad habits), but that the very fact that people don't flaunt it is proof of that shame. Now maybe some are unabashed now, especially in big cities, but similarly if you call someone "a fatty" enough they'll either: fix themselves (lol), hide their eating while trying to show effort or justify their weight, or just stop giving a fuck. > people got hooked on legal prescription drugs I want to address this, not because I think you're making this argument (your wording suggests not), but because it can be common. Many people set up the situation as if there are one of two directional graphs. Drugs -> homelessness or homelessness -> drugs (with variations on paths and some other nodes). But the effect in reality is coupled. Both can be true. It's a clique to drink your sorrows away and everyone knows the call of a stiff drink after a hard breakup or the call to eat a tub of ice cream. Of course losing your livelihood and having difficulties putting it back together can lead to that kind of addiction. But similarly we've seen people go off the deepend and take a bender too far, so of course that can lead to losing your livelihood. Most things in the world are not DAGs. There's lots of complex and coupled phenomena with feedback loops and many paths to reach certain steady state solutions. The danger is oversimplifying it and pretending these are trivial to avoid or trivial to escape. But the nature of their existence is proof of the lack of triviality, while a single counter example is not proof that they are. Similarly it boggles my mind that a comment about shame is the solution. As if the Victorian times were well known for their safety and high prosperity. As if highly religious cultures have demonstrated exceptional prosperity (Christian, Muslim, Hindu, or whatever). That we're seeing similar comments about punishment, as if North Korea, Russia, and Iran are pinnacles of prosperity, wealth, and morality. How people are unabashedly hand waving away any nuance and pretending that the solutions are simple. But if they were then the examples before would be utopias, and that we'd speak of the many historical draconian eras in high regard.

K0balt 3y ago

Fwiw I actually wasn’t trying to advocate shaming people as a solution to drug addiction. At all. I’m not even addressing addiction, but rather the socially disruptive manifestations of drug addiction related activities that are becoming increasingly common, especially in the United States. Obviously my (now suppressed) comment was poorly written if it gave that impression. I was suggesting rather that the disruptive social circumstances that we are seeing in the USA surrounding drug addiction are partly a result of people not feeling that they need to keep disruptive behaviours to a minimum out of a sense of personal discretion. I have lived all over the world, and in many areas with serious addiction problems, but the kind of overt behaviour common in the last decade in the USA is uncommon in most of those cultures, and i posit that is a direct extension of the addicts themselves retaining a sense of personal dignity. The idea of personal dignity and it’s corollary, shame, seems to be conspicuously missing in the subcultures where these kind of problems are recently erupting compared to subcultures with similar base problems where the public presentation tends to be more benign. But that is just my empirical observation from living amongst different peoples and cultures. Furthermore, I think that replacing personal standards and self moderation with stronger regulations and reductions of civil liberties is a dangerous path that can jeopardise the functioning of a healthy democratic society. In summary, I see shame ( not being shamed by others, but rather feeling shame in oneself) is an undervalued component in the moderation of behaviour and has utility that we ignore at our peril. Some commenters have pointed out that shame sometimes prevents people from seeking help for addiction or other circumstances. I think that is an excellent example of where a usually useful thing can sometimes be tragically harmful. It’s an excellent counterpoint, though I never meant to suggest that shame was universally a good thing, only that it is often a useful thing. It’s definitely worth mentioning though, since my examples do tend towards being unreasonably rosy in that regard. Personally, I strive to be able to look back at my actions and words of 5 years ago and feel a deep sense of shame- this is an indication that I have grown as a person and have transcended behaviour that I earlier would have thought of as being nominal. That’s just one example of how I find shame to be useful in my own growth.