17 ms·

Rethinking addiction as a chronic brain disease

66 points by prismatic 2y ago

toomuchtodo 2y ago
Related: The growing scientific case for using Ozempic and other GLP-1s to stop addiction -https://news.ycombinator.com/item?id=40357196 https://news.ycombinator.com/item?id=40357196 https://recursiveadaptation.com/p/the-growing-scientific-case-for-using https://recursiveadaptation.com/p/the-growing-scientific-cas... > The consistency that I'm hearing from all across patient groups is gain of control, whereas previously, there was a loss of control… All of a sudden they're able to step back and say, 'oh, well I had this shopping phenomenon that was going on, gambling, addiction, or alcoholism, and all of a sudden, it just stopped,' - Dr. Gitanjali Srivastava, Vanderbilt Medical Center
- aszantu 2y ago
  Makes sense to me. Im on keto/carnivore, when im strict w no cheating. After about 2 weeks im reorganizing and less interested in videogames. I think, sugar is stressing out the whole system
  - toomuchtodo 2y ago
    Root cause is a hormone imbalance, GLP-1 agonists patch a reward center in the brain (scoped to addiction, whether that be food, drugs, alcohol, gambling, etc). What’s interesting is that we’re about to have a large scale natural experiment around addiction and whether it is chronic due to brain chemistry or more willpower as GLP-1 agonist uptake rate skyrockets in the general population (which should result in addiction reduction at scale).
    - fragmede 2y ago
      It'll certainly affect how society views addiction in general. Most people don't have a good picture of addiction, and don't understand that a drug addict can no more stop doing drugs than you can yell at a cripple to get them to stand up. it's a mental disease, not a moral failing, and as we learn more about the brain, we're going to find out that who we are comes down to just getting lucky with chemistry and physics. The sci-fi future is what if you could go into a clinic and get your personality tuned up. Yes I'd like to add some humor but not sarcasm to my personality. Give me a bit more motivation, and I'd like to like jazz.
- Fluorescence 2y ago
  Fiddling with our "reward centre" does not seem like it can have a localised effect to a couple of unwanted behaviours. I'm not sure we are braced for how widespread or impactful the other consequences might be especially if a vast percentage of the population take them life. For example, could they significantly change voting preference? Why wouldn't they? Do we not respond to political messages with our "reward centre"? Will we find political charisma more or less entrancing? Will we find calls for vengeance and punishment more or less attractive? Does tinkering with desire and reward dull our emotional response? Will we find compassionate appeals to help less fortunate more or less attractive? Does "enhanced control" manifest as a political preference for rational altruism or as machiavellian selfishness?
  - amelius 2y ago
    If taking a substance removes our desire to shop, then I'm sure there are powers in this world that will stop it from happening.
    - hsbauauvhabzb 2y ago
      Illicit drug trade has demonstrated that even long term prohibition does not work.
      - gryfft 2y ago
        Depends on the molecule. Cannabis can be produced by any teenager in a closet with a grow light. Quaaludes on the other hand are now impossible to come by.
        cassianoleal 2y ago
        I imagine the reason for the popularity of Quaaludes was easy access. Remove that, and the myriad other substances available become more attractive, be it MDMA, LSD, magic mushrooms, 2-CB, Ketamine, cocaine, heroin, or a number of others.
        fragmede 2y ago
- delichon 2y ago
  It may be that it flattens all affect rather than addictions in particular. "Ozempic personality" is associated with anhedonia. https://www.healthline.com/health-news/ozempic-personality-change#What-is-Ozempic-personality,-and-is-it-real https://www.healthline.com/health-news/ozempic-personality-c...? I deal with my own addictions but I'm not happy about the prospect of trading them for less joy of life in general. For me Ozempic isn't an option because it's associated with reduced gut motility and I already have serious problems with that.
  - moron4hire 2y ago
    Frankly, I'm enjoying life a hell of a lot more now that my feet, knees, and back aren't killing me all the time. The article you linked actually gets into that, in a quote from a doctor disputing the validity of the concept of "Ozempic personality".
    - Auracle 2y ago
      Right, but we’re talking about people that aren’t necessarily obese using it. That said it’s not like there aren’t widely used drugs that mess with reward centers. Stimulants and antidepressants both come to mind.
    - Workaccount2 2y ago
      I know it's really tired, everyone knows it, and it is repeated constantly: Drugs affect different people in different ways. If 20% of ozempic patients have personality changes, that is very significant. Yet you would still have 80% of users going around saying they never had any issues with it and those who are might just be doing it wrong/misunderstanding/confused etc.
      - amelius 2y ago
        I guess also: a drug might affect the same person in different ways based on different circumstances, age included.
      - fragmede 2y ago
- ta24090811 2y ago
  Personal anectode / not a doctor / YMMV. I started Ozempic about 3 months ago, prescribed by a nutrologist, first with the minimal weekly dose of 0.25mg, then 0.5mg, now back to 0.25mg to control my glucose levels (prediabetes). During this period, I lost about 25 lbs, which is fine (but I lose weight easily, just by exercising, so I wouldn't call this phenomenal by itself). The biggest difference I felt was indeed in gain of control, being more aware of my body and living in the moment. I've been practicing meditation for a long time, and what I can say is that the drug keeps you in a medidative state for longer (most of the week). The result is that I still like fatty foods and sweets, but I don't crave them. Binge eating has stopped, and all addictive/obsessive behavior, including social network / news sites / porn consumption has stopped. I am normaly hyperfocused, but my standard m.o. has been peaks of absurdly high performance interspaced with a hiatus of low productivity/creativity. Right now, the the ability to focus on what I want/need to instead of what serendipity brings my way has been awesome.
  - almost_usual 2y ago
    Curious if you consumed alcohol or any other substance before and if you still do after?
    - ta24090811 2y ago
      Alcohol, socially. Before I'd have 3 or 4 drinks, now it's 1 or 2. Sometimes I don't feel like drinking at all. My perception of some foods is different as well. For instance, as I mentioned, fat still tastes good but doesn't attract me as much any more. Fish otoh tastes much better.
  - 01HNNWZ0MV43FF 2y ago
    Huh. sounds more like an ADHD drug than a weight loss drug. I actually hate eating and routinely have conflicts of "I'm physically hungry but have no appetite". I wonder if Ozempic would make me gain weight.
    - deepfriedchokes 2y ago
reify 2y ago
Its very convenient for big pharma to lump all addictions to a chemical imbalance in the brain. We have been here before with the first wonder drug "Prozac" back in the late 80's. A cure all for everything. yet there was no research to support those chemical imbalance claims. I worked as a methadone dispenser for 15 years and this is not my experience of addiction. There is no chemical or hormonal imbalance when you become addicted to drugs that relieve you from the psychotic hallucinations you experience daily or the young woman who did not know her boyfriend was a heroin addict and started chasing the dragon with him or even the young stressed out mother who's husband has abandined her who has been told by endless TV advertising that a glass of red wine a day is good for you or the young man who has sufferred sexual and psychological abuse as a child who drinks to forget. Wegovy a cure for everything from the flu to cancer.
- navjack27 2y ago
  But everything a living creature does is chemical. Even the process of that young man who has suffered sexual and psychological abuse as a child, that brain that can't stop ruminating can't stop ruminating because of a chemical feedback loop that the brain is doing natively. When my mom got diagnosed with pancreatic stage 4 cancer and I couldn't cope with it and I was already in a drug explorer mindset at the time and I started taking her opioids and I became quite addicted (no she wasn't deprived of any of her medications she was fine). This whole process absolutely was chemical imbalance. Years before in high school I stopped taking all of my ADHD medication and then started spiraling out of control dabbling in all sorts of disassociative and psychedelic drugs. If I didn't stop taking my Adderall in high school I wouldn't have gone down any of that path.
  - threecheese 2y ago
    It has taken me many years to come to that same realization, which many of us must have learned in school bio class. I continually observe the value of attacking life-problems from this perspective -that behavior is a product of chemical signaling and continuous chemical-reinforcement learning, and our decisions are steered by it and not the reverse. I find that my level of empathy has increased, both for others (like the guy that cut me off in traffic) and for myself and my failures. A willpower-based explanation of the self only leads to resentment, “why can’t i just stop behaving this way it is killing me” or “if they loved me they would change”; knowing that we are all literally enslaved to our chemical neuro anatomy allows forgiveness and openness. I don’t mean to imply that will doesn’t exist and isn’t a powerful force, but it’s not the Layer One protocol like some parts of society claim.
brudgers 2y ago
https://archive.ph/HPzNO https://archive.ph/HPzNO
ChrisMarshallNY 2y ago
Yet another attempt to categorize addiction into a simplified form that can be treated with $MY_SOLUTION. Good luck with that.
niemal_dev 2y ago
Big pharma expanding psychiatric propaganda.
ziknard 2y ago
Addiction is a failure of education. If our schools were better, and more honest, we would explain the biology of addiction well enough that no one who understood the lessen would become addicted. The lesson is simply this: Any pleasurable experience results in a normal and natural down-regulation by the body of the receptors that are responsible for that experience. It is impossible to repeat the same dose (whether drug, food, roulette wheel, or skydiving) and have an equally intense experience until enough time has elapsed that the receptors have been up-regulated back to their original levels. The hallmark of addiction, "chasing the dragon", is therefore pointless and quickly becomez harmful. The other important lesson, of course, is that quality control is essential. Variations in the drug (concentration, impurities, improperly attached bungee cords) are solely responsible for the non-dragon-related dangers.
- hsbauauvhabzb 2y ago
  While I agree that education would reduce addiction, it would not cure it as you’ve suggested.
  - deleted 2y ago
    [deleted]
- rco8786 2y ago
  I was taught this in school, as well as all of my classmates. And I, and many of them, have still had struggles.
- iamdbtoo 2y ago
  One of the defining aspects of addiction is the inability to stop doing the harmful act despite knowing it's harmful.
- vaidhy 2y ago
  By this logic, no emotional arguments should work because they are logically incorrect, right? (This is your first point) However, since you seem to like logic, let us take it to the extreme - Can you do anything you like? Because, the thing you like will become your dragon.. (This is your second point) Drug impact variations can also happen because of the state of your body. Hence nothing can be done and should be done (Third point). Now I am wondering if I am responding to a robot :(
tcj_phx 2y ago
When my friend overdosed on heroin she was revived with two doses of naloxone. Her drinking was under control for about 2 weeks. Naltrexone is very similar to Naloxone, and is FDA-approved to help people with opioids and alcohol use. https://en.wikipedia.org/wiki/Naltrexone https://en.wikipedia.org/wiki/Naltrexone The Sinclair Method uses naltrexone to help people get their alcohol use under control: Naltrexone is at the heart of the Sinclair Method (TSM) for Alcoholism. When you take Naltrexone prior to drinking, it blocks endorphins, the naturally occurring opiates in the brain, from being released when alcohol is consumed. When the endorphins are blocked, there is no “buzz” or rewarding experience, and the alcohol doesn’t make you feel the pleasure that drives you to drink excessively. Over time, your brain learns not to associate alcohol with pleasure, resulting in reduced cravings and improved control over alcohol use. Naltrexone must be taken at least one hour before your first drink. https://www.sinclairmethod.org/what-is-the-sinclair-method-2/ https://www.sinclairmethod.org/what-is-the-sinclair-method-2...
- kccqzy 2y ago
  I don't understand at all what is this "buzz" that people talk about that causes alcoholism. When I drink too much, I feel dizzy and I hate that feeling of not being fully in control. When I do drink moderately, it's because the drink tastes good, period. Some mocktails taste just as good as the real alcoholic version so I'll opt for that. Wines have a much more complex profile so grape juice isn't a substitute, but still I enjoy the taste and aroma of wines, not that it gives me any pleasurable "buzz" (whatever it is).
  - washadjeffmad 2y ago
    You've reinforced the premise of the article! Your brain has to learn how to be "buzzed", thus the experience is a function of your very complicated physiology and neurochemistry. If you are susceptible and drink often enough, your brain will begin to associate drinking and its effects with certain activities. The addiction arises when your brain tells you it's a good idea, and you comply. I tell younger people this, but when you're an alcoholic, you don't realize it until you're not addicted to alcohol. I went through this when I was maybe 20, and when I quit, I was often surprised when and where I suddenly felt the urge to look for a drink. After, I saw it all around me in others. As soon as a remotely stressful situation, and they began pouring themselves drinks, often maintaining a certain level until their day ended. Most of them never got drunk, and many could drink several drinks before they reached a point where they "felt" it. It doesn't have to be overtly pleasurable to be felt. Sometimes, it's merely the removal of difficult feelings that drives someone.
mystified5016 2y ago
People get so upset when confronted with the fact that humans, like all animals, are largely clockwork machines driven by chemistry. Like it or not, you (yes, you) are a slave to your internal chemistry. No amount of willpower or happy thoughts will cause your hormones or neurotransmitter levels into the homeostasis you want. If your chemistry is off, your physical and emotional behavior will be off. You are a sentient pile of molecular machines ticking along because the chemistry happens to work out. There is nothing special about you, you're exactly like every other plant, animal, and fungus on this planet. So yes, plenty of mental, behavioral, and physical disorders arise from chemical imbalances. If you take this fact, consider what happens when you indtroduce foreign and extremely powerful chemicals into such a complex organic system. If you come back with the assertion that addiction is a question of willpower, you didn't understand the assignment.
- meroes 2y ago
  How do you explain some of the most drastic and lasting changes in many peoples lives coincide with wanting them very deeply? We just happened to want most what we achieve?
  - herval 2y ago
    there's many ways the causality might be inversed. We tend to tell stories to justify what happened all the time, so the "strong wish" can always be a self-justification. You can also be tricked by your brain to wishing more of something by "programming" (that's positive reinforcement in practice - our brains aren't that different from other mammals). Lots of people who are successful at, say, going to the gym regularly, only do it because they found a way to create that feedback loop. so it's likely that just "wishing something very deeply" doesn't actually lead to anything, but acting in a way that affects your mental chemistry (be it via creating feedback loops that make your brain crave more of X or simply by taking certain medicine that does it for you) does
    - meroes 2y ago
      If we are that self-deceptive as you are claiming, don’t we need to be extremely careful we aren’t deceiving ourselves into less autonomy? How can we?
almost_usual 2y ago
There’s a big difference between psychological addiction and physical dependency. At some point during addiction your body depends on these substances to operate and stopping becomes much more difficult. Alcoholics need to taper or take benzodiazepines to quit otherwise they may seize or die when going through withdrawals. I would say anyone who begins drinking to numb the feeling of withdrawals (morning or middle of the night) is beginning the journey of serious alcoholism. That’s not really a craving it’s more of a need at that point.
- sublinear 2y ago
  I can only speak for my own drinking, but tapering off is as natural as other forms of long term planning. The drinking tends to fall off the calendar like anything else. I'm not saying alcoholism isn't a thing, but the way some people discuss alcohol seems like they're blaming the symptoms rather than the root cause. Low impulse control, not seeking novelty enough, and otherwise living a messy life is the actual problem.
- wongarsu 2y ago
  Both play a role. But in my experience for most common addictions the psychological component is the bigger issue. The physical dependency can't be ignored and is something you have to manage when quitting, but what brings people back is usually the psychological addiction. Of course this depends on the addiction. With some hard drugs or coffee the physical dependency is the bigger factor
deepfriedchokes 2y ago
More attention should be paid to why people start using in the first place. If someone is using a substance to feel good, it’s because they don’t feel good. Obesity, same thing; people are eating their feelings.

66 points by prismatic 2y ago

Related: The growing scientific case for using Ozempic and other GLP-1s to stop addiction -https://news.ycombinator.com/item?id=40357196 https://news.ycombinator.com/item?id=40357196 https://recursiveadaptation.com/p/the-growing-scientific-case-for-using https://recursiveadaptation.com/p/the-growing-scientific-cas... > The consistency that I'm hearing from all across patient groups is gain of control, whereas previously, there was a loss of control… All of a sudden they're able to step back and say, 'oh, well I had this shopping phenomenon that was going on, gambling, addiction, or alcoholism, and all of a sudden, it just stopped,' - Dr. Gitanjali Srivastava, Vanderbilt Medical Center

aszantu 2y ago
Makes sense to me. Im on keto/carnivore, when im strict w no cheating. After about 2 weeks im reorganizing and less interested in videogames. I think, sugar is stressing out the whole system
- toomuchtodo 2y ago
  Root cause is a hormone imbalance, GLP-1 agonists patch a reward center in the brain (scoped to addiction, whether that be food, drugs, alcohol, gambling, etc). What’s interesting is that we’re about to have a large scale natural experiment around addiction and whether it is chronic due to brain chemistry or more willpower as GLP-1 agonist uptake rate skyrockets in the general population (which should result in addiction reduction at scale).
  - fragmede 2y ago
    It'll certainly affect how society views addiction in general. Most people don't have a good picture of addiction, and don't understand that a drug addict can no more stop doing drugs than you can yell at a cripple to get them to stand up. it's a mental disease, not a moral failing, and as we learn more about the brain, we're going to find out that who we are comes down to just getting lucky with chemistry and physics. The sci-fi future is what if you could go into a clinic and get your personality tuned up. Yes I'd like to add some humor but not sarcasm to my personality. Give me a bit more motivation, and I'd like to like jazz.
Fluorescence 2y ago
Fiddling with our "reward centre" does not seem like it can have a localised effect to a couple of unwanted behaviours. I'm not sure we are braced for how widespread or impactful the other consequences might be especially if a vast percentage of the population take them life. For example, could they significantly change voting preference? Why wouldn't they? Do we not respond to political messages with our "reward centre"? Will we find political charisma more or less entrancing? Will we find calls for vengeance and punishment more or less attractive? Does tinkering with desire and reward dull our emotional response? Will we find compassionate appeals to help less fortunate more or less attractive? Does "enhanced control" manifest as a political preference for rational altruism or as machiavellian selfishness?
- amelius 2y ago
  If taking a substance removes our desire to shop, then I'm sure there are powers in this world that will stop it from happening.
  - hsbauauvhabzb 2y ago
    Illicit drug trade has demonstrated that even long term prohibition does not work.
    - gryfft 2y ago
      Depends on the molecule. Cannabis can be produced by any teenager in a closet with a grow light. Quaaludes on the other hand are now impossible to come by.
      - cassianoleal 2y ago
        I imagine the reason for the popularity of Quaaludes was easy access. Remove that, and the myriad other substances available become more attractive, be it MDMA, LSD, magic mushrooms, 2-CB, Ketamine, cocaine, heroin, or a number of others.
      - fragmede 2y ago
delichon 2y ago
It may be that it flattens all affect rather than addictions in particular. "Ozempic personality" is associated with anhedonia. https://www.healthline.com/health-news/ozempic-personality-change#What-is-Ozempic-personality,-and-is-it-real https://www.healthline.com/health-news/ozempic-personality-c...? I deal with my own addictions but I'm not happy about the prospect of trading them for less joy of life in general. For me Ozempic isn't an option because it's associated with reduced gut motility and I already have serious problems with that.
- moron4hire 2y ago
  Frankly, I'm enjoying life a hell of a lot more now that my feet, knees, and back aren't killing me all the time. The article you linked actually gets into that, in a quote from a doctor disputing the validity of the concept of "Ozempic personality".
  - Auracle 2y ago
    Right, but we’re talking about people that aren’t necessarily obese using it. That said it’s not like there aren’t widely used drugs that mess with reward centers. Stimulants and antidepressants both come to mind.
  - Workaccount2 2y ago
    I know it's really tired, everyone knows it, and it is repeated constantly: Drugs affect different people in different ways. If 20% of ozempic patients have personality changes, that is very significant. Yet you would still have 80% of users going around saying they never had any issues with it and those who are might just be doing it wrong/misunderstanding/confused etc.
    - amelius 2y ago
      I guess also: a drug might affect the same person in different ways based on different circumstances, age included.
    - fragmede 2y ago
ta24090811 2y ago
Personal anectode / not a doctor / YMMV. I started Ozempic about 3 months ago, prescribed by a nutrologist, first with the minimal weekly dose of 0.25mg, then 0.5mg, now back to 0.25mg to control my glucose levels (prediabetes). During this period, I lost about 25 lbs, which is fine (but I lose weight easily, just by exercising, so I wouldn't call this phenomenal by itself). The biggest difference I felt was indeed in gain of control, being more aware of my body and living in the moment. I've been practicing meditation for a long time, and what I can say is that the drug keeps you in a medidative state for longer (most of the week). The result is that I still like fatty foods and sweets, but I don't crave them. Binge eating has stopped, and all addictive/obsessive behavior, including social network / news sites / porn consumption has stopped. I am normaly hyperfocused, but my standard m.o. has been peaks of absurdly high performance interspaced with a hiatus of low productivity/creativity. Right now, the the ability to focus on what I want/need to instead of what serendipity brings my way has been awesome.
- almost_usual 2y ago
  Curious if you consumed alcohol or any other substance before and if you still do after?
  - ta24090811 2y ago
    Alcohol, socially. Before I'd have 3 or 4 drinks, now it's 1 or 2. Sometimes I don't feel like drinking at all. My perception of some foods is different as well. For instance, as I mentioned, fat still tastes good but doesn't attract me as much any more. Fish otoh tastes much better.
- 01HNNWZ0MV43FF 2y ago
  Huh. sounds more like an ADHD drug than a weight loss drug. I actually hate eating and routinely have conflicts of "I'm physically hungry but have no appetite". I wonder if Ozempic would make me gain weight.
  - deepfriedchokes 2y ago

reify 2y ago

Its very convenient for big pharma to lump all addictions to a chemical imbalance in the brain. We have been here before with the first wonder drug "Prozac" back in the late 80's. A cure all for everything. yet there was no research to support those chemical imbalance claims. I worked as a methadone dispenser for 15 years and this is not my experience of addiction. There is no chemical or hormonal imbalance when you become addicted to drugs that relieve you from the psychotic hallucinations you experience daily or the young woman who did not know her boyfriend was a heroin addict and started chasing the dragon with him or even the young stressed out mother who's husband has abandined her who has been told by endless TV advertising that a glass of red wine a day is good for you or the young man who has sufferred sexual and psychological abuse as a child who drinks to forget. Wegovy a cure for everything from the flu to cancer.

navjack27 2y ago
But everything a living creature does is chemical. Even the process of that young man who has suffered sexual and psychological abuse as a child, that brain that can't stop ruminating can't stop ruminating because of a chemical feedback loop that the brain is doing natively. When my mom got diagnosed with pancreatic stage 4 cancer and I couldn't cope with it and I was already in a drug explorer mindset at the time and I started taking her opioids and I became quite addicted (no she wasn't deprived of any of her medications she was fine). This whole process absolutely was chemical imbalance. Years before in high school I stopped taking all of my ADHD medication and then started spiraling out of control dabbling in all sorts of disassociative and psychedelic drugs. If I didn't stop taking my Adderall in high school I wouldn't have gone down any of that path.
- threecheese 2y ago
  It has taken me many years to come to that same realization, which many of us must have learned in school bio class. I continually observe the value of attacking life-problems from this perspective -that behavior is a product of chemical signaling and continuous chemical-reinforcement learning, and our decisions are steered by it and not the reverse. I find that my level of empathy has increased, both for others (like the guy that cut me off in traffic) and for myself and my failures. A willpower-based explanation of the self only leads to resentment, “why can’t i just stop behaving this way it is killing me” or “if they loved me they would change”; knowing that we are all literally enslaved to our chemical neuro anatomy allows forgiveness and openness. I don’t mean to imply that will doesn’t exist and isn’t a powerful force, but it’s not the Layer One protocol like some parts of society claim.

brudgers 2y ago

https://archive.ph/HPzNO https://archive.ph/HPzNO

ChrisMarshallNY 2y ago

Yet another attempt to categorize addiction into a simplified form that can be treated with $MY_SOLUTION. Good luck with that.

niemal_dev 2y ago

Big pharma expanding psychiatric propaganda.

ziknard 2y ago

Addiction is a failure of education. If our schools were better, and more honest, we would explain the biology of addiction well enough that no one who understood the lessen would become addicted. The lesson is simply this: Any pleasurable experience results in a normal and natural down-regulation by the body of the receptors that are responsible for that experience. It is impossible to repeat the same dose (whether drug, food, roulette wheel, or skydiving) and have an equally intense experience until enough time has elapsed that the receptors have been up-regulated back to their original levels. The hallmark of addiction, "chasing the dragon", is therefore pointless and quickly becomez harmful. The other important lesson, of course, is that quality control is essential. Variations in the drug (concentration, impurities, improperly attached bungee cords) are solely responsible for the non-dragon-related dangers.

hsbauauvhabzb 2y ago
While I agree that education would reduce addiction, it would not cure it as you’ve suggested.
- deleted 2y ago
  [deleted]
rco8786 2y ago
I was taught this in school, as well as all of my classmates. And I, and many of them, have still had struggles.
iamdbtoo 2y ago
One of the defining aspects of addiction is the inability to stop doing the harmful act despite knowing it's harmful.
vaidhy 2y ago
By this logic, no emotional arguments should work because they are logically incorrect, right? (This is your first point) However, since you seem to like logic, let us take it to the extreme - Can you do anything you like? Because, the thing you like will become your dragon.. (This is your second point) Drug impact variations can also happen because of the state of your body. Hence nothing can be done and should be done (Third point). Now I am wondering if I am responding to a robot :(

tcj_phx 2y ago

When my friend overdosed on heroin she was revived with two doses of naloxone. Her drinking was under control for about 2 weeks. Naltrexone is very similar to Naloxone, and is FDA-approved to help people with opioids and alcohol use. https://en.wikipedia.org/wiki/Naltrexone https://en.wikipedia.org/wiki/Naltrexone The Sinclair Method uses naltrexone to help people get their alcohol use under control: Naltrexone is at the heart of the Sinclair Method (TSM) for Alcoholism. When you take Naltrexone prior to drinking, it blocks endorphins, the naturally occurring opiates in the brain, from being released when alcohol is consumed. When the endorphins are blocked, there is no “buzz” or rewarding experience, and the alcohol doesn’t make you feel the pleasure that drives you to drink excessively. Over time, your brain learns not to associate alcohol with pleasure, resulting in reduced cravings and improved control over alcohol use. Naltrexone must be taken at least one hour before your first drink. https://www.sinclairmethod.org/what-is-the-sinclair-method-2/ https://www.sinclairmethod.org/what-is-the-sinclair-method-2...

kccqzy 2y ago
I don't understand at all what is this "buzz" that people talk about that causes alcoholism. When I drink too much, I feel dizzy and I hate that feeling of not being fully in control. When I do drink moderately, it's because the drink tastes good, period. Some mocktails taste just as good as the real alcoholic version so I'll opt for that. Wines have a much more complex profile so grape juice isn't a substitute, but still I enjoy the taste and aroma of wines, not that it gives me any pleasurable "buzz" (whatever it is).
- washadjeffmad 2y ago
  You've reinforced the premise of the article! Your brain has to learn how to be "buzzed", thus the experience is a function of your very complicated physiology and neurochemistry. If you are susceptible and drink often enough, your brain will begin to associate drinking and its effects with certain activities. The addiction arises when your brain tells you it's a good idea, and you comply. I tell younger people this, but when you're an alcoholic, you don't realize it until you're not addicted to alcohol. I went through this when I was maybe 20, and when I quit, I was often surprised when and where I suddenly felt the urge to look for a drink. After, I saw it all around me in others. As soon as a remotely stressful situation, and they began pouring themselves drinks, often maintaining a certain level until their day ended. Most of them never got drunk, and many could drink several drinks before they reached a point where they "felt" it. It doesn't have to be overtly pleasurable to be felt. Sometimes, it's merely the removal of difficult feelings that drives someone.

mystified5016 2y ago

People get so upset when confronted with the fact that humans, like all animals, are largely clockwork machines driven by chemistry. Like it or not, you (yes, you) are a slave to your internal chemistry. No amount of willpower or happy thoughts will cause your hormones or neurotransmitter levels into the homeostasis you want. If your chemistry is off, your physical and emotional behavior will be off. You are a sentient pile of molecular machines ticking along because the chemistry happens to work out. There is nothing special about you, you're exactly like every other plant, animal, and fungus on this planet. So yes, plenty of mental, behavioral, and physical disorders arise from chemical imbalances. If you take this fact, consider what happens when you indtroduce foreign and extremely powerful chemicals into such a complex organic system. If you come back with the assertion that addiction is a question of willpower, you didn't understand the assignment.

meroes 2y ago
How do you explain some of the most drastic and lasting changes in many peoples lives coincide with wanting them very deeply? We just happened to want most what we achieve?
- herval 2y ago
  there's many ways the causality might be inversed. We tend to tell stories to justify what happened all the time, so the "strong wish" can always be a self-justification. You can also be tricked by your brain to wishing more of something by "programming" (that's positive reinforcement in practice - our brains aren't that different from other mammals). Lots of people who are successful at, say, going to the gym regularly, only do it because they found a way to create that feedback loop. so it's likely that just "wishing something very deeply" doesn't actually lead to anything, but acting in a way that affects your mental chemistry (be it via creating feedback loops that make your brain crave more of X or simply by taking certain medicine that does it for you) does
  - meroes 2y ago
    If we are that self-deceptive as you are claiming, don’t we need to be extremely careful we aren’t deceiving ourselves into less autonomy? How can we?

almost_usual 2y ago

There’s a big difference between psychological addiction and physical dependency. At some point during addiction your body depends on these substances to operate and stopping becomes much more difficult. Alcoholics need to taper or take benzodiazepines to quit otherwise they may seize or die when going through withdrawals. I would say anyone who begins drinking to numb the feeling of withdrawals (morning or middle of the night) is beginning the journey of serious alcoholism. That’s not really a craving it’s more of a need at that point.

sublinear 2y ago
I can only speak for my own drinking, but tapering off is as natural as other forms of long term planning. The drinking tends to fall off the calendar like anything else. I'm not saying alcoholism isn't a thing, but the way some people discuss alcohol seems like they're blaming the symptoms rather than the root cause. Low impulse control, not seeking novelty enough, and otherwise living a messy life is the actual problem.
wongarsu 2y ago
Both play a role. But in my experience for most common addictions the psychological component is the bigger issue. The physical dependency can't be ignored and is something you have to manage when quitting, but what brings people back is usually the psychological addiction. Of course this depends on the addiction. With some hard drugs or coffee the physical dependency is the bigger factor

deepfriedchokes 2y ago

More attention should be paid to why people start using in the first place. If someone is using a substance to feel good, it’s because they don’t feel good. Obesity, same thing; people are eating their feelings.