6 ms·

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" ba

by 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.
  - Spivak 2y ago
    I don't think you have to deny that will or willpower exists, just that willing your brain is an action that requires mental energy and your average adult is mentally exhausted constantly.
    - tsimionescu 2y ago
      Willpower and mental energy are entirely pseudoscientific concepts. They co-opt sciencey language to sound smart, but they have no backing in experiment or observation. What exactly is this "mental energy" being expended on (converted to)? What is it's law of conservation, that we might call it "energy"? Is willpower defined as the consumption of mental energy per unit time, that we might call it "power"? You could think that maybe willpower/mental energy is a resource you have to consume to suppress natural instincts like overeating or consuming a drug that triggers pleasure in order to achieve some long term goal. But then you find that some people routinely engage in behaviors that contradict basic natural instincts, and in fact find it very hard to stop doing those behaviors (e.g. cutting or other self-harm behaviors, suicidal tendencies). Are they just a font of mental energy?
      - Spivak 2y ago
        You can argue the explanation but it's hard to argue the observation— kids are tired after school even with no physical exertion, knowledge workers are tired after work. People need to "decompress" after mentally taxing work, burnout is a thing. Name it what you like, but your theory does have to account for people's lived experience. Why does studying make you tired? Actively using certain parts of your brain is a limited resource in some respect no matter how you swing it. The rules are super weird so maybe energy is a bad name but it's the best we have right now.
        tsimionescu 2y ago
        Oh, tiredness due to knowledge work is real, and relatively easily explained: you spend energy (real, physical energy - calories) on computation in your brain. Whether you're learning at school, designing bridges, driving, or what have you, there are measurable outcomes of your work. But there is no obvious relationship between this and the concept of "expending mental energy" on combating your cravings. It's not at all clear that there is any measurable "effort" involved in not doing something like eating a sweet. Chess masters consume more calories during a tournament. People who avoid eating cake at a birthday party don't. And yes, I have of course experienced the difficulty with not giving in to a craving. But I'm not at all convinced that it is the same thing as the difficulty of taking a math exam. If anything, my experience is that it's easier to control my cravings after accomplishing a difficult mental task then it is if I've just idly been watching TV all day.
- ethanol-brain 2y ago
  > I wouldn't have gone down any of that path Yet, if you actually believe in biological determinism, there is no way you could have taken anything but that path.
  - tsimionescu 2y ago
    Biological determinism is not necessarily full determinism. External circumstances could have been other than they were, and then the biologically determined decision could have changed. Plus, for every deterministic model, the same arguments would also support a world that also includes pure randomness in addition to the deterministic laws.
    - ethanol-brain 2y ago
      Still, the author is making a deterministic leap by stating that they wouldn't have been X if Y.
      - navjack27 2y ago
        I'm not making a deterministic leap I'm leaving out vast amounts of information from my story that are way way more personal. Of course there are more things that I know that don't make this a deterministic leap but I don't care to share them.
- larodi 2y ago
  Do you realize that this basically translates to "had I not stopped taking prescribed amphetamines, I'd never be exploring other drugs"... sounds a little hypocritical to me, and particularly when ADHD-diagnosed-on-prescription drugs fail to note that they been treating themselves with micro-dosing. So then how is Psilocybin or THC microdosing different? If it's all about the dosage, then we need to focus on a different narrative. Besides, I'm sure a lot of very sane, and very performant people, met lots of these, actually enjoy the regular micro-dosing of alcohol or tobacco...
  - from-nibly 2y ago
    Prescribed amphetamines are very different than meth. Its not just about dosages.
    - SkyPuncher 2y ago
      "Very different" is a strong word. They're more similiar than different and both have similiar intermediaries within the body. Thankfully, that difference is largely the difference between long-term debilitating addiction and short-term focus.
      - from-nibly 2y ago
        Ive taken two different amphetamines and 1 brings on panic attacks and the other doesn't. I call that very different. The molecule doesn't have to be that different in order to be vastly different in what it does to humans.
        larodi 2y ago
        Two street amphétamines or two prescribed? Sorry not trying to be rude, but you know there seem to be like 4 in Aderall, so how do you tell them apart? Besides you can be absolutely sure there is very clean stuff out there on the streets. All I’m saying is that bros are effectively micro-dosing to cater to condition and there are lots of people taking this in very regular manner.
- marginalia_nu 2y ago
  It's specifically because the brain is an electrochemical computer that the whole "brain chemistry imbalance" narrative isn't very useful. After all, every feeling you experience and every thought you think is brain chemicals in action. It's like saying a software bug is an electromagnetic imbalance in the hard drive. Well, technically yes, but there's also more to it than that.
  - sickblastoise 2y ago
    That’s a great analogy! The chemical imbalance thing has always sounded to me like there “are spirits in the system”
    - marginalia_nu 2y ago
      The brain imbalance narrative really is a double-edged sword. On the one hand, it can help people understand that a condition is real and not imagined, especially other than the sufferer. "Look at this brain scan, it looks different from a healthy person's" is quite tangible and convincing. On the other hand, it can lead to a sense of helplessness, and notions that because there's a physical element to the mental illness, it's a permanent disability, or to be exclusively treated with pills and injections. That just doesn't follow. Sometimes it's true, but in many cases, lifestyle interventions can help, talk therapy can help.
      - soulofmischief 2y ago
        That's just your projection. A proper neurological diagnosis can absolutely help a patient find a viable path to recovery, as well as enable them to find support groups. And not every neurological disorder is fixable. And the question of whether this is "sometimes" or "in many cases" is still in the air, unless you can provide solid citations proving otherwise. So there is no need for this kind of judgement.
        marginalia_nu 2y ago
        Yeah dude I think you're the one who is projecting. You're reading a lot into what I wrote that just isn't there.
- wslh 2y ago
  The danger from the article's perspective is, once again, viewing addiction solely as a disease rather than as a symptom of multiple underlying issues. This is similar to how anxiety and depression have been framed as single diseases, when in reality, they can be symptoms of various conditions. Even if we consider addiction a disease, there's often an oversimplified focus on a "single root cause" when, in fact, multiple, independent factors can contribute to addiction. One clear example is the physical dependence on certain drugs, which can be beyond a person's control. On the other hand, many young people start using marijuana under the old, now cliché, mantra that it doesn’t cause physical addiction, as if physical addiction were the only form of addiction possible. My 2 cents, from someone with a [strong] non-addictive trait but having witnessed people with various addictions, including gambling.
- adamtaylor_13 2y ago
  Having experienced my fair share of awful life circumstances, I’ve came away with an opposite understanding. You can’t boil everything down the chemicals. Life boils down to choices. Some are easier and some are harder, but as soon as you take away the fact that it’s all a choice, you find yourself in a very dark place where you’re always a victim of your circumstances. At the end of the day though, whether you believe me or not, your reality will reflect your beliefs. If you believe you can’t, you won’t. If you believe you can, you will. It’s an unpopular and rather inconvenient truth that we have choice, but accepting that leads to a far better life than believing everything is just chemicals.
ethanol-brain 2y ago
A lot of disease has environmental and intrinsic causes. Categorizing disease as having a set of characteristics in the body doesn't make it solely rooted within those characteristics. I think there will always be a desire to solve disease with a single pharmaceutical, as that would be an incredible thing. However the existence of drugs that do not work for everyone doesn't necessitate that the signals for characterizing disease are off or that a pharmaceutical isn't useful to some people. Organisms are incredibly complex, even those composed of relatively few cells. Thinking there is always some magic bullet to address a biological or emergent phenomenon is probably not the answer, but neither is being dismissive of treatments that don't meet that criteria.
rikafurude21 2y ago
chemical imbalances are very real, its just that the cures dont actually help you alleviate those imbalances. On a intuitive level, it makes sense that any chemical that you introduce to your body (be it drugs, or even just food) creates an imbalance that your body tries to compensate for, since your bodys main goal is normalizing its internal state. Most pharma drugs are band aids, which dont actually cure the root causes, leading to dependence in order to feel normal. even just an unhealthy lifestyle causes chemical imbalances, it doesnt have to be a drug you take. the detrimental part of this is that some drugs can temporarily cover up the imbalances as well, which leads to people reaching to these drugs to 'feel normal' - this leads to what we would call addiction, because addicts mostly self medicate. the drug doesnt have to be the root cause.
SkyPuncher 2y ago
> Its very convenient for big pharma to lump all addictions to a chemical imbalance in the brain. This is also a lazy argument that tends to get a strong response without being meaningful. It's basically equivalent to saying "it's convenient for big speaker that all music requires sound". Chemicals are the regulation system in most living things. They are necessary and that can't be ignored. Some can be artificially manipulated to get desirable responses, hence "chemical imbalance". I'm also not sure how your examples are relevant to your argument. #1 is a pretty exceptional case, but hard to take as a representative argument. The rest are all secondary effects from human interaction, drugs are incidental to the outcome you describe. ----- Ultimately, humans respond to positive and negative reinforcements. This is a pretty primal level thing and can be seen in nearly every other living thing. Do X, receive Y, reinforcement. Living things need these positive reinforcement cycles to thrive. For the most case, these are "mundane" things like talking with other humans, eating normal meals, drinking water, etc, etc. They guide people to keep doing things that make them feel good, even if those things are overall harmful. GLP-1 drugs are rather exceptional as they seem to temper people's responses to certain reinforcement. Particularly, addictive or addictive-like reinforcements, like overeating. Whether this is the result of a "chemical imbalance" is pretty much just semantics. It's not really meaningful. They also have some strong, powerful secondary effects, but really only by happen-stance. Patients who eat less, are less likely to develop diabetes. Patients who have less desire to drink alcohol are less likely to develop cancer. Patients who have less desire to do drugs are less likely to become addicts, etc, etc, etc.
empath75 2y ago
I had a drug and drinking problem in my 20s and the cause of it was just me dealing with unresolved childhood trauma from an abusive parent and years of bullying that left me unable to interact with other human beings unless I was drinking. Taking MDMA (and the self reflection and opening up to people) is what finally let me process it and move on with my life and quit taking drugs and drinking and still be able to function like a normal human being, but I want to be clear -- I didn't have a chemical imbalance that MDMA "corrected". I was abused for years and had trauma to deal with because of that, and MDMA just temporarily opened my eyes to a new way of viewing the world that wasn't clouded by that trauma. Thinking of all psychological issues as if they're some innate property of the person and not something that's a consequence of _their environment_ is going to lead to bad results. People see that drug addicts are unhappy and think the drug addiction is causing the unhappiness, but that might be reversing cause and effect. Happy people with satisfying lives don't generally develop debilitating drug addictions, and I think that just making people satisfied with living in a bad environment is a bad solution. It's bad for them as an individual and bad for society. Sometimes the solution for depression and other stuff is to just get your shit together and take control of your life -- and drugs can have a role in getting you off your ass and doing something, but I worry about just pushing them as a long term permanent solution.

by reify 2y ago

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.
- Spivak 2y ago
  I don't think you have to deny that will or willpower exists, just that willing your brain is an action that requires mental energy and your average adult is mentally exhausted constantly.
  - tsimionescu 2y ago
    Willpower and mental energy are entirely pseudoscientific concepts. They co-opt sciencey language to sound smart, but they have no backing in experiment or observation. What exactly is this "mental energy" being expended on (converted to)? What is it's law of conservation, that we might call it "energy"? Is willpower defined as the consumption of mental energy per unit time, that we might call it "power"? You could think that maybe willpower/mental energy is a resource you have to consume to suppress natural instincts like overeating or consuming a drug that triggers pleasure in order to achieve some long term goal. But then you find that some people routinely engage in behaviors that contradict basic natural instincts, and in fact find it very hard to stop doing those behaviors (e.g. cutting or other self-harm behaviors, suicidal tendencies). Are they just a font of mental energy?
    - Spivak 2y ago
      You can argue the explanation but it's hard to argue the observation— kids are tired after school even with no physical exertion, knowledge workers are tired after work. People need to "decompress" after mentally taxing work, burnout is a thing. Name it what you like, but your theory does have to account for people's lived experience. Why does studying make you tired? Actively using certain parts of your brain is a limited resource in some respect no matter how you swing it. The rules are super weird so maybe energy is a bad name but it's the best we have right now.
      - tsimionescu 2y ago
        Oh, tiredness due to knowledge work is real, and relatively easily explained: you spend energy (real, physical energy - calories) on computation in your brain. Whether you're learning at school, designing bridges, driving, or what have you, there are measurable outcomes of your work. But there is no obvious relationship between this and the concept of "expending mental energy" on combating your cravings. It's not at all clear that there is any measurable "effort" involved in not doing something like eating a sweet. Chess masters consume more calories during a tournament. People who avoid eating cake at a birthday party don't. And yes, I have of course experienced the difficulty with not giving in to a craving. But I'm not at all convinced that it is the same thing as the difficulty of taking a math exam. If anything, my experience is that it's easier to control my cravings after accomplishing a difficult mental task then it is if I've just idly been watching TV all day.
ethanol-brain 2y ago
> I wouldn't have gone down any of that path Yet, if you actually believe in biological determinism, there is no way you could have taken anything but that path.
- tsimionescu 2y ago
  Biological determinism is not necessarily full determinism. External circumstances could have been other than they were, and then the biologically determined decision could have changed. Plus, for every deterministic model, the same arguments would also support a world that also includes pure randomness in addition to the deterministic laws.
  - ethanol-brain 2y ago
    Still, the author is making a deterministic leap by stating that they wouldn't have been X if Y.
    - navjack27 2y ago
      I'm not making a deterministic leap I'm leaving out vast amounts of information from my story that are way way more personal. Of course there are more things that I know that don't make this a deterministic leap but I don't care to share them.
larodi 2y ago
Do you realize that this basically translates to "had I not stopped taking prescribed amphetamines, I'd never be exploring other drugs"... sounds a little hypocritical to me, and particularly when ADHD-diagnosed-on-prescription drugs fail to note that they been treating themselves with micro-dosing. So then how is Psilocybin or THC microdosing different? If it's all about the dosage, then we need to focus on a different narrative. Besides, I'm sure a lot of very sane, and very performant people, met lots of these, actually enjoy the regular micro-dosing of alcohol or tobacco...
- from-nibly 2y ago
  Prescribed amphetamines are very different than meth. Its not just about dosages.
  - SkyPuncher 2y ago
    "Very different" is a strong word. They're more similiar than different and both have similiar intermediaries within the body. Thankfully, that difference is largely the difference between long-term debilitating addiction and short-term focus.
    - from-nibly 2y ago
      Ive taken two different amphetamines and 1 brings on panic attacks and the other doesn't. I call that very different. The molecule doesn't have to be that different in order to be vastly different in what it does to humans.
      - larodi 2y ago
        Two street amphétamines or two prescribed? Sorry not trying to be rude, but you know there seem to be like 4 in Aderall, so how do you tell them apart? Besides you can be absolutely sure there is very clean stuff out there on the streets. All I’m saying is that bros are effectively micro-dosing to cater to condition and there are lots of people taking this in very regular manner.
marginalia_nu 2y ago
It's specifically because the brain is an electrochemical computer that the whole "brain chemistry imbalance" narrative isn't very useful. After all, every feeling you experience and every thought you think is brain chemicals in action. It's like saying a software bug is an electromagnetic imbalance in the hard drive. Well, technically yes, but there's also more to it than that.
- sickblastoise 2y ago
  That’s a great analogy! The chemical imbalance thing has always sounded to me like there “are spirits in the system”
  - marginalia_nu 2y ago
    The brain imbalance narrative really is a double-edged sword. On the one hand, it can help people understand that a condition is real and not imagined, especially other than the sufferer. "Look at this brain scan, it looks different from a healthy person's" is quite tangible and convincing. On the other hand, it can lead to a sense of helplessness, and notions that because there's a physical element to the mental illness, it's a permanent disability, or to be exclusively treated with pills and injections. That just doesn't follow. Sometimes it's true, but in many cases, lifestyle interventions can help, talk therapy can help.
    - soulofmischief 2y ago
      That's just your projection. A proper neurological diagnosis can absolutely help a patient find a viable path to recovery, as well as enable them to find support groups. And not every neurological disorder is fixable. And the question of whether this is "sometimes" or "in many cases" is still in the air, unless you can provide solid citations proving otherwise. So there is no need for this kind of judgement.
      - marginalia_nu 2y ago
        Yeah dude I think you're the one who is projecting. You're reading a lot into what I wrote that just isn't there.
wslh 2y ago
The danger from the article's perspective is, once again, viewing addiction solely as a disease rather than as a symptom of multiple underlying issues. This is similar to how anxiety and depression have been framed as single diseases, when in reality, they can be symptoms of various conditions. Even if we consider addiction a disease, there's often an oversimplified focus on a "single root cause" when, in fact, multiple, independent factors can contribute to addiction. One clear example is the physical dependence on certain drugs, which can be beyond a person's control. On the other hand, many young people start using marijuana under the old, now cliché, mantra that it doesn’t cause physical addiction, as if physical addiction were the only form of addiction possible. My 2 cents, from someone with a [strong] non-addictive trait but having witnessed people with various addictions, including gambling.
adamtaylor_13 2y ago
Having experienced my fair share of awful life circumstances, I’ve came away with an opposite understanding. You can’t boil everything down the chemicals. Life boils down to choices. Some are easier and some are harder, but as soon as you take away the fact that it’s all a choice, you find yourself in a very dark place where you’re always a victim of your circumstances. At the end of the day though, whether you believe me or not, your reality will reflect your beliefs. If you believe you can’t, you won’t. If you believe you can, you will. It’s an unpopular and rather inconvenient truth that we have choice, but accepting that leads to a far better life than believing everything is just chemicals.

ethanol-brain 2y ago

A lot of disease has environmental and intrinsic causes. Categorizing disease as having a set of characteristics in the body doesn't make it solely rooted within those characteristics. I think there will always be a desire to solve disease with a single pharmaceutical, as that would be an incredible thing. However the existence of drugs that do not work for everyone doesn't necessitate that the signals for characterizing disease are off or that a pharmaceutical isn't useful to some people. Organisms are incredibly complex, even those composed of relatively few cells. Thinking there is always some magic bullet to address a biological or emergent phenomenon is probably not the answer, but neither is being dismissive of treatments that don't meet that criteria.

rikafurude21 2y ago

chemical imbalances are very real, its just that the cures dont actually help you alleviate those imbalances. On a intuitive level, it makes sense that any chemical that you introduce to your body (be it drugs, or even just food) creates an imbalance that your body tries to compensate for, since your bodys main goal is normalizing its internal state. Most pharma drugs are band aids, which dont actually cure the root causes, leading to dependence in order to feel normal. even just an unhealthy lifestyle causes chemical imbalances, it doesnt have to be a drug you take. the detrimental part of this is that some drugs can temporarily cover up the imbalances as well, which leads to people reaching to these drugs to 'feel normal' - this leads to what we would call addiction, because addicts mostly self medicate. the drug doesnt have to be the root cause.

SkyPuncher 2y ago

> Its very convenient for big pharma to lump all addictions to a chemical imbalance in the brain. This is also a lazy argument that tends to get a strong response without being meaningful. It's basically equivalent to saying "it's convenient for big speaker that all music requires sound". Chemicals are the regulation system in most living things. They are necessary and that can't be ignored. Some can be artificially manipulated to get desirable responses, hence "chemical imbalance". I'm also not sure how your examples are relevant to your argument. #1 is a pretty exceptional case, but hard to take as a representative argument. The rest are all secondary effects from human interaction, drugs are incidental to the outcome you describe. ----- Ultimately, humans respond to positive and negative reinforcements. This is a pretty primal level thing and can be seen in nearly every other living thing. Do X, receive Y, reinforcement. Living things need these positive reinforcement cycles to thrive. For the most case, these are "mundane" things like talking with other humans, eating normal meals, drinking water, etc, etc. They guide people to keep doing things that make them feel good, even if those things are overall harmful. GLP-1 drugs are rather exceptional as they seem to temper people's responses to certain reinforcement. Particularly, addictive or addictive-like reinforcements, like overeating. Whether this is the result of a "chemical imbalance" is pretty much just semantics. It's not really meaningful. They also have some strong, powerful secondary effects, but really only by happen-stance. Patients who eat less, are less likely to develop diabetes. Patients who have less desire to drink alcohol are less likely to develop cancer. Patients who have less desire to do drugs are less likely to become addicts, etc, etc, etc.

empath75 2y ago

I had a drug and drinking problem in my 20s and the cause of it was just me dealing with unresolved childhood trauma from an abusive parent and years of bullying that left me unable to interact with other human beings unless I was drinking. Taking MDMA (and the self reflection and opening up to people) is what finally let me process it and move on with my life and quit taking drugs and drinking and still be able to function like a normal human being, but I want to be clear -- I didn't have a chemical imbalance that MDMA "corrected". I was abused for years and had trauma to deal with because of that, and MDMA just temporarily opened my eyes to a new way of viewing the world that wasn't clouded by that trauma. Thinking of all psychological issues as if they're some innate property of the person and not something that's a consequence of _their environment_ is going to lead to bad results. People see that drug addicts are unhappy and think the drug addiction is causing the unhappiness, but that might be reversing cause and effect. Happy people with satisfying lives don't generally develop debilitating drug addictions, and I think that just making people satisfied with living in a bad environment is a bad solution. It's bad for them as an individual and bad for society. Sometimes the solution for depression and other stuff is to just get your shit together and take control of your life -- and drugs can have a role in getting you off your ass and doing something, but I worry about just pushing them as a long term permanent solution.