6 ms·

I'm a psychiatrist and I work with an addiction population. I think many of them would be glad to have this as an option. It's certainly not perfect, but it wou

I'm a psychiatrist and I work with an addiction population. I think many of them would be glad to have this as an option. It's certainly not perfect, but it would provide an additional layer of protection to people who struggle to maintain sobriety. I think it's sad that the first reaction to this is to think of it as something from "dystopian" science fiction. The oral medication disulfram shares a similar mechanism of action, but it has to be taken every day. When a patient begins to struggle they often stop the antabuse, losing the benefit. At least gives them a few months of protection and if after that they choose not to resume it sounds like that's a possibility. With proper informed consent, it's a welcome tool to a common and potentially devastating problem.

nowarninglabel 14y ago
Thank you for sharing, my very first question was going to be about antabuse and how this would differ in mechanism.
- jtheory 14y ago
  From the article -- they're hoping the fully-developed vaccine would last 6 months to a year. That's a big deal -- you decide "yes" once, and even when the going gets rough, you don't get to change your mind for many months yet... you'll have a much better chance to build better habits, etc. before you have to decide yes/no again. Much, much better than something you have to take daily, or even weekly.
anigbrowl 14y ago
I hope you're right. I used to be a heavy smoker and even after I cut back I was still addicted to nicotine and unable to give it up completely. Eventually I was prescribed Chantix (which was still fairly new at the time) and took it in hope rather than expectation. It worked - to such an extent that it was like a time machine for my brain, unwinding it back to an earlier stage before I had overcome my dislike for the smell and taste of tobacco. Every day that I wake up without the taste of yesterday's cigarettes or draw a deep breath I feel grateful for it's availability; it was easily the best $400 I ever spent. I hope this offers a similar benefit for people in the grip of alcohol addiction, a much heavier burden than the one I had to cope with.
nnq 14y ago
...and then the alcoholics will turn to harder drugs for which they don't have intolerance. Great news! ...if you're a drug dealer.
- mpyne 14y ago
  So you're saying that you believe in 'gateway drugs'?
  - nnq 14y ago
    not really, but imagine that you're a drinker that also smokes pot occasionally. what do you do when alcohol no longer gives you any satisfaction? increase the consumption of the other, or if you're not using smth else, look for other stimulants or disinhibitors. it's not about gateway drugs, it's about addiction swapping! Edit: + and it's not like if you're a pot smoker, you're gonna start doing heroin when pot is no longer enough for you, so I don't believe in gateway drugs.
  - Falling3 14y ago
    I don't think there's necessarily an implication of the validity of "gateway drugs" there. The same idea crossed my mind, but only if this sort of treatment is not accompanied by anything else. It's generally agreed that people abuse alcohol because of some sort of underlying problem. If you take the option of alcohol away and do nothing to address the problem, then it's reasonable to assume that they will look elsewhere.
    - DanBC 14y ago
      > It's generally agreed that people abuse alcohol because of some sort of underlying problem. Is it?
- Sumaso 14y ago
  Its quite the jump going from, a trip to the corner store to grab your bottle of vodka, to hunting down a drug dealer so you can try "harder drugs". Accessibility definitely plays a role here.
- 14y ago
leknarf 14y ago
The article suggests that some people's addiction might manifest in other ways. That is, if you take away alcohol, an alcoholic will look for other inebriants. Is that actually correct? I thought alcoholism was largely a genetic disorder, which predispositions some people to abuse a particular drug. If someone with the disposition has one drink, he is then enticed to have 10 drinks. But if the same person smoked a joint, he wouldn't have any more interest in smoking more weed than a normal person. If so, then this sounds like a fantastic tool for people with an physiological addition to alcohol.
- phren0logy 14y ago
  There's a lot of individual variability on this point. Many people might have a higher susceptibility to similar substances (like heroin and oxycodone), then to a slightly lesser degree broader groups like "uppers" or "downers," and then finally some people will take anything they can get their hands on. There are wrinkles to that general formula. Some people only want cocaine and have no affinity for amphetamines, but will take opiates or benzodiazepines without discrimination. It's pretty messy, sorry I don't have a better answer but's that's how it is.
berlinbrown 14y ago
General question... What kind of level of drinking or drugs do you think constitutes a real problem? I know it varies, but what is the average. I assume that one drink a month is not a problem, but where is the middle amount of alcohol do you see an issue?
- phren0logy 14y ago
  Not to answer with a tautology, but it becomes a problem when it is a problem. For example, when you are missing work (or drunk/hungover at work leading to consequences), or it is causing problems in relationships, you spend an inordinate amount of time or money getting/using alcohol, etc. I would also add when you develop physical dependence as manifested by alcohol withdrawal symptoms, as alcohol withdrawal can be life threatening. People joke about "the DTs" (short for delirium tremens) but not many realize that you can die from them. Check out the DSM for more detail about how addiction criteria are currently operationalized.
  - berlinbrown 14y ago
    Still, I wish I had a number. I am sure there is a datapoint out there but I haven't seen it. Even if it is, "on average a heavy drinker that claims to have a problem and registers with a psychiatrist says that they drink on average '10 drinks a week'".
deleted 14y ago
[deleted]

nowarninglabel 14y ago

Thank you for sharing, my very first question was going to be about antabuse and how this would differ in mechanism.

jtheory 14y ago
From the article -- they're hoping the fully-developed vaccine would last 6 months to a year. That's a big deal -- you decide "yes" once, and even when the going gets rough, you don't get to change your mind for many months yet... you'll have a much better chance to build better habits, etc. before you have to decide yes/no again. Much, much better than something you have to take daily, or even weekly.

anigbrowl 14y ago

I hope you're right. I used to be a heavy smoker and even after I cut back I was still addicted to nicotine and unable to give it up completely. Eventually I was prescribed Chantix (which was still fairly new at the time) and took it in hope rather than expectation. It worked - to such an extent that it was like a time machine for my brain, unwinding it back to an earlier stage before I had overcome my dislike for the smell and taste of tobacco. Every day that I wake up without the taste of yesterday's cigarettes or draw a deep breath I feel grateful for it's availability; it was easily the best $400 I ever spent. I hope this offers a similar benefit for people in the grip of alcohol addiction, a much heavier burden than the one I had to cope with.

nnq 14y ago

...and then the alcoholics will turn to harder drugs for which they don't have intolerance. Great news! ...if you're a drug dealer.

mpyne 14y ago
So you're saying that you believe in 'gateway drugs'?
- nnq 14y ago
  not really, but imagine that you're a drinker that also smokes pot occasionally. what do you do when alcohol no longer gives you any satisfaction? increase the consumption of the other, or if you're not using smth else, look for other stimulants or disinhibitors. it's not about gateway drugs, it's about addiction swapping! Edit: + and it's not like if you're a pot smoker, you're gonna start doing heroin when pot is no longer enough for you, so I don't believe in gateway drugs.
- Falling3 14y ago
  I don't think there's necessarily an implication of the validity of "gateway drugs" there. The same idea crossed my mind, but only if this sort of treatment is not accompanied by anything else. It's generally agreed that people abuse alcohol because of some sort of underlying problem. If you take the option of alcohol away and do nothing to address the problem, then it's reasonable to assume that they will look elsewhere.
  - DanBC 14y ago
    > It's generally agreed that people abuse alcohol because of some sort of underlying problem. Is it?
Sumaso 14y ago
Its quite the jump going from, a trip to the corner store to grab your bottle of vodka, to hunting down a drug dealer so you can try "harder drugs". Accessibility definitely plays a role here.
14y ago

leknarf 14y ago

The article suggests that some people's addiction might manifest in other ways. That is, if you take away alcohol, an alcoholic will look for other inebriants. Is that actually correct? I thought alcoholism was largely a genetic disorder, which predispositions some people to abuse a particular drug. If someone with the disposition has one drink, he is then enticed to have 10 drinks. But if the same person smoked a joint, he wouldn't have any more interest in smoking more weed than a normal person. If so, then this sounds like a fantastic tool for people with an physiological addition to alcohol.

phren0logy 14y ago
There's a lot of individual variability on this point. Many people might have a higher susceptibility to similar substances (like heroin and oxycodone), then to a slightly lesser degree broader groups like "uppers" or "downers," and then finally some people will take anything they can get their hands on. There are wrinkles to that general formula. Some people only want cocaine and have no affinity for amphetamines, but will take opiates or benzodiazepines without discrimination. It's pretty messy, sorry I don't have a better answer but's that's how it is.

berlinbrown 14y ago

General question... What kind of level of drinking or drugs do you think constitutes a real problem? I know it varies, but what is the average. I assume that one drink a month is not a problem, but where is the middle amount of alcohol do you see an issue?

phren0logy 14y ago
Not to answer with a tautology, but it becomes a problem when it is a problem. For example, when you are missing work (or drunk/hungover at work leading to consequences), or it is causing problems in relationships, you spend an inordinate amount of time or money getting/using alcohol, etc. I would also add when you develop physical dependence as manifested by alcohol withdrawal symptoms, as alcohol withdrawal can be life threatening. People joke about "the DTs" (short for delirium tremens) but not many realize that you can die from them. Check out the DSM for more detail about how addiction criteria are currently operationalized.
- berlinbrown 14y ago
  Still, I wish I had a number. I am sure there is a datapoint out there but I haven't seen it. Even if it is, "on average a heavy drinker that claims to have a problem and registers with a psychiatrist says that they drink on average '10 drinks a week'".

deleted 14y ago

[deleted]