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The Myth of Drug-Induced Addiction (Heroin and cocaine)

Olm the Water King

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A nearly perfect illustration of mind-numbingly absurd and infantile views that still seem to be quite popular; demons and witches still live in people's minds:

'Mind-altering drugs have been invested by the public with qualities which are not directly linked to their visible or most probable effects. They have been elevated to the status of a power deemed capable of tempting, possessing, corrupting, and destroying persons without regard to the prior conduct or condition of those persons—a power which has all-or-none effects. Gradations of results are not ordinarily considered as a function of the factors empirically shown to be responsible for them, such as dosage, purity, route of administration, frequency of use, nutritional states, the presence of biochemical antagonists or potentiators, social setting, subject's health, intentions and personality, and the like. The "power" in drugs is such that those identified as users are immediately reclassified socially—most likely as unregenerate outcasts. Such a power comes close to being demoniacal. Has Cotton Mather's demon in rum changed his residence? Have witches turned now to technology whereby they lurk in heroin, LSD, methamphetamine, and other materials?

Mather's demonology provided for exotic demons—some tawny colored, some Indian red, some black, but notably few white like a Puritan—who invested a person and turned him, or in those days more often her, into a witch. Once possessed by a devil, people themselves became devils capable of all manner of fiendish exploits. The witch embraced his possessor—that is, they incorporated one another, so that it was natural for the hangman to destroy both at once, the two being in league. There were exceptions: confession and repentance could save a person. The repentant witch was not hanged then, sincé she had presumably by that act returned to mortal ground and, in so doing, had evicted her dreadful tenant in ways not made explicit. On the other hand, the unrepentant witch, who claimed there was no demon inside her, no witchcraft abiding, or even denied the phenomenon of demons itself—that woman went a-carting to gallows hill.'

...Still another aspect may be considered. Mather's demon rum turned out to be a bore after long acquaintance. He is being defanged as polar practices of teetotaling or drunkenness are slowly being replaced by moderate drinking. Alcoholism is with us but, as with the cultural evolution of madness, no longer as possession but as illness or, in another set of formulations, as interpersonal behavior complexly determined. The public has not become so well acquainted with other forms of drug use that familiarity allows acceptance of medical or psychosocial theories about what is happening. The illicit-exotic drugs and their devotees are strangers to this public, and it is only in response to strangers and the strange that romance and fascination develop. How many Americans sense transport to the nether reaches of the archetypical racial unconscious when smoking a Chesterfield? How many learn to "love" when drinking a beer and watching a ball game? Do they discover inner beauty when taking an aspirin for a headache? It is no surprise that romance requires a stranger. If there is to be that fascination, there is also idealization. Ordinary romantic attraction or hatred in the service of sentiment prefers simple objects. Pure evil is a loftier enemy; Iago as interpreted at the high school level is what is needed. Against pure evil one marshals the choicest antagonist—the innocent purity of the child, just as the fairy stories have it.

For the confirmed drug user, the druggie, the same scheme applies; only he reverses the field. He is the innocent and pure-born, corrupted only insofar as he has been soiled by his parents and other worldly folk. He is the flower child, free and loving. It is the rest of the world which stinks of evil, the evil of the city, of technology, of government—the overpowering evil of human beings living ordinary lives. The way both sides characterize themselves reeks, of course, of simplicity and sentimentality.

If the speculations presented in this essay are pertinent to an accounting of how people think about drug use, the conclusion is warranted that a mythology pervades our approach to certain kinds of drugs and to certain groups of drug users. For the sake of classification that mythology is demoniacal. If it is a demonology, then its essence is that the fervent among druggies and antidruggies are both true believers.

XIV On the Presence of Demons | Society and Drugs

The Birth of Heroin and the Demonization of the Dope Fiend

by Th. Metzger

Ah, heroin! The scourge of American civilization! The enslaver and despoiler of all that is good and pure! And heroin's ambassador, the drug addict: a craven, diseased, desperate minion of Morpheus who wallows in a cesspool of decadence and habitual debasement! Yes, fearsomely addictive heroin and the deranged dope fiends who inject it have somehow been merged in the American public's mind to form a two-pronged skewer that diabolically rips away at society's most vital organs, leaving a trail of despair and death in its obscene wake.

At least, that's the way it's portrayed today. But, as author Th. Metzger posits, this wasn't always so. Like everything else, heroin has a history, and so does the societal archetype of the heroin addict. Over time, heroin has came to be associated with defilement, sin and disease and its users have become synonymous with devolution and degeneracy. How this came to be makes for a fascinating tale, and Th. Metzger tells it well in The Birth of Heroin and the Demonization of the Dope Fiend.
 

Olm the Water King

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I don't understand why doctors are prescribing such strong pain medications for simple things like that. Fentanyl had the original intended use of palliative care. Oxys were only given to terminal cancer patients. These drugs are way over prescribed for simple crap. That said, it sounds like you enjoyed yourself.

I have to say I'm with Obama on this one. He's actually one of the few people not completely ridiculous on this issue.

Obama Rejects Limits on Opioid Prescribing — Pain News Network

Obama Rejects Limits on Opioid Prescribing

February 22, 2016

By Pat Anson, Editor

President Barack Obama declined to endorse a sweeping proposal by some governors to put limits on the number of opioid painkillers that doctors can prescribe, saying such a policy would be unfair to rural Americans who don’t have easy access to pain medication or addiction treatment programs.


"If we go to the doctors right now and say 'Don't overprescribe' without providing some mechanisms for people in these communities to deal with the pain that they have or the issues that they have, then we're not going to solve the problem,” Obama said. "Because the pain is real. The mental illness is real. In some cases, addiction is already out there. In some cases these are underserved communities when it comes to the number of doctors and nurses and practitioners."

President Obama met with the governors Monday at the White House and endorsed their bipartisan approach to addressing the so-called opioid epidemic.

"This is an area where I can get agreement from Bernie Sanders and Mitch McConnell. That doesn't happen that often," Obama said.

Contrary to popular opinion, pain is actually severely undertreated in the US.

IOM Report: Chronic, Undertreated Pain Affects 116 Million Americans and Costs the U.S. $560 Billion Per Year | TIME.com

Report: Chronic, Undertreated Pain Affects 116 Million Americans

By Maia Szalavitz @maiaszJune 29, 2011

Serious, chronic pain affects at least 116 million Americans each year, many of whom are inadequately treated by the health-care system, according to a new report by the Institute of Medicine (IOM). The report offers a blueprint for addressing what it calls a “public health crisis” of pain.

...“I’m shocked and surprised at the magnitude of [the problem],” said Dr. Perry Fine, president of the American Academy of Pain Medicine, while attending the press conference on Wednesday announcing the release of the IOM report. He was not associated with the research.

P.S.: Also, this is relevant to the whole topic: Heroin Hysteria: Media Misinformation and Responsible Reporting

As is this: How the Media Is Fueling the So-Called Opioid Overdose Epidemic
 

Olm the Water King

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Speaking of overdose, drug mixing is an important issue:

The reason drug mixing is so common is that the current crop of new opioid users simply does not know how dangerous it is. This has not always been the case; as Edward Brecher attests, old time junkies in New York City used to pass on information about drug mixing to each other and they avoided it like the plague it is. If today’s opioid users were equally well-informed of the dangers of drug mixing, most would avoid it and countless lives could be saved.

New York City has the best info on this:

http://www.nyc.gov/html/doh/downloads/pdf/epi/databrief27.pdf

In 2011, nearly one third of opioid analgesic poisoning deaths involved two or more types of opioid analgesics.

In 2011, benzodiazepines were involved in half of opioid analgesic deaths.

Heroin was involved in four of ten opioid analgesic deaths; cocaine was involved in 39% of opioid analgesic deaths, down from 58% in 2005.

Alcohol was involved in 36% of opioid analgesic deaths
.

http://www.nyc.gov/html/doh/downloads/pdf/epi/databrief33.pdf

In 2012, nearly all (97%) unintentional drug poisoning deaths involved more than one substance, including alcohol, licit, and illicit drugs.

http://www.nyc.gov/html/doh/downloads/pdf/epi/databrief50.pdf

In 2013, nearly all (94%) of overdose deaths involved more than one substance.

In other words, these people are mixing drugs, sometimes several. They're either ignorant or suicidal.

Why is the mainstream media completely silent about this? They should be telling people not to mix drugs, not demonizing them.

Also,this:

The research shows us that graduates of 28 day abstinence-based rehabs are over 30 times more likely to die of heroin-related drug poisoning (so-called “overdose”) than untreated heroin addicts continuing to use on the streets. This was the kind of rehab Dr. Drew was running on television where he killed five of his patients. Odds are that if Dr. Drew had maintained these patients on methadone instead of telling them to surrender to a “Higher Power” every single one would still be alive.
 

Olm the Water King

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...75% of regular prescription opioid misusers had also taken cocaine, and two-thirds had taken psychedelics; earlier research on adults with Oxycontin addictions found similarly high proportions of other illegal drug use. The same research also showed that nearly 80% had previously been in addiction treatment. This suggests immersion in a drug-using subculture, not a life of doctor’s appointments and pain management.

A study published in 2014 in the International Journal of Drug Policy compared the US to the UK and found that both countries saw opioid prescribing roughly quadruple in the last two decades. But in Great Britain, death rates stayed stable or fell when prescribing rose most sharply. In the US, meanwhile, opioid overdoes deaths increased 200% between 2000 and 2014 alone, and admissions to treatment for opioid problems skyrocketed.

...any Brits who do become addicted have cheap and easy access to maintenance treatment with methadone or buprenorphine, the most effective therapy. Here, 80% of people who need treatment don’t get it – and if they do, they are often limited to abstinence-only treatments.

This matters a great deal: research conducted on all patients treated for opioid addiction in England found that those who took medications indefinitely had half the death rate of those who received abstinence-based rehab.

Curbing pain prescriptions won't reduce overdoses. More drug treatment will | Maia Szalavitz | Opinion | The Guardian
 

ChocolateMoose123

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The research shows us that graduates of 28 day abstinence-based rehabs are over 30 times more likely to die of heroin-related drug poisoning (so-called “overdose”) than untreated heroin addicts continuing to use on the streets. This was the kind of rehab Dr. Drew was running on television where he killed five of his patients. Odds are that if Dr. Drew had maintained these patients on methadone instead of telling them to surrender to a “Higher Power” every single one would still be alive.

This is someone's opinion. One I disagree with. For one, Dr. Drew didn't kill anyone. The users took fatal doses. We can place responsibility without blame. That responsibility belongs to the users.

The reason most die after abstinence is they take the same doses that they were previously taking while using. They being unaware that their tolerance has lessened with discontinued use.

Would education help here? Yes. But to blame it on abstinence type therapy is not the full picture.

What also isn't said here is a big one....

Mental illness and drug addiction go hand in hand. You don't always see which hand has the firmer grip.

In order to properly diagnose and treat a mental illness, you cannot have the sufferer self medicate themselves. This is not a path toward stability. A period of detox is necessary for proper evaluation.

As for my opinion, I'm all for lessening the stigma of addiction as it is symptomatic of deeper issues. It is a band-aid. The real wound lies uncleansed underneath. This is what needs to be treated.

But while we are singing kumbayya about all this, let's not ignore the real fact that drug taking is a serious endeavor. One with risk attatched. There are predispositions for addiction and sometimes, these are blind spots in a person.

Addiction doesn't happen overnight. It's a perfect storm of events, choice and biology.

A person can be recreationally using for some time. This person may never become an addict. But if he got fired, divorced within the span of a couple months...and if he became depressed and started using more....etc. He loses his job next...It's not difficult to see this happening in many people's lives.

Let's face it. The recreational users that never become addicts...go under the radar and are not subject to stigma, really.

I guess what I'm saying is let's be careful about the education. It should be neutral and factual. It shouldn't be overly lax and permissive about risks or lazily falling back on scare tactics.
 

ChocolateMoose123

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4. Genetic research provides no substantial evidence of a genetic predisposition to addiction.

False.

Genetic research has identified genes (mainly in animal testing) that show linkage (not causation) to predisposition. There is not just one magic addiction gene. But many that work together to enhance ones *susceptibility* to certain drugs like cocaine, etc.

Again. This does not show causation or foreshadowing of addiction. There are other factors (environment, etc) that go toward this.

6. Although their scientific merits are constantly proclaimed in the mainstream literature, neuroscientific explanations of addiction are not convincing, are constantly changing, and are rarely used in diagnosing addiction or in treating it even by their strong supporters.

I suppose you mean to say since science can't explain HOW addiction works for EVERYONE as one encompassing explanation then the theories should be discarded?


Addiction cannot be understood simply as an affliction of certain individuals with genetic or acquired predispositions to addiction in otherwise well-functioning societies.

Agreed. In all fairness - it isn't regarded as only "simply a genetic affliction" by a lot of people who treat addiction. It is complex.


The most powerful risk factors for addiction are social and cultural rather than genetic or individual. This contradicts the 6th foundational element of the Official View.

Chicken or the egg. What if it is a combination of all of those things?
 

tkae.

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The truth is, from the very beginning, the consumer's control over the size of dosage and frequency of use has varied over a very wide range. Today, and virtually since 1920 - at any point in the range, at any dose with whatever frequency - use of the drug is called addiction.

That's simply wrong.

There are very specific criteria according to the DSM for Substance Abuse Disorder; they don't even use the word "addiction". Just because somebody uses something doesn't mean they're addicted to it. However, there's two caveats:

1.) Addiction is a medical term used much more frequently than addictive behavior. For example, it's highly likely that if you're a worker in the American workforce you have a mild Caffeine addiction. It means you have a tolerance and would experience withdrawal.

2.) It's generally safe to assume with certain drugs that use means abuse. For example, people don't take meth because they think it's a good idea. Unless they're just really, really dumb. But in those cases they will quickly become addicted. There's a threshold in drugs where a single use can be so likely to result in addiction that it's an exceptional event when someone doesn't get addicted.

You also have to consider that part of the change in language has been a result of increased awareness about drugs. Heroin and cocaine were considered medicinal back in the early 1900s. FDR was high on cocaine when he gave his Pearl Harbor speech. Freud was a huge proponent of cocaine as the next wonder drug. Now we know that cocaine causes damage to the nervous system. When we know something causes significant damage to the human body and people keep doing it and using it anyways, the definitions change. That's addiction because it's highly irrational and will kill them if not stopped quickly enough.

But to suggest we just label drug users as addicts automatically is just false. There's a process involved, and not all users are addicts.
 
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