Friday, January 13, 2006

Is It the Water?

Our government's position is that drugs cause addiction. It is kind of like saying water causes thirst. If there was no water you wouldn't be thirsty. Thirst is caused by access to water. If we eliminate access to water thirst can never develop.

So far there is no prohibition against water use. Lucky, huh?

The question then is it the drugs or some underlying condition? i.e. Is it the water or the thirst?


jj mollo said...

You can't be serious.

That sounds like an alcoholic's denial. I'm willing to agree that self-medication is part of it. People are being deprived of choices, restrained from the Pursuit of Happiness. It's true that some people may be searching for the thing that corrects their condition, whatever that may be, but you can't deny the danger of addiction.

Some drugs have a scientifically documented tendency to lose impact with repeated doses. Physiological tolerance, that can be one component of addiction. They also have an associated detoxification requirement, where the unmedicated state of the user has changed from the pre-usage condition, and the only cure for that state may be more of the same drug. Combine that with an impact on the pleasure center and it's fair to say that usage causes addiction.

I'm also willing to agree that prohibition has a destructive effect -- more harmful to society than the drugs themselves. But there's no denying that some drugs are addictive and harmful. The use of these drugs, or at least the associated lifestyle changes, can be destructive or even lethal. Many addicts are slowly killing themselves and making the rest of us miserable as well. If the drugs didn't exist, most of the addicts and the rest of us would be happier.

M. Simon said...

Sure I'm serious.

A cannabinoid deficiency, although genetically determined (along with sufficient trauma)rather than than universal, is no different than a water deficiency.

You see, my take is that people take drugs because they need them.

It's the pain.

We have no trouble with lifetime opiate use if the pain is a broken foot that can't be healed. However, if it's your brain that is broke we have special re-ed camps (called AA or re-hab or jail or what ever) for you.

You see my problem is that I no longer believe in addiction. I no longer see the world through that filter.

What I see is homeostasis. People do what they do to improve their function.

Now just because, to an outsider, function seems more disturbed does not mean that is so to the "addict". It all has to do with the way some people's brains store pain memories.

I'd love to thrash this out with you if you'd care to. Here or by e-mail. The link is on the sidebar.

As I said. If the pain is in the foot we understand. If it is in the brain we have a lot of superstious clap trap to tell us what to do.

Tolerance comes from two things. You can't relieve pain if all the pain receptors are filled. That is short term. Longer term, the body adds new receptors if the original ones are always filled. i.e. we are not designed to be permanently happy.

I do believe in detox. However, if you study the history of detox we find that it does not cure addiction. People "relapse". Why do they relapse? Because the pain that causes "addiction" is not cured.

I do agree that there is a change in brain function. However, there is no proof that the change in brain function is caused by the drugs. None. Why? Because we have only retrospective studies. Not before and after ones.

Now where can we get before and after studies? Soldiers. We know that the vast majority are not "addicts" before combat. Yet a sizeable fraction become "addicts" after exposure to combat.

The studies are not being done.


Because every one knows drugs cause addiction.

In addition such studies with their requirement for DNA testing would be expensive. Plus, at this time there is no test for PTSD. That will change in the next year or two.

BTW if useage causes addiction why doesn't every one who tries drugs become addicted? For most drugs the "addiction" rate is about 10%.

I can explain 10% - 20% have the genetic predeliction. About 1/2 of those get sufficient trauma to cause long term "problems".

What is your explanation? The addictive personality? Which no one has ever explained or proved. No one can describe what such a peersonality is. It has no predictive value. So far what it amounts to is hand waving.

I tie my explanation to physiology, genetics, and life experience.

I can predict in advance who is liable for "addiction". Other than the trauma aspect. So far such experiments have never been carried out. It would be good to see such an experiment.

I did talk to a brain researcher who thought such an experiment would clear up a lot. He also thought I was on to something.

Well any way. People take pain relievers to relieve pain. Such a position sure makes more sense than "drugs cause addiction".

jj mollo said...

People are different. I have consumed alcohol safely all my life. I enjoy it, but if I drink more than normal I don't feel good. Never have. No temptation. My parents and grandparents were the same way. I'm not claiming to be better than the person who gets a rush of pleasure from the first swallow. It's probably genetic. My wife never met 5 of her six uncles because they got into alcohol and died one way or another because of it.

If you get the big rush from your first drink, I advise you to stop, because your chances of survival just went down. But even if you don't have that feeling, it's still possible to learn your way into it.

I've gotten addicted to cigarettes. I wasn't when I started and for some time afterward. It took a lot of practice. I had asthma for God's sake. Why would I do it? It wasn't that much fun, but it made me feel grown up. I kept feeling grown up until I tried to quit, may a hundred times I tried. Then I just felt stupid.

I'm doing fine now, but the addiction is still there. I smell tobacco smoke and it had a definite lure. That lure wasn't there before I started. I would be too frightened to take a puff, though.

People drink and take drugs for many reasons, most of which are social. Susceptible people will be more tempted to continue than others. I think most people can get addicted to drugs and alcohol if they try hard enough. Unfortunately, the pain caused by the addiction generally outweighs whatever pain it is meant to treat. The real suffering comes from the Pain to Obtain.

I think it should be legal, but I don't approve of people using it. I would like to be able to take cocaine and marijuana legally if I get sick or just too old to enjoy life. That's the pursuit of happiness angle.

The main reason I think it should be legal is to coopt the subculture that supplies it. Armies of pushers, essentially making less than minimum wage, are distracted from the economic and ethical mainstream. Their lives are more reliably ruined than the people who use it.

Drugs are bad. They cause addiction. You can't deny the danger of addiction. Prohibition is worse.

M. Simon said...

I claim that addiction is not what it seems.

Is a person that has an untreatable physical condition that causes constant pain that can be relieved with drugs an addict?

Is a person that has an untreatable mental condition that causes constant pain that can be relieved with drugs an addict?

I claim the to cases are alike.

The world so far does not see things my way (despite Freud's input on the matter in the 1890s).

So let me ask again. Is self medication for undiagnosed conditions the same as addiction?

If so then we must look at the underlying cause for the cure.

What I'm asking is: does food cause hunger?

Does water cause thirst?

Do drugs create desire for drugs?

Or is the drug question better understood by seeing people in chronic pain chronically craving pain relievers?

If the latter is the case then the cure for "addiction" is finding the pain and treating it.

Most studies on drug use show that it is 50% determined by genetics. If the other component is trauma which gets embeded in the brains of the genetically susceptable then all our current programs for treating "addiction" are worse than useless.

So far there is no know effective treatment for embeded (brain) pain. The best you can do is give the patient drugs to make them comfortable. Admitedly we ought to wean folks off of hard drugs like tobacco and alcohol and get them on softer drugs like pot and heroin. However, that is a different question.