Addiction: now with less responsibility! And how!

[01101010]

http://www.msnbc.msn.com/id/44147493/ns/health-addictions/#.Tkl_J4JIkec

Addiction now defined as brain disorder, not behavior issue.

[Mrbloodworth]

Oh goody.

[Der Helm]

I agree with the article. Why is this not in politics ? 

[Ingmar]

I could have sworn it already was. 

[Sand]

And like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; so it must be treated, managed and monitored over a person's lifetime, the researchers say.

Its a money grab.

[sigil]

Annnnd we're off! 

[Simond]

And like cardiovascular disease and diabetes, addiction is recognized as a chronic disease; so it must be treated, managed and monitored over a person's lifetime, the researchers say.

Its a money grab.

That depends. If countries with sane healthcare systems pick up on this then no, it's progress through improved scientific understanding.

[Ghambit]

I didnt bother reading the article, but since it's now a disorder and not a behavior issue, why come put people in jail for it?

[ghost]

I agree with the article. Why is this not in politics ? 

5......4.........3.......2.........1..............

[Merusk]

I didnt bother reading the article, but since it's now a disorder and not a behavior issue, why come put people in jail for it?

Because the only way to save society from them is to hide them away.  Just like lunatics, the poor and the homosexual.

Duh.

[Paelos]

I like to post in things before they get moved to Politics.

So. Yeah. 

[SnakeCharmer]

I didnt bother reading the article, but since it's now a disorder and not a behavior issue, why come put people in jail for it?

People don't get put in jail for being addicted, they get put them in jail for being caught with an illegal substance.  Not sure what could be remotely confusing about it.  

[Sheepherder]

Off to politics we go.

[Surlyboi]

So I'm gonna go to jail for all that plutonium in my trunk?

[Jeff Kelly]

If you followed the state of the art in addiction research you wouldn't be surprised.

There is a huge correlation between addiction and attempted self-therapy. Addiction often is a coping strategy for other underlying disorders or diseases.

This is nothing new. It is common knowledge that some addicts turn to illegal substances, alcohol or other addcitive behaviours to treat depression or other disorders.

There is also a huge correlation between addiction and AD(H)D (30 - 40 % depending on the study), not because of the attention deficit but because of the low dopamine or norepinephrine levels that cause AD(H)D. There is huge correlation between addiction and bipolar disorder (which is also a neurological condition and not a behavioral issue) or other brain disorders.

Most EU drug treatment programmes now test for neurological issues like bipolar disorder, AD(H)D or atypical depression before they decide on a treatment.

This is because if the addiction is not a behavioral issue but a neurological one treating the underlying issue is a much more succesful way to treat the addiction than self-help programmes or psychotherapy.

Until today though you are very limited in the way you are allowed to treat addicts because most antidepressants, neuroleptica or other medication is off limits for addicts even if it might help treat their underlying condition.

The more I learn about neurology and psychology (to understand my own disorder better) the more I realize that a lot off stuff that is considered to be accepted knowledge today is stuff from 60 or 80 years ago.

Classifying addiction as a behaviroral disorder and not realizing that there might be underlying neurological issues is one of them.

The EU addiction treatment program with the highest success rate is the one that screens its patients for underlying neurological conditions and treats them.

[Minvaren]

There is a huge correlation between addiction and attempted self-therapy. Addiction often is a coping strategy for other underlying disorders or diseases or life situations.

Very true, but I added the bit in bold.  Reminds me of a phrase I heard during my counseling training:

"Depression existed before they came up with a label for it around 1960.  It was called 'alcoholism.'"

[Numtini]

This makes me very sad about my MSW program. Addiction was framed entirely in the simplistic terms of the 12 step programs.

[01101010]

This makes me very sad about my MSW program. Addiction was framed entirely in the simplistic terms of the 12 step programs.

And now it will soon come with a magic pill. 

[Jeff Kelly]

Very true, but I added the bit in bold.  Reminds me of a phrase I heard during my counseling training:

"Depression existed before they came up with a label for it around 1960.  It was called 'alcoholism.'"

Look I wasn't trying to deny that there are behavioral or situational causes for addiction (the life situation thing you bolded). I was just pointing out that addiction therapy and counceling so far mainly focused on occupational, situational and behavioral factors and flat out ignored the fraction of cases where addiction was the result of self-therapy to treat underlying neurologiocal disorders.

The DSM even acknowledges the distinction between neurological and situational causes of e.g. depression. The therapy programmes to treat obsessive behavior or addictions don't though.

[Mrbloodworth]

So, my smoking is REALLY about some repressed issue I have. Not the highly addictive chemicals.

Got it.

[Jeff Kelly]

Now you're touching on the real issue. An issue nobody has a clean cut and simply answer to. The nature of addiction.

[01101010]

Now you're touching on the real issue. An issue nobody has a clean cut and simply answer to. The nature of addiction.

Queue the discussion of physical addiction vs. psychological addiction!

[ghost]

I'm not sure why this is shocking.  Addiction is almost 100% related to responses elicited by a receptor-ligand interaction somewhere in the body, e.g. opiates or barbiturates.  Sure, alcohol isn't as well understood and appears to act as a membrane destabilizer, but the effect is essentially the same in the end-  it leads to a specific effect in the body which alters the milieu, thus creating compensations within the body.  Even compulsions like gambling or risk taking are essentially substance addiction, it's just that the substance is produced within the body.  Any of the coping mechanisms that we have as humans have a biochemical basis somewhere down the line.

Does this mean that we should abandon all forms of psychologically based treatments?  No, but for the most highly addicted those forms of treatment are not often effective, predominantly because those folks have a different physiology that is hindering them from getting better.  

[Nebu]

I'm not sure why this is shocking.  Addiction is almost 100% related to responses elicited by a receptor-ligand interaction somewhere in the body, e.g. opiates or barbiturates.  Sure, alcohol isn't as well understood and appears to act as a membrane destabilizer, but the effect is essentially the same in the end-  it leads to a specific effect in the body which alters the milieu, thus creating compensations within the body.  Even compulsions like gambling or risk taking are essentially substance addiction, it's just that the substance is produced within the body.  Any of the coping mechanisms that we have as humans have a biochemical basis somewhere down the line.

Does this mean that we should abandon all forms of psychologically based treatments?  No, but for the most highly addicted those forms of treatment are not often effective, predominantly because those folks have a different physiology that is hindering them from getting better.  

This.

Addiction is a biochemical process with reinforcing psychological/habitual stimuli.  Treatment requires both the adjustment of neurotransmitters as well as counseling. 

[Jeff Kelly]

Queue the discussion of physical addiction vs. psychological addiction!

Nah, you see that's not what this is about.

How addiction works is somewhat understood. See Nebu's or ghost's post. Why people get addicted, why some people get addicted and others don't and why some substances even elicit a response in the brain that's where it get's tricky.

Also it's never a vs. Every addiction has a physical and a psychological component. Even someone who is addicted to a certain behavior (like work, sex etc.) is because he/she wants to elicit the physical response the activity usually brings.

It doesn't explain though why not everybody on earth is an addict. Why can the majority of people deal with work, sex, alcohol, sports, driving, the lot but some can't.

The most popular explanation is that addicts have psychological issues or live in depressing situations and addiction is a coping mechanism for that. "The addicts are weak-minded" behavioral explanation.

[ghost]

The most popular explanation is that addicts have psychological issues or live in depressing situations and addiction is a coping mechanism for that. "The addicts are weak-minded" behavioral explanation.

You pointed out instances where people were "self treating" for problems like depression, etc.  That is still a biochemical interaction, but may blur the lines on what is addiction and what is not.  It is very, very common for folks with PTSD to be alcoholics.  Why?  Because they can't fucking sleep without going bonkers and this is their method of dealing with it.  Are they still alcoholics?  Sure.  They have the same problems quitting as anyone else.  Everything can be explained by biochemical interactions.  Some of those interactions we don't fully understand yet, but behavior, while complex, is based on chemical interactions within the body.  Hell, we may get to the point where "free will" is disproven. 

[Minvaren]

Look I wasn't trying to deny that there are behavioral or situational causes for addiction (the life situation thing you bolded)...

I wasn't trying to disagree with you here or put down what you said - I was just expounding on the fact that people self-medicate for all sorts of reasons (yes, even me), which can lead to addiction depending on a variety of factors that you and lots of others have already hit on.

[Jeff Kelly]

I'm not debating this just for kicks. I have my own experiences. I've never been a full blown addict but I know what a formidable and outright devious enemy your own brain can be.

The amount of sheer willpower and concentration necessary to not give in to certain things was so high that I was even burned out and physically exhausted at one point. This is no issue of mere discipline. The fight against my own brain left me emotionally and physically completely exhausted.

This is why I simply cannot subscribe to the behavioral explanation - at least completely. The compulsion to act in a certain way is as strong as it must be for a person suffering from OCD. As soon as my neurological and chemical imbalances were treated all of my debilitating and bad behaviors simply vanished.

I didn't become obessive because I was depressed, I became depressed because I was obsessive and ran out of options to control it. If a simple treatment option can make all of these issues simply vanish and not over a few months but instantly. By using a certain mechanism that cures a certain chemical imbalance in my brain then the issue cannot simply be behavioral. Which is sad if everything anybody ever tried attacked my behavior or a subset of my symptoms.

Quite frankly in my own studies I've never found anybody that can explain what is cause and what is effect in this interaction.

What came first the erratic behavior or the depression? Addiction or something that led to it? It is only now that people actually try to find an answer to those questions because the assumption about what is cause and what is effect has been out there for so long.

[ghost]

Well, in your case you got rid of obsessive behavior and it cured your depression (if I'm hearing you correctly).  This is very clearly a biochemical interaction.  I may be misunderstanding you, but it appears if you are suggesting that there is some nebulous psychological reason behind addiction/behavior or what have you, and then you are providing evidence that would suggest otherwise. 

[Jeff Kelly]

I'm not debating you at all.

The point I'm failing to make is that I don't believe the "addiction is a psychological issue" explanation at least not completely. Alas it is the accepted explanation for most medical and psychological professionals.

The OP also seems to believe in that explanation because he seems to be outraged that doctors are now trying to "fix" a psychological issue with pills and not with "dealing" with the underlying psychological issue.

It's basically the first argument people bring to the table to argue against antidepressants or AD(H)D medication or a number of other psychopharmaka. Why are you prescribing pills instead of really helping those people? Pills are a cop out for people that don't want to face their real issue. It's an invented disease so that big pharma can make a profit.

State of the art in medical research contradicts that, though.

[Ghambit]

I didnt bother reading the article, but since it's now a disorder and not a behavior issue, why come put people in jail for it?

People don't get put in jail for being addicted, they get put them in jail for being caught with an illegal substance.  Not sure what could be remotely confusing about it.  

Well, you're right and so am I... kinda.  They pretty much get put in jail for being addicted.  All a state needs to put your ass in jail for imbibing ANYTHING illegal is the fact that it's still flowing through your veins.  i.e.  intoxication is the same thing as possession.  MaryJ is becoming a special case finally, where you only get nabbed if you have it on you and not if you're high - as long as you're not underage, disorderly, driving, etc.  But if you're acting foolish enough whilst on something like Meth (which is now a DISORDER and not a BEHAVIOR) they can easily throw you in jail if they want.

So basically you get a court date (instead of a clinic, psych. eval, etc.) for being physiologically addicted (note: now not simply behaving badly) to something and having it flow through your veins.      And we taxpayers get to pay for it...  the cops' time on the beat, the processing, most of the legal fees, your meals while incarcerated, your bond if you jump, etc.

This is why they need to separate stuff like this from y'know, actually doing something wrong.  I'd rather spend my tax monies on a specialized section of a jail or a clinic that people will get sent to rather than having them shuffled through the criminal system.

[ghost]

Reply to JeffK-  Very much so.  Psychology is extremely limited in efficacy for many disorders.  It can help a lot with milder problems, but when you get to the extremes there is usually an imbalance that needs to be addressed biochemically as you've stated.  I think that a lot of people that tend to pontificate on medical issues just don't have the background/education to understand how much there is out there that there was no explanation for in the past.  Also, a lot of research done in the mid to late 1900's was not to current standards.  The picture we have now is so much better than even 10 years ago.  What I think is going to be really cool is when they get all the alternative splicing and RNA stuff lined out.  

[Nebu]

1. People with a biochemical imbalance, particularly one that involves a neurotransmitter, didn't choose for that to be the case.  

2. The imbalance further complicates matters as those with them are often difficult to treat (pharmacologically and psychologically) due to compliance problems.  

3. Many common psychological issues are over diagnosed (depression, anxiety, ADD, etc) primarily because we live in a service based health care economy.  When people go to the doctor, they get pissed off if they don't leave with a prescription or a bottle of pills.  

[ghost]

they get pissed off if they don't leave with a prescription or a bottle of pills.  

We should probably just give those folks penicillin.  That's what MDs did for years with any sniffle that came in the door, and it's basically useless now as it is.   

[Sand]

There is a huge correlation between addiction and attempted self-therapy. Addiction often is a coping strategy for other underlying disorders or diseases.

This is nothing new. It is common knowledge that some addicts turn to illegal substances, alcohol or other addcitive behaviours to treat depression or other disorders.

Did you read the article? They are claiming its now not a behavior associated with an underlying medical condition. It is a prime chronic condition in and of itself.

The new definition also describes addiction as a primary disease, meaning that it's not the result of other causes, such as emotional or psychiatric problems.

So hey you arent an addict because you used heroine, a chemically addictive substance, to get high and escape your shitty life. You have a addictive behavioral disorder!
Cheated on your wife 10 times? Really like sex with strange women? You have a addictive behavioral disorder!

What a bunch of bollocks.