Addiction: now with less responsibility! And how!

[Paelos]

I'm addicted to sports.

[ghost]

I'm addicted to sports.

To cure that you have to drink a lot of beer.   

[Nebu]

I'm addicted to sports.

It's a hormone disorder, easily treated with daily estrogen injections.  

[01101010]

So how about that cocaine man? 

[Simond]

3. Many common psychological issues are over diagnosed (depression, anxiety, ADD, etc) primarily because we live in a service based health care economy.

Speak for yourself.

[Jeff Kelly]

It's sad that every discussion about a real world issue now gets dragged down and ridiculed and turned into a rehashing of personal prejudices on this site. Usually by the same few people.

Why do you even participate when you just want to crap on the thread anyway?

I could dig up peer reviewed studies that show the limited effectiveness of psychotherapy alone or the positive results of recent studies into the effectiveness of alternative addiction treatment programs. Point out the paradigm shift in psychology and psychiatry in the approach to treat certain disorders. Or I could watch sand and others patting themselves on the back while they fuck up yet another thread.

With the same old people shitting up yet another thread why bother to discuss things at all.

So for everybody who wanted to keep a discussion going thank you for trying and to the rest: go fuck yourself.

Peace and out.

[Nebu]

Speak for yourself.

I am speaking for myself.  Do you have any idea how many people are prescribed SSRI's, pain meds, or ADD meds simply to placate to their complaints? Look up a few of these drugs and see what they're used for.  

Top Prescriptions for 2005 by Number of US Prescriptions Dispensed

    Paxil
    Lexapro
    Hydrocodone
    Xanax
    Tramadol
    Vicodin
    Lyrica
    Oxycodone
    Lisinopril
    Cymbalta
    Lipitor
    Percocet
    Zoloft
    Metformin
    Effexor
    Ambien
    Prednisone
    Atenolol
    Wellbutrin
    Morphine

[ghost]

It's sad that every discussion about a real world issue now gets dragged down and ridiculed and turned into a rehashing of personal prejudices on this site. Usually by the same few people.

Why do you even participate when you just want to crap on the thread anyway?

I could dig up peer reviewed studies that show the limited effectiveness of psychotherapy alone or the positive results of recent studies into the effectiveness of alternative addiction treatment programs. Point out the paradigm shift in psychology and psychiatry in the approach to treat certain disorders. Or I could watch sand and others patting themselves on the back while they fuck up yet another thread.

With the same old people shitting up yet another thread why bother to discuss things at all.

So for everybody who wanted to keep a discussion going thank you for trying and to the rest: go fuck yourself.

Peace and out.

Just ignore the blathering.  You had good points. 

[01101010]

Jeff man... slow down. I am just popping bullet points. You are teasing out your own conclusions and making a huge argument on my behalf that I might take credit for since I don't think I could come up with that eloquent of a debate based on a few offhanded comments.

Sadly, in the U.S., it is in fact all about pushing out the drugs haphazardly tested and scantily supported. It's only after the drug has been on the market and made a ton of $$ that some researchers comes out with a finding that <drug x> either does nothing or will kill you. Add in the advertising pharama has done in the last decade has convinced the population here that they have something wrong with them and need to "talk to their doctor about the benefits of taking <drug x> here" based on some universal symptom list that everyone experiences. This almost always leads to the situation Nebu brings up - people don't talk to their doctor's here about a drug, they convince their doctors that is the drug they need and will seek out a doctor who agrees with them if the first ones don't.

Mix in the fact that since the U.S. has such a hostile attitude toward all drug addiction as a means of personal failure, switching the definition to a physical ailment now means people will seek out a 'cure.' Nope, not my fault, my brain is sick. That will, at least here in the States, inevitably come in capsule format and cost a tremendous amount till the patent on the formula runs out.

I am by no means arguing there is not a physiological component to addiction nor am I saying that psychological component is on the same level as praying it away. Some of my graduate work was on this very thing... but I studied the social aspects of it which is smoke and mirrors research around these parts, so I'll refrain from being nailed to that cross with my own nails.

In a more altruistic society, I am sure this news would be put in its proper place, but in this screwball society of the good old US of A, we'll twist as much profit out of anything we can get.

[Ingmar]

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.  

I'm not sure I agree with this. It could be overdiagnosis, but it could also just be that our understanding of the underlying causes of these issues has progressed to the point where we can recognize them as medical problems more easily.

[Sand]

It's sad that every discussion about a real world issue now gets dragged down and ridiculed and turned into a rehashing of personal prejudices on this site. Usually by the same few people.

Why do you even participate when you just want to crap on the thread anyway?

I could dig up peer reviewed studies that show the limited effectiveness of psychotherapy alone or the positive results of recent studies into the effectiveness of alternative addiction treatment programs. Point out the paradigm shift in psychology and psychiatry in the approach to treat certain disorders. Or I could watch sand and others patting themselves on the back while they fuck up yet another thread.

With the same old people shitting up yet another thread why bother to discuss things at all.

So for everybody who wanted to keep a discussion going thank you for trying and to the rest: go fuck yourself.

Peace and out.

And I could point out studies that the number one disability for children in the United States is now mental disease and they are pushing ANTI-PSYCHOTIC drugs on these kids in order to turn them into zombies because its to difficult for overworked parents to actually parent so they would rather give their kid a pill.

And maybe you could understand that not everyone is going to agree with you on every point. But disagreement isnt "shitting up a thread" you sanctimonious prick, its simply a divergence of opinions.

I actually love most of your posts, but in this one your simply being a douche. Get a grip.

Sadly, in the U.S., it is in fact all about pushing out the drugs haphazardly tested and scantily supported. It's only after the drug has been on the market and made a ton of $$ that some researchers comes out with a finding that <drug x> either does nothing or will kill you. Add in the advertising pharama has done in the last decade has convinced the population here that they have something wrong with them and need to "talk to their doctor about the benefits of taking <drug x> here" based on some universal symptom list that everyone experiences. This almost always leads to the situation Nebu brings up - people don't talk to their doctor's here about a drug, they convince their doctors that is the drug they need and will seek out a doctor who agrees with them if the first ones don't.

Mix in the fact that since the U.S. has such a hostile attitude toward all drug addiction as a means of personal failure, switching the definition to a physical ailment now means people will seek out a 'cure.' Nope, not my fault, my brain is sick. That will, at least here in the States, inevitably come in capsule format and cost a tremendous amount till the patent on the formula runs out.

I am by no means arguing there is not a physiological component to addiction nor am I saying that psychological component is on the same level as praying it away. Some of my graduate work was on this very thing... but I studied the social aspects of it which is smoke and mirrors research around these parts, so I'll refrain from being nailed to that cross with my own nails.

In a more altruistic society, I am sure this news would be put in its proper place, but in this screwball society of the good old US of A, we'll twist as much profit out of anything we can get.

Well said.

[Ingmar]

Discounting the last 20 years of scientific research in favor of "PILLS BAD BE BETTER PARENTS" is pretty much textbook thread-shitting.

[01101010]

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.  

I'm not sure I agree with this. It could be overdiagnosis, but it could also just be that our understanding of the underlying causes of these issues has progressed to the point where we can recognize them as medical problems more easily.

And yet this begs the question of normality. When normal becomes diagnosable, then what?

If you have enough credentials and enough alphabet soup behind your name, you can change definitions if you crusade hard enough - and those can become extremely salient even in light of counter evidence... even a whole lot of counter evidence. So then what?

[Ingmar]

The point where you draw the line would be 'is this person's life actually improved by the treatement' I would think. And yes, that's a tricky if not impossible thing to pin down.

[Paelos]

I'm also addicted to the internet.

[Nebu]

The point where you draw the line would be 'is this person's life actually improved by the treatement' I would think. And yes, that's a tricky if not impossible thing to pin down.

All drugs have a downside.  ALL of them.  The question that I tend to ask myself is: will taking the drug provide benefits that outweigh the long term consequences.  Messing with neurotransmitter levels isn't something I consider lightly.  I wish more physicians would take it more seriously as well, hence my comment about service-based healthcare (aka $$$).

[Sand]

Discounting the last 20 years of scientific research in favor of "PILLS BAD BE BETTER PARENTS" is pretty much textbook thread-shitting.

Discounting current research which shows that the usage of anti-psychotics on children is a huge new growth industry for pharma companies and doctors and that mental disorder is the number one current disability in children nationwide is what exactly then?

[Ingmar]

Discounting the last 20 years of scientific research in favor of "PILLS BAD BE BETTER PARENTS" is pretty much textbook thread-shitting.

Discounting current research which shows that the usage of anti-psychotics on children is a huge new growth industry for pharma companies and doctors and that mental disorder is the number one current disability is children nationwide is what exactly then?

Maybe mental problems really are the #1 problem with kids in America, shocking as that may sound (not very shocking IMO). We've eliminated or greatly reduced the occurence of quite a lot of other childhood diseases and simultaneously gotten much better at understanding and diagnosing mental problems. What exactly would you expect the outcome to be?

[Dren]

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.'"

That reminds me of an episode of "Deadly Sins" on the History channel.  They covered "sloth" and determined it was really a description of depression.  I'm sure there were plenty of ways to provide self-therapy for that even back when the deadly sins were put to paper.  The one that got the church involved was suicide (the unforgivable sin.)  That got sloth put at the top of the list real quick.

I found that episode particular interesting considering I battle depression from time to time and still haven't figured out what causes it, triggers it, or makes it go away.  Of course, the religious aspect of it was that it is caused by demons and must be exercised.  More self-help!

For me, alcohol is the direct opposite of self-help.  I typically just stop doing anything.  Anything at all.  Sleep.  Lots of that.  Sloth.  Indulgence in sloth.

I think I'll bring this up with my doctor at my next visit...

[Sand]

Maybe mental problems really are the #1 problem with kids in America, shocking as that may sound (not very shocking IMO). We've eliminated or greatly reduced the occurence of quite a lot of other childhood diseases and simultaneously gotten much better at understanding and diagnosing mental problems. What exactly would you expect the outcome to be?

 

Because the research shows that the occurrence of diagnoses and the resulting prescriptions goes up in direct correlation to the FDA allowing pharma companies to use drugs in previously untapped market segments.
Where as if it really was an increase in diagnoses based on increased medical diagnostics or rates within the population then the diagnosis would have been their from the beginning, whether or not, a drug existed to treat them.

The drugs came first, then the diagnoses. See the difference?

[ghost]

Where as if it really was an increase in diagnoses based on increased medical diagnostics or rates within the population then the diagnosis would have been their from the beginning, whether or not, a drug existed to treat them.

This is not really the way it works most of the time.

[Ingmar]

Where as if it really was an increase in diagnoses based on increased medical diagnostics or rates within the population then the diagnosis would have been their from the beginning, whether or not, a drug existed to treat them.

This is not really the way it works most of the time.

I'm guessing the only stats we have for 'was something diagnosed' is 'was something prescribed to treat it' anyway, which of course would correlate. Not that I've seen anything actually cited here so far.

[rattran]

This thread is going places. That place will be the Den soon I suspect.

[Nebu]

I'm guessing the only stats we have for 'was something diagnosed' is 'was something prescribed to treat it' anyway, which of course would correlate. Not that I've seen anything actually cited here so far.

Patient confidentiality and survey bias would prevent anything more accurate than what you describe.  This is complicated by the fact that many drugs are used to treat a variety of psychological conditions.  Add to this that compliance is a big problem as well.  Even if a prescription is given, more than half of the people will either a) not take the medication at all or b) take the medication incorrectly (see: the rule of thirds in medicine).

[Sand]

Not that I've seen anything actually cited here so far.

I posted this article a few weeks ago, pretty scary stuff. Thread was locked for some unknown reason, given the discussion in the thread was fairly benign.

http://english.aljazeera.net/indepth/opinion/2011/07/20117313948379987.html


Two of the most relevant statements from the article:

Marcia Angell, former editor of the New England Journal of Medicine and a leading critic of the Big Pharma, puts it more bluntly: "Psychiatrists are in the pocket of industry." Angell has pointed out that most of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of mental health clinicians, have ties to the drug industry. Likewise, a 2009 study showed that 18 out of 20 of the shrinks who wrote the American Psychiatric Association's most recent clinical guidelines for treating depression, bipolar disorders, and schizophrenia had financial ties to drug companies.

The use of psychoactive drugs—including both antidepressants and antipsychotics—has exploded, and if the new drugs are so effective, Angell points out, we should "expect the prevalence of mental illness to be declining, not rising." Instead, "the tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007 - from one in 184 Americans to one in seventy-six. For children, the rise is even more startling - a thirty-five-fold increase in the same two decades.

Carl Elliott reports in Mother Jones magazine: "Once bipolar disorder could be treated with atypicals, rates of diagnoses rose dramatically, especially in children. According to a recent Columbia University study, the number of children and adolescents treated for bipolar disorder rose 40-fold between 1994 and 2003." And according to another study, "one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug."

Patient confidentiality and survey bias would prevent anything more accurate than what you describe. 

What would your opinion be on these studies?

The most damaging blow to the atypicals was an authoritative 2005 study funded by the National Institute of Mental Health—the so-called CATIE study—which found that the atypical antipsychotics worked no better than a much older antipsychotic called Trilafon (perphenazine), which was developed in the 1950s. The CATIE study also found that, contrary to the way the drugs had been marketed, side-effect profiles of the atypicals were generally no better than the older drug. Other research showed that atypicals were associated with significant weight gain, increased risk of diabetes, and greater possibility of death in patients with dementia. After another large analysis in The Lancet found that most atypicals actually performed worse than older drugs, two senior British psychiatrists penned a damning editorial that ran in the same issue. Dr. Peter Tyrer, the editor of the British Journal of Psychiatry, and Dr. Tim Kendall of the Royal College of Psychiatrists wrote: "The spurious invention of the atypicals can now be regarded as invention only, cleverly manipulated by the drug industry for marketing purposes and only now being exposed."

A 2006 study in The American Journal of Psychiatry, which looked at 32 head-to-head trials of atypicals, found that 90 percent of them came out positively for whichever company had designed and financed the trial. This startling result was not a matter of selective publication. The companies had simply designed the studies in a way that virtually ensured their own drugs would come out ahead—for instance, by dosing the competing drugs too low to be effective, or so high that they would produce damaging side effects.

[Nebu]

And according to another study, "one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug."

Two points to note with this:

1) By the time a child sees a psychiatrist, they have already been seen by a pediatrician.  If they were referred, then it's already likely that the pediatrician already had some sort of diagnosis in mind.

2) Many neuroleptics are given with a "try it and see" attitude.  Titration is the best tool we have for treating mental illness and efficacy varies greatly from patient to patient in both drug type and drug dose. 

[Sand]

And according to another study, "one in five children who visited a psychiatrist came away with a prescription for an antipsychotic drug."

Two points to note with this:

1) By the time a child sees a psychiatrist, they have already been seen by a pediatrician.  If they were referred, then it's already likely that the pediatrician already had some sort of diagnosis in mind.

2) Many neuroleptics are given with a "try it and see" attitude.  Titration is the best tool we have for treating mental illness and efficacy varies greatly from patient to patient in both drug type and drug dose. 

See my edits above directed to you about recent studies. And add this one:

One of those potentially damaging studies led back to the University of Minnesota. In the late 1990s, a clinical trial known as Study 15 unexpectedly failed to show that Seroquel was any better than Haldol, a generic antipsychotic that's been on the market since the 1960s. In fact, on the main measures, Seroquel performed worse than Haldol. The study also showed that Seroquel increased the risk of weight gain and diabetes. Internal correspondence repeatedly refers to Study 15 as a "failed study," and company officials discuss possible ways to spin or bury it. "I am not 100% comfortable with this data being made publicly available at the present time," wrote Richard Lawrence, a senior AstraZeneca official, in 1997. "However I understand that we have little choice...Lisa [Arvanitis, a company physician] has done a great 'smoke-and-mirrors' job." Lawrence referred approvingly to a strategy that he said would "put a positive spin (in terms of safety) on this cursed study." Later, apparently hoping to find a way to present Seroquel in a better light, the "commercial support team" performed an analysis of a number of other studies, but even that did not show Seroquel to be better than Haldol. Yet when a summary of the AstraZeneca data was presented at the American Psychiatric Association annual conference in 2000, the author claimed Seroquel was "significantly superior" to Haldol. That author was Dr. Charles Schulz, the University of Minnesota psychiatry department chair—and a well-compensated consultant for AstraZeneca. In a press release claiming Seroquel's superiority over Haldol, Schulz praised it enthusiastically as a "first-choice antipsychotic."

[Nebu]

See my edits above directed to you about recent studies. And add this one:

I'm not sure what your point is.  I've read all of that stuff and far more.  I used to teach these drugs to MD and PharmD students. 

Yes, big pharma has a vested interest in selling drugs.  I've already mentioned the pressure to overprescribe above.  I'm not sure what you're after here...

[Ingmar]

Took a while but I found the original article from the NYT that Al Jazeera cited MoJo citing: http://www.nytimes.com/2006/06/06/health/06psych.html

And it still isn't the actual study, which I unfortunately couldn't track down at the actual journal site. (The chain of articles citing other articles was almost Kotaku-like...)

EDIT: One thing all this discussion has me wondering, in a general sense, is how much objection to the idea of mental illness having physical causes, and psychatric medication in general is rooted in people not wanting to believe that so much of their personalities is ultimately just the result of chemical interaction, and can be changed by changing those interactions. I mean, it really eats away at people's general notions of identity and even the soul and such. That's probably a Politics/Den line of discussion for sure, though.

[01101010]

EDIT: One thing all this discussion has me wondering, in a general sense, is how much objection to the idea of mental illness having physical causes, and psychatric medication in general is rooted in people not wanting to believe that so much of their personalities is ultimately just the result of chemical interaction, and can be changed by changing those interactions. I mean, it really eats away at people's general notions of identity and even the soul and such. That's probably a Politics/Den line of discussion for sure, though.

Good point. If all it turns out to be is a chemical reaction controlled by the addition of a chemical supplement in a pill or in say water/food/air well then we get on the Godwin dancefloor much earlier in the thread and into the Den we go (or worse  )

[CmdrSlack]

Clearly, those foolish doctors have no idea how the real world works, up in their ivory towers and whatnot. I hear that if you throw a rock from a doctor's window, you can usually hit an economist in the next tower over.

[Malakili]

EDIT: One thing all this discussion has me wondering, in a general sense, is how much objection to the idea of mental illness having physical causes, and psychatric medication in general is rooted in people not wanting to believe that so much of their personalities is ultimately just the result of chemical interaction, and can be changed by changing those interactions. I mean, it really eats away at people's general notions of identity and even the soul and such. That's probably a Politics/Den line of discussion for sure, though.

I'm pretty sure it has a lot to do with it.  But hey, lets ignore reality so we can preserve a couple thousand old notion of free will based on dualism instead of actually figuring out how our brains work.

TO THE DEN WITH YOu.

[Sand]

Clearly, those foolish doctors have no idea how the real world works, up in their ivory towers and whatnot. I hear that if you throw a rock from a doctor's window, you can usually hit an economist in the next tower over.

And clearly you're just trolling and didnt read a thing I quoted or linked to which included studies by Columbia University. Pretty sure when they mention a "Columbia University" study, its not one being conducted by the Freshmen orientation class.

EDIT: One thing all this discussion has me wondering, in a general sense, is how much objection to the idea of mental illness having physical causes, and psychatric medication in general is rooted in people not wanting to believe that so much of their personalities is ultimately just the result of chemical interaction, and can be changed by changing those interactions. I mean, it really eats away at people's general notions of identity and even the soul and such. That's probably a Politics/Den line of discussion for sure, though.

I'm pretty sure it has a lot to do with it.  But hey, lets ignore reality so we can preserve a couple thousand old notion of free will based on dualism instead of actually figuring out how our brains work.

Well I think thats the ultimate goal of doctors trying to fix mental health disorders through drugs. A chemical change in a person's outward behavior. Not sure anyone here is denying that it can be done.
There is even precedent for changes in humans behavior based on being infected by certain parasites and the chemical changes they create with in the person. Their have been studies on the nature of behavioral changes in humans due to infection with Toxoplasmosis. Link- http://en.wikipedia.org/wiki/Toxoplasmosis#Behavioral_changes

[MahrinSkel]

Okay, explain this: Why is there no STD that induces nymphomania/satyriasis/priapism?

--Dave

[Sjofn]

That reminds me of an episode of "Deadly Sins" on the History channel.  They covered "sloth" and determined it was really a description of depression.  I'm sure there were plenty of ways to provide self-therapy for that even back when the deadly sins were put to paper.  The one that got the church involved was suicide (the unforgivable sin.)  That got sloth put at the top of the list real quick.

I found that episode particular interesting considering I battle depression from time to time and still haven't figured out what causes it, triggers it, or makes it go away.  Of course, the religious aspect of it was that it is caused by demons and must be exercised.  More self-help!

For me, alcohol is the direct opposite of self-help.  I typically just stop doing anything.  Anything at all.  Sleep.  Lots of that.  Sloth.  Indulgence in sloth.

I think I'll bring this up with my doctor at my next visit...

You know, that is totally one of those things that makes perfect sense but never occured to me. Depression is Sloth! Duh! I stop doing things, too. Like. Everything. Except I can't sleep either, I prefer to stay awake, thinking about what a useless sack of meat I am.  

Stupid brains, why u no werk rite?


EDIT: I am also reminded of a conversation I had with a friend of mine who was considering taking medication for ... something or another. It wasn't depression, but it was something in that vein where half the people you know secretly think you just aren't sucking it up enough and are looking for solutions in a "magic pill" because if there's something people love, it's being considered mentally ill! Anyway, her concern was that if she took this medication, she would cease being "her." Basically, she was worried a lot of what made her "her" was bound up in this issue (I think it was anxiety?). All I could say was that while I was on my medication, I felt like me, only without the crushing despair, so that was pretty nice. But I do think a lot of the hoo-ha about all this brain chemistry shit is the sneaking suspicion we really are just big bags of chemicals that happen to shake out a particular way and crap that is sort of terrifying to think about.