Yep, addiction is a complex subject that we still know very little about. I recommend reading the study I linked to. And check out the kratom forums to read many personal accounts from people using kratom to quit alcohol, cocaine, heroine and more. Thanks.
Did I read it? No, but I read the abstract and intro. Study was about adults addicted to nicotine, alcohol, cannabis, or cocaine. 43k people total, about 12k people with a real DSM-IV diagnosis of addiction to one of these substances. Eventual remission rates for these things were over 90% (except nicotine, which was 88%).
The study is interesting, so let's start there. The results of the study surprised me, personally. I wouldn't have guessed the remission numbers were that high. I would have liked to see heroin, meth, or, far more pervasive in this day and age: prescription opiates.
It's certainly nice to see good news, and I do consider the study a kind of good news. The study obviously doesn't overstep its bounds or draw any big conclusions. I'm sure the people who actually did the study knew and experienced how damaging drugs CAN be in those 15-25 years before remission.
However, then we get to the article. The author runs the site substance.com and has published a book and several articles with a strong point of view about 12 step programs and the way young people with drug dependence are treated in today's society. I do think she's bending the study a little to her own aims, but I do appreciate her call towards sanity. It's a stretch, but I don't think she's being unfair to use this study to support her approach.
I don't think soft-selling the total life destroying danger of drug abuse is wise, and obviously it would suck if someone started taking drugs because they read an article or study like this, but it's possible.
Thanks you for the suggestions and for pointing to a more realistic point about addiction. As I see - and I've been living in this for many years - addiction has nothing to do with the chemical.
Johann Hari has some very good thoughts on the topic. The first time I heard about him was this talk: https://www.ted.com/talks/johann_hari_everything_you_think_y...
His books worth checking out too. As someone who struggled with addiction since childhood it is something I can very much relate to.
I also kicked all those habits. I'm curious and I was a bit of psychonaut.
This isn't me defending myself as not having an addictive personality, I'm sure I do, but I managed to stop smoking, coffee, alcohol and marijuana, some of those at the same time. Addiction is a problem that still plagues pretty much every country but even then I wouldn't say I'm necessarily in favor of banning kratom.
My original comment was only to point out that it clearly isn't as benign as a wide range of people make it seem. Of course if you go on the kratom subreddit you'll see addicts praising its benefits and rationalizing all sort of life improvements in the short term, as well as legitimate "success" stories, but most people who kicked the addiction don't repeatedly frequent and post there. I'd think this massive bias to be fairly obvious, but it might be worth repeating (this isn't aimed at your comment specifically).
Can you elaborate? Don't know the guy, but just what I read here seems mostly backed up by science - that is to say, I haven't read a lot on addiction so am definitely not an expert, but none of what I read here seems to contradict with what I think I know about it.
When you consider that (probably) most of the people who exhibit serious substance abuse problems are self-medicating, the numbers aren't difficult to digest. (I say this not as somebody with studies in hand, but as a person who's been clean and sober for more than a quarter-century, and who has significant experience dealing with other addicts and alcoholics. One can make pretty reliable predictions about underlying issues based entirely on the addict's "drug of choice".)
Let me start off by saying I feel for you and your family.
It's important to remember a single data point (an anecdote) is no substitute for large-scale studies (country-wide in the case of Portugal). The data I gave you covers millions and millions of individuals, and in my opinion, and should be weighed accordingly. I'd love for you to read them and provide your own thoughts rather than just saying "no, I have one data point close to me and advocate policy based on it."
Drug addictions are truly complicated things. In regards to the relapse after release, there's some evidence that addictions are in part situational. By the end of the Vietnam war, some 20% of service members where addicted to heroin. 95% of them were no longer addicted to heroin as soon as they returned home. Whereas people with additions in the US had a 90% chase of relapse after they returned home to the environment in which they used to be addicted. [1] I even notice this to a smaller degree myself, I drink more in SF - when I'm there, I drink more, when I travel, I drink less even controlling for everything else to the best of my abilities (again, an anecdote not a study).
Prison is a hammer, we need a scalpel, and it's important we use data dispassionately to solve this problem. What we have so far is clearly not working, and it's time to look outside and adopt things that have worked elsewhere even if they fly in the face of the status quo. I would argue especially if they fly in the face of the status quo.
The author of that study (Bruce Alexander) wrote an incredibly in-depth book about the relationship between environment and addiction. It covers not just drug addictions, but also other addictions such as overeating and excessive consumerism.
Thanks for the reference. Do you know if Lembke has had much success in treating addiction? That is how I usually filter authors like this, there is too much content and almost none of it actually helps addicts.
In my experience the mainstream view of addiction is harmful, so I feel the need to push back to help others who have fell into the trap of “it’s a disease so I don’t have a choice”. Of course I am simplifying, this is a comment thread and not a dissertation.
There's even hard data on this with regards to alcohol and cocaine that show that some people are predisposed to have a higher risk of addiction. With alcohol we know it's at least partially hereditary, so people with histories of alcohol abuse in their families are often told to be extra careful. I would love to see more research on this and even the ability to give individuals info on their own risk levels.
The only thing that seems to be near-universally dangerous in terms of addiction are opioids. But even still, most people who try heroin or get prescribed oxycodone never become addicted.
Let's also not forget that there's a bunch of rewiring that goes on in the brain when someone becomes addicted to drugs, gambling, alcohol, or whatever it is. 'Unwiring' that change is really difficult and can take a very long time.
So I think the key takeaway from the article is this: addiction is not just about the chemical hook, there's a social angle that's generally underestimated. But doesn't mean we should forget about the (1) chemical hook and (2) neurological changes that happen when someone becomes addicted.
Totally anecdotal. My point is that I think that addiction in general runs deeper than we currently understand and that we shouldn't underestimate the potential for people to become dependent on something newly available just because it is broadly conceived as harmless.
Interesting. Thank you very much for sharing. I don't know a single addict, so really have no insight. Probably that acquaintance's institution simply focuses on such patients. I don't know.
Agree fully on the points about people working with addicts, and Purdue seem to have no moral compass to counteract the profit motive. About the enslavememt to the chemical itself, it’s more complicated. The drugs primarily tend to serve as substitutes for the natural positive reinforcers the addicted person is missing, and there’s often a history of trauma and psychological unhealth prior to the drugs entering the picture. Like for the Krokodil users in the parent post, the natural and externally imposed consequences of maintaining the habit lead to a negative spiral where there’s more pain, suffering and hopelessness to face when trying to quit. I highly recommend Johann Hari’s book ”Chasing the Scream”, and Gabor Mate’s ”In The Realm of Hungry Ghosts”. Truly enlightening reads if one wants to better understand addiction
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