Freedom and treatments for drug addicts

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Sanchez
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Re: Freedom and treatments for drug addicts

Post by Sanchez » May 12th, 2016, 11:26 pm

Belinda wrote:Sanchez, on the basis of what you wrote it sounds like the second meaning of 'voluntary'. Not involuntary but needs a determined effort to not take the drug.
Taking the drug requires determined effort as well. It's not like the addict becomes aware somewhere along the line that he's driving to the liquor store. It doesn't compare to a nasty habit like biting your fingernails, which people can do without thinking about it. The Big Book says that "I knew from that moment that I had an alcoholic mind. I saw that will power and self-knowledge would not help in those strange mental blank spots." I argue that there are no such blank spots. It doesn't seem to be that the human brain would be capable of such a complex behavior as addiction without the involvement of higher-order functions.

Belinda
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Re: Freedom and treatments for drug addicts

Post by Belinda » May 13th, 2016, 5:12 am

Sanchez wrote:
Taking the drug requires determined effort as well. It's not like the addict becomes aware somewhere along the line that he's driving to the liquor store. It doesn't compare to a nasty habit like biting your fingernails, which people can do without thinking about it. The Big Book says that "I knew from that moment that I had an alcoholic mind. I saw that will power and self-knowledge would not help in those strange mental blank spots." I argue that there are no such blank spots. It doesn't seem to be that the human brain would be capable of such a complex behavior as addiction without the involvement of higher-order functions.
"Higher-order functions " I approve of that reference to those powers that are special to human beings, of which driving a car or setting aside are mundane examples which you have already mentioned. I believe that you might also have included in "higher- order powers" the human ability to be insightful about impulses and to reflect on ideas about what is not concretely present.

I am wondering therefore if loss of will can be caused by the direct action of some substances upon a specific part of the physiological brain stem, that part where voluntary function is located.

If so, we may question how it is that some people such as yourself can retain the voluntary function while others lose it.

Looking ahead I hope and trust, Sanchez, that you are not going to accuse me of medicalising. I am not medicalising here; my suggestion purports to be scientifically neutral not a model for anything else.
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Supine
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Re: Freedom and treatments for drug addicts

Post by Supine » May 13th, 2016, 10:37 am

Sanchez wrote:Supine: You claim that my views on 12 steps are mistaken and accuse me of lying about my meeting attendance. I admit that your group might be an old-school group, which unlike most, hasn't been influenced by newer pop psychology elements. I have heard the "AA ain't what it used to be"-argument before so clearly there are differences among groups.
Sanchez, I'm surrounded by people that lie. In the views of most people that are hardcore AA'ers the "normies" (a term many of them use to refer to people that can drink socially, non-alcoholics) don't lie, walk on water like Christ, can't swear and bring about peace and equality to all humans on earth. Apparently, in their views not a war on earth, the Trans Atlantic Slave Trade, denying women the right to vote, adultery, envy, racism was ever carried out by a non-alcoholic or drug addict. But encounter people that don't go to AA, presumably have no substance addictions, that lie about having been Navy SEAL's, about being high paid CEO's, nurses aids that call themselves "nurses," about the degrees they've earned and their academic credentials. I know one veteran that claims to have been Army Special Forces (doing the math based on his age, at age 15) carrying out secret missions in Cambodia so secret not even the Army top brass knew (impossible, only possible CIA spec ops, because all military spec ops answer to military brass in the Pentagon from which their orders come down from). Another veteran that can barely read, incorrectly signs his name by placing his first name first with a coma after it and then his last name but claims to have worked 20 years as a social worker (more likely he's had 20 years of supervision by a social worker as he has less independence than many 14 year-olds). I have encountered many other addicts that claim not to be addicts though all indications say they are but they enjoy ridiculing all people in AA even those 20 years sober as not being mentally strong enough, not exercising sheer will power.

And I'm sure in all grandiosity there are those that like to lie about having spent decades in AA.

One could claim to have been a Catholic for 20 years and go one to say the Catholic Church in official doctrine teaches the Virgin Mary is God and the Pope anointed a deity. This would be a flat out lie and give indication the person was never a Catholic for 20 years. Likewise with a person who claims to have been Muslim and that Muslims worship Mohammad as God. A flat lie.

No person spending 2 years in AA could mistake what AA means by being "powerless" over alcohol. Actually, every rehab in the VA hospitals I've been in using their "scientifically" derived educational/psychological platforms ALWAYS goes over that one characteristic of the addict is constantly trying to control his/her drinking/use and/or figure out ways to control it. The classic example of alcoholics giving up whiskey for beer to control their addiction in hopes of altering the outcome for a positive good. It's not that they can never drink alcohol, that one drink is too many, but rather its the type of alcohol they drink causing the problem. AA and all rehabs I've been in teach this notion is incorrect and that physically one is alcoholic forever, no matter what alcoholic beverage they drink.

I know 15 year sober crack cocaine addicts in Narcotics Anonymous that won't even take opiates, prescription pain pill medication, after having teeth pulled by the dentist. Even though they are not opiate addicts they fear reigniting their active addiction or even becoming addicted to opiates. I personally took 3 days worth of prescription opiates after my hernia stomach operation in January when discharged from VA hospital, after I declined being prescribed them but it was the doctor that talked me into taking them. He said, "let's compromise," he gave me only 3 days worth (rather than say... 7 days worth) and prescribed me the less potent hydrocoden (vicoden) rather than the Oxycotin he was going to give me. And I'm not an opiate addict. But I'm cognizant of the statistical and physical reality that once a person becomes addicted to a mind altering substance that are at high risk odds of becoming addicted to another substance (alcoholics even to gambling). So, I treat opiate pain medication the way slim female heath nuts treat baked foods and fast foods. I will every blue moon (it's been over 15 years at least) gamble at a casino for a few dollar ($5 or maybe $20), but I make it no habit because I'm terrified of getting addicted to something else.

I'm 44 and can out run most Americans in their 20's and teens I come across (judging from past boxing training). With crack addiction I graduated from community college with honors. I would catch the bus to boxing training and the catch another bus afterward to martial arts training. And unlike a growing number of Americans I don't have self-caused Type 2 diabetes or self caused skin or lung cancer. And I've been around many diabetic military veterans in rehabs and transitional housing. They keep horrible diets which are akin to crack addicts relapsing constantly, obese people on diets relapsing and eating foods their not, and gay people dating members of the opposite sex but relapsing and finding their mouths around the genitals of yet another person of their same sex. Pleasure. What humans are weak too.

As for "triggers." My crack cocaine triggers are no different than my heterosexual triggers or any of my sexual fetish triggers. The inward motivation (craving/arousal) comes so fast, too fast, to be brought about by choice or rational deliberation. They are deterministic. I don't choose to be attracted to Latina women with round butts like J-Lo no more than I choose to be addicted to crack cocaine. My actions are my choices however. I choose to smoke crack just as I choose to have premarital sex with a woman or have gay sex with a man. I've had on separate occasions a crack pipe in my mouth and a penis in my mouth. Both were out of pure choice. Now, I know the Americans taught the Nazis in Germany their eugenics beliefs, and those beliefs were held as sacred, dogmatic, and holy as American pro LGBTQ beliefs. And I'm aware I'm living under a new era of American neo-eugenics movement, with all its scared creeds and holy professions, and therefore what I'm saying with fly over the head of an American. I don't care about American laws or the Lord Your God Obama. I'm no worse than Caitlyn Jenner and too divorce his wife, place his own pleasures above his children, get on prescription hormones, radically alter his body, date women, and become "open minded" to giving oral sex to a man or getting sodomized by a man... is no more holy in the eyes of the protagonist Christ Almighty than my own lowly sins.

Sure, I'm the new "Jew" of the day. Worst I'm a Jew that follows the heretic protagonist known by the Greek name Jesus. The LGBTQ with their finger pointing and fat diabetic Americans with their subprime loans at adjustable mortgage rates, may grab their stones to throw at me the sinner bloodied, on his belly at the feet of the protagonist Jesus. Everyone needs someone to look down their superior noses at. But I've not killed person in auto accident. Even the most celebrated and beloved Virgin Madonna of the Americans known as Caitlyn Jenner can't say that.

I have no children by the way. And I've not "eaten up" my families income as you've put it. Albeit, I have been financially helped many times by my parents, but far from bankrupting them. I wasn't raised with a silver spoon in my mouth nor will I inherit impressive sums of money. But many American Jews will and many American whites (at least at a higher percentage to blacks and Latinos) will. Yet, according to the Old American tale, placed right beside it's pro-black woman and pro-LGBTQ stories, ethnic Black-American males like myself only ever cry and concern ourselves about how others have more than us. You'll never catch me complaining about the good fortunes of others given luxury cars from their parents. So, if my middle-class parents gave me $10 or $200 here and there then what business is it of yours? I don't complain about the million dollars Trump's father gave him or the farm or $60,000 some white 40 year-old is being left by his parents. Worry about yourself.

Go find some other scapegoat for your poor American economy. It's you people that demand spending billions of dollars forcing cops to patrol in mass numbers, stopping, questioning, demanding photo ID, physically searching black men (or poor whites) in your holy war on drugs. I didn't ask you to do. So, take some "personal responsibility."




However from my extensive reading online, I gather that my experience wasn't in any way unique. The things that I mentioned are routinely taught in the meeting rooms. I don't think it's a new problem either. Jack Trimpey wrote of it in Rational Recovery twenty years ago and the meetings he attended in the late 1960s were very similar to what I experienced four decades later. Keep in mind that nobody speaks for AA, which means that everybody speaks for AA (which you are doing here). You effectively used the No true scotsman-fallacy by arguing that the real AA teaches personal responsibility.

I argue that personal responsibility over substance abuse is not only incompatible with AA, it's incompatible with any support group. If one takes full responsibility over substance use, he will solve the problem independently and make no appeals to diseases or any baffling entities to explain what is ultimately just ultra-hedonism. You got caught up in semantics and me quoting out of context, and I admit that these things are quoted from memory, not directly from the Big Book or other literature. However, I feel this is irrelevant because your posts themselves have proven my core argument: that AA members see their drinking as a process outside of their direct control and in case of a "relapse", they will blame themselves for not "working recovery", but not for the act of drinking because they assume that to be beyond their control.

I think the problems of AA were there from the beginning. Bill W. was a narcisstic cult leader who never really solved his own addiction. After sobering up, he spent years in deep depression and only extramarital sex seemed to bring him comfort. AA is built on the ideas of people who have never solved an addiction and are therefore poor teachers for others on that goal. Peer support is based on the idea that a lot of poor advice somehow accumulates into good advice. As the research I've mentioned below shows, most people get better without groups or any form of treatment (and conversely, very few benefit from AA). It also illustrates that there are deep problems with the disease model. For example, the supposed loss of control after consuming alcohol is disproven both by priming experiments where alcoholics unknowingly consume alcohol and also the research showing that many actually go back to moderate drinking.

I stand by my assertion that the teachings of Twelve Steps do treat addiction as a disease that people are powerless over. While the question of your future drinking might have gone too far, it is a good measure of personal responsibility. At the very least, AA members need to give some good reason why they actively prevent people from committing to sobriety. And don't tell me they don't do this. Tell people at an AA meeting that you will never drink again and never have any relapses. Will they pat you on the back for finally taking full responsibility? No, they will tell you that the idea is insane and a symptom of the disease. Their entire doctrine is built on keeping the door to relapse open.

One of the largest studies on drinking problems showed that independent recovery is the most common way of doing it and that untreated were more likely to recover. It also showed that quite a few people with drinking problems go back to moderate use: http://pubs.niaaa.nih.gov/publications/ ... 31-142.pdf

The study is analyzed here: http://www.thecleanslate.org/self-chang ... treatment/

About priming experiments, which disprove the idea that alcohol causes some physical reaction in alcoholics and makes them lose control: http://www.thecleanslate.org/do-alcohol ... ts-say-no/

About the effectiveness of AA: http://www.orange-papers.org/orange-effectiveness.html
(Although the website is explicitly anti-AA, all the research is cited, so you can't accuse the author of making it up. )

Another piece about the effectiveness and how AA beliefs may lead to more binge drinking: http://www.hamsnetwork.org/effective.pdf

Here's a good criticism of the disease model: http://www.thecleanslate.org/myths/addi ... -a-choice/

Here are quotes from experts opposing the disease model: http://www.thecleanslate.org/addiction- ... m-experts/

And finally some solid advice from a former drunk: https://rational.org/index.php?id=97

-- Updated May 12th, 2016, 10:56 am to add the following --
Belinda wrote: 'Voluntary' and 'involuntary ' have more than one meaning.

The knee jerk reflex is wholly involuntary and cannot really be inhibited.

The nervous person's licking their lips is often referred to as involuntary but the lip licker can stop doing it when he is aware of it and wants to inhibit the licking.

The woman who places her lipstick by rubbing her lips together is doing a wholly voluntary act , however someone might inform her that using a lip brush is better.

What I am wondering is if the alcoholic might belong to any one of those 3 classes ,2 of which are separate varieties of voluntary.
Think about how much effort sustaining an addiction actually takes. One cannot go to the store or visit his local dealer without the conscious intention of doing so. Money has to be set aside for this purpose. Purposeful motor control is needed to get there. Often excuses have to be made and prior appointments cancelled to make time for the WOW-Experience. Effort is needed to hide the act. Prior to "relapse", addicts even fantasize about what they're gonna take. As Jack Trimpey put it, people have "yummy relapses" with the finest stuff they can afford. If anything, thinking increases prior to resuming use. It's certainly not in the first two categories. I'm not saying it's a simple choice or a no-brainer. Often there is a lot of internal debate and second-guessing and even regretting it beforehand. This is not unique to addiction and doesn't change the fact that the addict ultimately chooses to go ahead with it.
You have no clue what "personal responsibility" is. I do it every time I go to physical therapy for my arm, shoulder, rotor cuff and receive dry needling as well as exercises. It's not much different than working on my substance recovery by going to AA meetings. I don't find boxing training much different either. The thing is the Marine Corps, Gulf War, boxing, physical therapy, and physically recovering from 3 bullet wounds that took a number of my organs, and crawling on all 4's dragging buckets of hot tar on metal sleds as a roofers helper were ALL EASIER THAN MY BATTLE WITH CRACK ADDICTION. I dismiss being shot as a the "p" word for vagina stuff. Albeit, the physical recovery was terrible in pain and I briefly had some PTSD from it which disallowed me from sleeping more than a few minutes at a time in the hospital recovery room. But I snapped back from that like a champ.

But you do know who is an alcoholic and cocaine addict? Oscar Dela Hoya. H says he's been one since his youth. Yet he operated not merely at a good level but at the most elite level of a global combat art: professional boxing. And you are who and have done what? Oscar--as pictures have revealed--would get high on crack cocaine and cross dress in female clothing. Caitlyn and the LGBTQ and diabetic Americans are no better morally than Oscar Dela Hoya.

Likewise, plenty of people in AA are high paid executives and some are musical and Hollywood celebrities.

According top my past sociology text book sociologist give examples of "categories" as these: women, blacks, Muslims, homosexuals, drug addicts, Jews, rich etc.

Why don't you go talk about Jews, women, and homosexuals the way you do drug addicts?

https://www.youtube.com/watch?v=JfmR8RoV_fE

Sanchez
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Re: Freedom and treatments for drug addicts

Post by Sanchez » May 13th, 2016, 11:13 pm

Supine wrote: Sure, I'm the new "Jew" of the day. Worst I'm a Jew that follows the heretic protagonist known by the Greek name Jesus. The LGBTQ with their finger pointing and fat diabetic Americans with their subprime loans at adjustable mortgage rates, may grab their stones to throw at me the sinner bloodied, on his belly at the feet of the protagonist Jesus. Everyone needs someone to look down their superior noses at. But I've not killed person in auto accident. Even the most celebrated and beloved Virgin Madonna of the Americans known as Caitlyn Jenner can't say that.
You claim to take full responsibility and yet here you play the victim and imply that critics are out to get you. I suppose you being the new Jew makes me the new Inquisition or the new NSDAP. You also seem to imply that this is because you're a Christian and presumably my posts are part of some anti-religious crusade. You go on about all sorts of wrongs in the world. I have never claimed drug addiction to be the worst problem of all. I do think, however, that a thread on drug addiction should be about drug addiction. I think that if you really had some solid argument against me, you would stated that and moved on. The fact that you launch into all sorts of accusations about me speaks for itself. You did nothing to refute any of the research I linked to. You didn't even try to argue with the claim that most addicts quit on their own and move on. You provided no evidence of this addictive disease and refused to address my question about your future drug use.
Supine wrote: I have no children by the way. And I've not "eaten up" my families income as you've put it. Albeit, I have been financially helped many times by my parents, but far from bankrupting them. I wasn't raised with a silver spoon in my mouth nor will I inherit impressive sums of money. But many American Jews will and many American whites (at least at a higher percentage to blacks and Latinos) will. Yet, according to the Old American tale, placed right beside it's pro-black woman and pro-LGBTQ stories, ethnic Black-American males like myself only ever cry and concern ourselves about how others have more than us. You'll never catch me complaining about the good fortunes of others given luxury cars from their parents. So, if my middle-class parents gave me $10 or $200 here and there then what business is it of yours? I don't complain about the million dollars Trump's father gave him or the farm or $60,000 some white 40 year-old is being left by his parents. Worry about yourself.
You're completely missing my point. Eating up finances was one of the possible negative effects of addiction. I wasn't talking of your finances. Stop taking this so personally. This is thread on addiction, not a thread on your addiction.
Supine wrote: Go find some other scapegoat for your poor American economy. It's you people that demand spending billions of dollars forcing cops to patrol in mass numbers, stopping, questioning, demanding photo ID, physically searching black men (or poor whites) in your holy war on drugs. I didn't ask you to do. So, take some "personal responsibility."
You make long, bizarre rants about American policy and accuse me of all sorts of things, despite the fact that I am not American. Like many addicts I've met, you like to talk about anything except quitting drugs.
Supine wrote: But you do know who is an alcoholic and cocaine addict? Oscar Dela Hoya. H says he's been one since his youth. Yet he operated not merely at a good level but at the most elite level of a global combat art: professional boxing. And you are who and have done what? Oscar--as pictures have revealed--would get high on crack cocaine and cross dress in female clothing. Caitlyn and the LGBTQ and diabetic Americans are no better morally than Oscar Dela Hoya.

Likewise, plenty of people in AA are high paid executives and some are musical and Hollywood celebrities.
Yes, lots of people in Hollywood are addicts (part of why the disease model is so popular), and because they attend Twelve Steps-meetings, they will probably stay that way. I have never claimed that addiction is incompatible with success. I don't know if you're actually claiming that your success (or Hoyas success) somehow entitles you to drug use, but that's how you're coming across. After telling me to worry about myself, you turn around and become interested in my personal achievements, as if the validity of my points depends on that. "Sanchez is a loser, so he's wrong."
Supine wrote: According top my past sociology text book sociologist give examples of "categories" as these: women, blacks, Muslims, homosexuals, drug addicts, Jews, rich etc.

Why don't you go talk about Jews, women, and homosexuals the way you do drug addicts?
You do a fine job of making my point for me. You see your drug use an inherent part of you, like ethnicity or gender. To be honest, this is probably the main reason why you're still struggling. You make an unfounded association between inherent character traits and what you yourself admitted to be chosen behavior.

Given all the personal attacks, I do hope that you will make amends to me when you get to Step Nine.

-- Updated May 14th, 2016, 12:17 am to add the following --
Sanchez wrote:
Supine wrote: Sure, I'm the new "Jew" of the day. Worst I'm a Jew that follows the heretic protagonist known by the Greek name Jesus. The LGBTQ with their finger pointing and fat diabetic Americans with their subprime loans at adjustable mortgage rates, may grab their stones to throw at me the sinner bloodied, on his belly at the feet of the protagonist Jesus. Everyone needs someone to look down their superior noses at. But I've not killed person in auto accident. Even the most celebrated and beloved Virgin Madonna of the Americans known as Caitlyn Jenner can't say that.
You claim to take full responsibility and yet here you play the victim and imply that critics are out to get you. I suppose you being the new Jew makes me the new Inquisition or the new NSDAP. You also seem to imply that this is because you're a Christian and presumably my posts are part of some anti-religious crusade. You go on about all sorts of wrongs in the world. I have never claimed drug addiction to be the worst problem of all. I do think, however, that a thread on drug addiction should be about drug addiction. I think that if you really had some solid argument against me, you would stated that and moved on. The fact that you launch into all sorts of accusations about me speaks for itself. You did nothing to refute any of the research I linked to. You didn't even try to argue with the claim that most addicts quit on their own and move on. You provided no evidence of this addictive disease and refused to address my question about your future drug use.
Supine wrote: I have no children by the way. And I've not "eaten up" my families income as you've put it. Albeit, I have been financially helped many times by my parents, but far from bankrupting them. I wasn't raised with a silver spoon in my mouth nor will I inherit impressive sums of money. But many American Jews will and many American whites (at least at a higher percentage to blacks and Latinos) will. Yet, according to the Old American tale, placed right beside it's pro-black woman and pro-LGBTQ stories, ethnic Black-American males like myself only ever cry and concern ourselves about how others have more than us. You'll never catch me complaining about the good fortunes of others given luxury cars from their parents. So, if my middle-class parents gave me $10 or $200 here and there then what business is it of yours? I don't complain about the million dollars Trump's father gave him or the farm or $60,000 some white 40 year-old is being left by his parents. Worry about yourself.
You're completely missing my point. Eating up finances was one of the possible negative effects of addiction. I wasn't talking of your finances. Stop taking this so personally. This is thread on addiction, not a thread on your addiction.
Supine wrote: Go find some other scapegoat for your poor American economy. It's you people that demand spending billions of dollars forcing cops to patrol in mass numbers, stopping, questioning, demanding photo ID, physically searching black men (or poor whites) in your holy war on drugs. I didn't ask you to do. So, take some "personal responsibility."
You make long, bizarre rants about American policy and accuse me of all sorts of things, despite the fact that I am not American. Like many addicts I've met, you like to talk about anything except quitting drugs.
Supine wrote: But you do know who is an alcoholic and cocaine addict? Oscar Dela Hoya. H says he's been one since his youth. Yet he operated not merely at a good level but at the most elite level of a global combat art: professional boxing. And you are who and have done what? Oscar--as pictures have revealed--would get high on crack cocaine and cross dress in female clothing. Caitlyn and the LGBTQ and diabetic Americans are no better morally than Oscar Dela Hoya.

Likewise, plenty of people in AA are high paid executives and some are musical and Hollywood celebrities.
Yes, lots of people in Hollywood are addicts (part of why the disease model is so popular), and because they attend Twelve Steps-meetings, they will probably stay that way. I have never claimed that addiction is incompatible with success. I don't know if you're actually claiming that your success (or Hoyas success) somehow entitles you to drug use, but that's how you're coming across. After telling me to worry about myself, you turn around and become interested in my personal achievements, as if the validity of my points depends on that. "Sanchez is a loser, so he's wrong."
Supine wrote: According top my past sociology text book sociologist give examples of "categories" as these: women, blacks, Muslims, homosexuals, drug addicts, Jews, rich etc.

Why don't you go talk about Jews, women, and homosexuals the way you do drug addicts?
You do a fine job of making my point for me. You see your drug use an inherent part of you, like ethnicity or gender. To be honest, this is probably the main reason why you're still struggling. You make an unfounded association between inherent character traits and what you yourself admitted to be chosen behavior.

Given all the personal attacks, I do hope that you will make amends to me when you get to Step Nine.

Lastly, I'd like to point a very strange thing about you. Presumably on some level you do want to quit using. However, you get mad at me when I suggest that you can do this. Don't you think it's odd?

-- Updated May 14th, 2016, 1:06 am to add the following --
Belinda wrote: I am wondering therefore if loss of will can be caused by the direct action of some substances upon a specific part of the physiological brain stem, that part where voluntary function is located.
This is actually two questions. Does the drug lead to impaired judgment (which I feel is a more accurate term than loss of will)? Yes, this is well-established. However, this doesn't explain what we call addiction, since people decide to resume using while they're in a sober state. The second question is whether long-term use results in changes to the brain that compromise self-control. There really is no evidence that it does. There is a small group of addicts who developed brain damage due to substance abuse, but their symptoms include much more than the inability to resist substances. Their problems will be apparent to everyone around them and likely they will need to be institutionalized. This is a result of addictive behavior, not a cause.

If the brain changes from drug use were somehow contributing to further drug use, we'd expect very few people to quit independently. In fact, we'd expect very few to quit even with treatment, since the treatment is not focused on the brain. George Vaillant's study on heroin users showed that the percentage of people quitting didn't go up or down as time went by. If brain changes alone made quitting harder even among a minority of addicts, we'd expect people to be less likely to quit the longer they've been using. This isn't what is observed.
Belinda wrote: If so, we may question how it is that some people such as yourself can retain the voluntary function while others lose it.
I would rather question whether others really lose it. There is no evidence other than the anecdotes provided by addicts. Addiction is characterized by cognitive dissonance and ambivalence. The addict might see his actions as morally wrong. In order to not see himself as a bad person, it becomes tempting to see the objectionable behavior as something impossible or at least very hard to control. Similarly people might see their actions as stupid and out of their control, since the alternative would be to view themselves as stupid. For similar reasons, the idea of lack of control appeals to people close to addicts. It really feels better to see Daddy as out of control, rather than seeing him as fully responsible and yet choosing to drink in spite of the troubles it causes. This cognitive distortion is made much easier by the fact that it is seemingly accepted as fact by much of society, often including authorities, such as the medical and scientific communities. Additionally, there are real conditions where voluntary control is compromised, so it seemingly makes sense to place addiction in the same category. So I think there is no loss of voluntary function that needs to be explained.

However, as I explained, addicts do perceive their behavior as out of control, which is just as damaging but much easier to cure. This is supported by the Brandsma-study, where belief in the disease model was shown to be the biggest single predictor of relapse. This is what Trimpey meant when he said that "The disease model IS the disease." Addiction is firstly about hedonism and secondly about a set of self-fulfilling beliefs that turns this to hedonism into something chronic and open-ended. We have debated over various models of addiction: disease model, disability model, moral model. I think we could find some common ground with the cognitive model, where addiction is largely driven by the pervasive mythology that has developed around addiction.

Trimpey had a great analogy on this. Imagine the addict as someone swimming in a sea. He feels exhausted and fears he is about to drown. He calls for help and gets mad when people tell him to stand up, since the water is only waist-deep. The tragedy here being that one can drown in shallow water. Lots of former addicts, such as myself, have noticed this. When I finally quit, it became apparent that the water had been really shallow all along. There was no real lack of control, but my belief that there was kept me locked in my hedonism. I remain extremely skeptical of the idea that there is actual loss of will at work, since the cognitive distortions I described are sufficient to explain everything we observe. Most importantly, it explains how most people are able to quit independently: they changed the way they view their behavior.

This has implications on the type of help that should be offered to addicts. While I oppose treatment, I would argue that a lot of people would benefit from education. Most wouldn't even need one-on-one counseling, studying the educational materials on their own would be sufficient. Some would benefit from personal instruction.
Belinda wrote:
Looking ahead I hope and trust, Sanchez, that you are not going to accuse me of medicalising. I am not medicalising here; my suggestion purports to be scientifically neutral not a model for anything else.
I think we could find some common ground with the cognitive model I described above. Semantics do matter so no help given to addicts should be called treatment. Someone could be up to his ears in debt. He can be helped and be taught about financial management. This doesn't mean that his mistakes should be seen as signs of disease, or that his identity should from thereon be defined by that period of poor choices. I think it would also be a mistake to promote any kind of dependency on the helpers. Addiction should be seen as something that can be over with fairly quickly. Any help should be just a push in the right direction. Perhaps this is something that liberals like you and conservatives like I could both stand behind.

I think this exchange with Supine illustrates my point well. Nicotine addiction is presumably one of the toughest to break and yet we don't consider it strange when someone quits smoking without making a big deal out of it. This can happen even after decades of smoking. How is this so? Because the harmful nonsense I described hasn't become associated with nicotine. There is a Twelve Steps group called Nicotine Anonymous. If it were as popular as AA, we'd have much fewer people quitting smoking. It would be transformed from a solvable problem to a integral part of ones identity.

Belinda
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Re: Freedom and treatments for drug addicts

Post by Belinda » May 14th, 2016, 5:02 am

I have to hand the rightness to you Sanchez, not only on the generalities of your arguments, although that too, but also, as you say, on your masterly response to Supine. The cognitive model it is then. I hope that the cognitive model is adopted as a official policy.

How can the cognitive model be taught in reality, without apportioning blame, blame as not at all identical with responsibility?
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Re: Freedom and treatments for drug addicts

Post by Sanchez » May 15th, 2016, 7:24 am

Belinda wrote: How can the cognitive model be taught in reality, without apportioning blame, blame as not at all identical with responsibility?
A tough question. I have a hard time answering this because I consider the moral model, with all its blame, an appropriate response to addiction. I do feel like I deserved all the troubles I had, and if anything, people were too kind and understanding towards my recklessness. Just like I did at the time, they thought addiction to be a disease and as a result expected very little from me. I do realize that in a professional context, you need to present it in another way. The client would need to come terms with the fact that all of his behavior was voluntary and he doesn't have any valid excuse for his actions. This itself can trigger pretty strong feelings of guilt and shame. The big question is whether the professional should try to reduce those feelings. I'd say that perhaps not. Those are appropriate feelings and signs of a working conscience. I guess one way of being less judgmental would be to examine the addicts own values and whether the addiction violates them. The professional can instead of blaming point out that there is a conflict, for example between his love for his family and the effect his drinking has on them. I don't think I answered your question in any way.

-- Updated May 16th, 2016, 1:55 am to add the following --

An interesting philosophical puzzle. If the addict is fully responsible for his conduct, what about the professional who tries to convince him otherwise? If the situation is what I claimed, that the current paradigm for addiction "treatment" is a major part of why people find it so hard to quit, then are the powers that be partially responsible? The cognitive model cannot become the New Powerlessness. "My beliefs made me do it." Yes, the addicts efforts at quitting were made harder by people around him who tried to convince him that addiction is not voluntary behavior, and essentially were predicting him to fail. But let's face it. The addict adopted those beliefs himself and one of the biggest reasons for doing so was because those beliefs seemed to promise unending addiction and shifted responsibility off the addict. Those beliefs appeal to addicts precisely because they make hedonism a non-moral issue.

It's a bit like that thought experiment by Daniel Dennett, where doctors perform an operation on a client's brain and later tell him that they also took away his free will and will control him from now on. The patient believes them and loses all faith in his abilities. He starts giving in to all sorts of impulses and gets in trouble. Are the doctors partially responsible? Dennett's point was that they are: they did in a very real sense paralyze him. The real irony here is that Dennett promotes the disease model of addiction and listed addicts as examples of people who don't have free will. So in a sense, he IS the doctor from his thought experiment.

Perhaps this depends on who actually is promoting those beliefs. It's one thing to hear it from some random guy on the street. It's another to hear it from a therapist, a doctor, a social worker, a judge, or a scientist. These people are in a position of authority and should know better. This is made more difficult because of the Twelve Steps concept of "denial". If the addict claims that he drinks too much but this is not because of a disease, this will be seen as denial, which is one of the symptoms. In other words, he cannot defend himself, since any attempt at doing so will be seen as further proof of the disease. I think I've changed the way you view addiction, Belinda. The way you changed my view was that now I do see more clearly that there is a broader societal force that encourages addiction: the widespread attitude towards addiction, or mythology, as I like to call it. You inquired into the causes of addiction and while this mythology doesn't start addiction, it certainly drives it deeper.

The big question is whether this is intentional or not. I do give people the benefit of a doubt and assume most of them mean well. However, these beliefs ultimately come from AA, which is a religious cult. The doctrines they promote make more sense when you view not as something designed to help people, but rather as cult beliefs designed to retain their members. It makes perfect sense that they promote the idea of addiction as incurable and lifelong, something people need to fight for the rest of their lives. In other words, once you get into AA, you cannot leave and you will self-destruct if you think you can run your own life.

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Re: Freedom and treatments for drug addicts

Post by Belinda » May 17th, 2016, 6:10 am

Sanchez wrote:
A tough question. I have a hard time answering this because I consider the moral model, with all its blame, an appropriate response to addiction. I do feel like I deserved all the troubles I had, and if anything, people were too kind and understanding towards my recklessness. Just like I did at the time, they thought addiction to be a disease and as a result expected very little from me.
In retrospect "people"should have understood that you were capable of taking responsibility, unlike some other users who would respond better to being patronised. Horses for Courses. You suggested the cognitive model, Sanchez. The cognitive model is what good teachers do. The cognitive model I'd say is child, or student-centred, which means in practice that the therapist/teacher starts with who the person is and what they are capable of. The cognitive model does not preclude the teacher/ therapist telling the user how they are behaving foolishly or wrongly. I'd guess that not every drug abuser is as capable as you of responding to reason.
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Re: Freedom and treatments for drug addicts

Post by Lucylu » May 20th, 2016, 2:23 pm

Helena visconti wrote:Dear collegues,

I am writing a paper on a specific issue ("freedom and treatments for drug addicts"). We are talking about very heavy drugs like heroin NOT cannabis et cetera. The issue is the following:

Should some sort of treatment be enforced on the drug addict (coerced treatments) or should the addict be totally free to decide wheter he wants to have a treatment or not? We are talking about psychotherapeutic treatments with the aim to cope with life and the aim to eventually come out of drug addiction.

Why is the question problematic?

I am referring to the two concepts of liberty (see Berlin´s paper with regards to it): positive freedom and negative freedom. To refresh memories:
Negative freedom asserts that freedom is the absence of restrictions. In this sense a coerced treatment would be a massive invasion of personal freedom and thus maybe ethically not justifiable. "Positive liberty is the possibility of acting — or the fact of acting — in such a way as to take control of one's life and realize one's fundamental purposes" (quoting the Plato Standord entry on "Positive and Begative Liberty"). (I hope you don´t bother the sloppy citation style for this purpose here). To make a classical example: even if the child doesn´t want to go to school, he is forced to do so, and in the future he will be happy for it, because he gained freedom. Without education you would be the slave of others opinions and rhetorical capacities. In this sense, enforcing a treatment, even though the addict may dislike it at the start, is much more justifiable, because you are assuring his freedom in the future, where he or she is not anymore a slave of the "drugs will".

So what do you think? Is some sort of coerced treatment better or worse than full liberal choice?

(Note: With coerced treatment I don´t mean something radical in the sense of either that or something bad happens to you. I think you can find nice ways to "nicely enforce", assuring that the addict is not stigmatized, that he is not seen as a problem, etc.. Maybe some of you heard of "drug-accepting approach" in social work. I would implement that with a mandatory group therapy (or single therapy)).

The physical addiction is only a relatively small part of the issue. That is why some people can just do coke every now and then or drink socially and yet for others these things take over their lives. The root cause is typically social anxiety. In my experience it is possible to kick a habit, but if your mentality and sensibility hasn't changed then you are bound to go back to it, especially in times of stress.

For instance, I had a boyfriend who was a recovered heroin addict. He drank heavily and did other drugs but considered himself in a good place because at least he was off the heroin. Apparently his parents had basically locked him in a room to get him off it as he was just not able to do it himself. Anyway, when I broke up with him, the stress of it sent him straight back to heroin. I don't feel that it was my fault- it was bound to happen to him at some point. He didn't feel able to cope without it.

My point is, that you can make someone break a physical addiction, but you cant break the emotional addiction. That is why any good therapist/ treatment centre will tell you that the person has to want to change, otherwise its just pointless. Further, I agree with others that it is a slippery slope with regards to free will but I do think that people should at least be given the chance to kick the physical side and then the emotional side has to be up to them. The physical side is too much for anyone to quit without intervention and could be perceived as a form of mental illness.

I would however advocate enforcing the temporary sterilization of women who are addicts for example.
"The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts". -Bertrand Russell

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Re: Freedom and treatments for drug addicts

Post by Belinda » May 21st, 2016, 5:22 am

LucyLu wrote:
My point is, that you can make someone break a physical addiction, but you cant break the emotional addiction. That is why any good therapist/ treatment centre will tell you that the person has to want to change, otherwise its just pointless. Further, I agree with others that it is a slippery slope with regards to free will but I do think that people should at least be given the chance to kick the physical side and then the emotional side has to be up to them. The physical side is too much for anyone to quit without intervention and could be perceived as a form of mental illness.

I would however advocate enforcing the temporary sterilization of women who are addicts for example.
Your advocacy for enforced temporary sterilisation of women addicts illustrates the point that I'm about to make regarding invasive procedures.

To protect our liberties there have to be legal formalities before any invasive procedure can be done upon another person whoever they are. If this temporary sterilisation were to be done to women addicts the addicts would have to be submitted to some form of setting aside from normal freedoms even more so than criminals. It is terribly drastic.

To perceive addiction as a form of illness has disadvantages such as Sanchez has described and with which I agree: the addict needs to have the will to stop her addiction, and to medicalise her situation is to treat her as having abandoned much of her self- will to the medical authority.

I'd classify LucyLu's recommendation as medicalising the will itself, when the will is diseased. Whether the will itself can become diseased is plainly a question for neuroscientists specifically those neuroscientists who are clinicians. I myself believe that the will is what we call the subjective aspect of the proper functioning of an actual, physical brain- part. If so, then the brain -
part can become poisoned like any other organ, tissue, or cell.


Sanchez's thesis is that to get free of addiction the successful model must be a cognitive one. This is a model that we would all wish could be applied to all addicts. In view of LucyLu's description of her friend's parents drastic actions upon their beloved son the question is whether some addicts are ineducable and their condition is such that the condition is amenable only to therapy, which would often have to be draconian and what in the UK is colloquially called "Sectioning".
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Re: Freedom and treatments for drug addicts

Post by Sanchez » May 21st, 2016, 6:30 am

Lucylu wrote: The physical addiction is only a relatively small part of the issue. That is why some people can just do coke every now and then or drink socially and yet for others these things take over their lives. The root cause is typically social anxiety. In my experience it is possible to kick a habit, but if your mentality and sensibility hasn't changed then you are bound to go back to it, especially in times of stress.
Care to show any real evidence that social anxiety is the root cause of addiction? Or that addiction even has any special root causes? I think the most overlooked fact is that addicts gain immense pleasure from their drug of choice. There may be secondary reasons and addicts are prone to rationalize and underplay the hedonistic aspect.

Steven Slate, a former addict, debunks the idea that negative events cause "relapses":
http://www.thecleanslate.org/victims-of ... f-relapse/
Lucylu wrote: For instance, I had a boyfriend who was a recovered heroin addict. He drank heavily and did other drugs but considered himself in a good place because at least he was off the heroin. Apparently his parents had basically locked him in a room to get him off it as he was just not able to do it himself. Anyway, when I broke up with him, the stress of it sent him straight back to heroin. I don't feel that it was my fault- it was bound to happen to him at some point. He didn't feel able to cope without it.

My point is, that you can make someone break a physical addiction, but you cant break the emotional addiction. That is why any good therapist/ treatment centre will tell you that the person has to want to change, otherwise its just pointless. Further, I agree with others that it is a slippery slope with regards to free will but I do think that people should at least be given the chance to kick the physical side and then the emotional side has to be up to them. The physical side is too much for anyone to quit without intervention and could be perceived as a form of mental illness.
Most addicts quit on their own, so it's certainly not too much. For most people, withdrawal is not worse than a bad flu. In some cases, it's much worse, to the point of being life-threatening. This needs to stay separate from addiction. Withdrawal symptoms, unlike addictions, are medical conditions. There is a wealth of evidence (I linked to it earlier in the thread) that about 75 % of former addicts never received any professional help. There is also a lot of evidence that people who are treated are not more likely to quit. Addiction is not a disease or a mental illness. It's voluntary behavior. The medical model itself is one of the biggest reasons why quitting is so hard. It essentially teaches people that they will likely keep using. As Slate put it, "If everything I’ve heard about what causes addiction/relapse is true, then addicts are in a truly impossible situation where relapse is eternally imminent."
or as Jack Trimpey, another former addict, put it:
"Denial-hazing, in which any suggestion of self-determination is made into a symptom of the group’s disease, is figuratively an intellectual “kneecap job,” in which the legs are shot out from under newcomers with the intention of crippling them for life."

In cases where addiction has got to a point where it's damaging others and the addict shows no intention of quitting, he cannot be treated against his will. However, he can made to feel the full consequences of his addiction. Zero-tolerance is often effective. Jack Trimpey quit drinking only when his wife told him that his next drink would be his way of leaving the family. He never took another sip after that. I've heard of many other cases where laying down the law has effectively forced the addict to quit. This makes me extremely suspicious that there is any loss of will among addicts. When the reasons for quitting are sufficient, people won't do drugs anymore. Of course, zero-tolerance will not guarantee quitting. It might be that the addict will prefer his addiction. This choice should be respected, but at least cutting ties to the addict makes sure others won't be hurt by his drug habit.

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Re: Freedom and treatments for drug addicts

Post by Lucylu » May 21st, 2016, 1:20 pm

Sanchez

I've had the chance to read through more of the thread so far, but will finish the rest later. My only knowledge of addiction is personal experience. My main question is:

Does there need to be one right way of approaching the treatment of addicts?

I would have thought that different things 'speak' to different people and, as in most things, we can not expect that everyone will respond to the same approach/ model/ paradigm. Does it matter if someone stops for the 'wrong' reasons, or what others may perceive to be a placebo effect, as long as they stop? Some might find that the idea of addiction as a disease helps them, some may turn to God, some find antidepressants helpful, others might find rehab or group therapy helpful, at least as part of the process and their journey to maintaining sobriety. Even if they don't think any of these has actually stopped them drinking/ using, they may just be a helpful part of their 'toolbox' against addiction. I know one man who has gone to AA meetings every night for years, after drink driving and crashing in to a car carrying 2 children. He feels the meetings help him stay sober, and help pass the evenings. I, on the other hand, didn't take to AA as I found it too somber and preachy.

You seem to follow more of an Allen Carr no-nonsense, physical dependence approach (although he did also leave out the hedonistic side). Personally, I agree with many of your points regarding the failings of the medical model but as I said, I think they may have benefit to some. I have found in recovered addicts that they often enjoy and even need to talk about their recovery and feel that their way is the best way. Perhaps this is necessary to renew their faith/ belief in their chosen model. Perhaps it is the belief that is key. There is sometimes an almost evangelical side to their sobriety. (I am not suggesting that is what you're doing, as I don't even know you of course, but I just thought it was worth mentioning.)

Belinda,

I've had a rethink reguarding forcing a drug addicted woman to be sterilised temporarily, however, I think they can be considered a criminal (child abuser) if they are unwilling to take any steps to prevent the same thing happening again. It would be beneficial to give them free optional treatment in a rehab centre. This is unlikely to be taken up, if the woman is a real junky but it should be available, as I feel that rehab should be available for free to all addicts.

Failing that, another option would be a contraceptive IUD that lasts 5-10 years. Society does take away people's freedoms if they are demonstrably harming others but it would be dangerous to put something inside an individual if they may later try to remove it themselves causing themselves harm. There are injections but they wouldn't last anywhere near as long. If, however, she refuses both options then she should be jailed.
Belinda wrote:I myself believe that the will is what we call the subjective aspect of the proper functioning of an actual, physical brain- part. If so, then the brain -
part can become poisoned like any other organ, tissue, or cell.
I am somewhere in the middle regarding which model I favour. Partly, I do believe that the will can become diseased in a way; that our psyche is much more real than we give it credit for and that it can become damaged as much as any physical part but again, I take an eclectic approach. It could also be that the will has never been trained/ formed properly during childhood, maybe not given the security and love necessary to feel safe. Perhaps for some it is the opposite, in cases of weak parents and a strong willed child without boundaries.

I think the best model is the one that works most consistently and positively for each individual.
"The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts". -Bertrand Russell

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Re: Freedom and treatments for drug addicts

Post by Sanchez » May 21st, 2016, 11:51 pm

Lucylu wrote: Does there need to be one right way of approaching the treatment of addicts?
No. The counter-question is this: does this mean that just about everything will do? No.
Lucylu wrote: I would have thought that different things 'speak' to different people and, as in most things, we can not expect that everyone will respond to the same approach/ model/ paradigm. Does it matter if someone stops for the 'wrong' reasons, or what others may perceive to be a placebo effect, as long as they stop? Some might find that the idea of addiction as a disease helps them, some may turn to God, some find antidepressants helpful, others might find rehab or group therapy helpful, at least as part of the process and their journey to maintaining sobriety. Even if they don't think any of these has actually stopped them drinking/ using, they may just be a helpful part of their 'toolbox' against addiction. I know one man who has gone to AA meetings every night for years, after drink driving and crashing in to a car carrying 2 children. He feels the meetings help him stay sober, and help pass the evenings. I, on the other hand, didn't take to AA as I found it too somber and preachy.
The problem is that the disease model and the Twelve Steps-philosophy are built on ideas that are empirically false. Here are some false tenets:

1) Addicts respond to intoxicating substances in a different physiological way. When the alcoholic drinks, he has something similar to an allergic reaction which causes him to spiral out of control. The priming experiments I linked to clearly debunk this idea, further reinforcing the idea that all addicts remain in control of themselves.
2) Addiction is not voluntary behavior. Something takes over the will of the person and relapses are something that happen to people, not something they consciously do. I recently read Gene Heyman's book Addiction: a disorder of choice, where he laid down powerful evidence against this idea. Research shows that people can paid to stay sober and that deterrents, such as losing one's job, are highly effective. The decision to use drugs is not qualitatively different from other decision making. People quit when the costs get too high.
3) Nobody can recover on their own and addiction requires treatment. The fact is that around 75 % of former addicts never sought any help. Think about one of the most common and reputedly one of the hardest addictions, smoking. Very few former smokers sought any professional help to quit. I argue that this is because, unlike alcohol and drugs, cigarettes haven't been turned into this all-powerful boogeyman.
4) Addiction lasts for a lifetime. I don't really see any reason why my identity should forever be defined by the things I'm never gonna do again. I think people with drinking problems should see themselves as teetotalers, not as recovering alcoholics. One reason why they might prefer the recovering addict identity is the assumption that they will have relapses. "In recovery" means unresolved addiction, where the person almost wants to quit.
5) Twelve Steps is a highly effective, perhaps the only effective, way of dealing with addiction. Also, it's not religious at all. And it certainly isn't a cult. In reality, very few people have recovered that way. The Big Book itself makes it quite clear that this vague Higher Power is just a training deity until the addict is ready for his religious conversion. The doctrine is full of ideas that are not meant to help people, but to retain the members by essentially crippling their ability to run their own lives. It's a standard cult tactic; teach people that they can't live without the cult.
6) Moderation is not possible after one has gotten addicted. In reality, quite a few former alcoholics do become moderate drinkers later on. Not that I'm advocating this. I wonder why people would still use a substance that caused them so much trouble and I wonder why professionals would help people with this goal. I think abstinence is blissfully simple and I'll never know if I could learn to moderate. However, I have to be honest and say it out loud that many addicts go back to moderate use.
Lucylu wrote: You seem to follow more of an Allen Carr no-nonsense, physical dependence approach (although he did also leave out the hedonistic side). Personally, I agree with many of your points regarding the failings of the medical model but as I said, I think they may have benefit to some. I have found in recovered addicts that they often enjoy and even need to talk about their recovery and feel that their way is the best way. Perhaps this is necessary to renew their faith/ belief in their chosen model. Perhaps it is the belief that is key. There is sometimes an almost evangelical side to their sobriety. (I am not suggesting that is what you're doing, as I don't even know you of course, but I just thought it was worth mentioning.)
I hadn't heard of Allen Carr, actually. I checked out his method on Wikipedia. I wouldn't say that I promote a physical dependence approach. People break their physical dependence on 28-day rehabs, and yet most go back to using after leaving. Why? Because addiction is not about a physical dependence or fighting off withdrawal symptoms. It's about the pleasure. Addicts struggle not because of a disease entity, but because they have a love/hate-relationship with their addiction. People are extremely ambivalent because on one hand they see the writing on the wall and realize they have a problem. On the other hand, people have a hard time giving it up because of the intense pleasure. This is made worse by the clinical mythology that has developed around the subject.

The weakness of the Twelve Steps is that it does absolutely nothing to resolve that ambivalence. In fact, any attempt to do so is labeled "denial", a symptom of the addictive disease. The problem of support groups is that they encourage sitting on the fence. In my personal experience, the disease model and the idea of lifelong addiction appealed to me precisely because I would get to have my cake and eat it. I could stay sober and avoid many problems. However, I could resume using anytime I really felt like it, which I often did. The price for this arrangement was a completely passive lifestyle, where all sobriety is credited to the program or the group or God Himself. All using is credited to a disease. The actual person is extremely passive, like a rat in a maze. Who knows what's coming around the corner? I'm not saying I was consciously abusing the support. I did come to really view my own behavior as something inexplicable, out of my control, described in third-person terms.

I wouldn't have such a problem with the Twelve Steps if it really were just a religious group that recruited people who really were into that lifestyle. However, they promote their views aggressively and deceptively (by claiming that it works, or that it's not religious) and often it's promoted by two-hatters. For those unfamiliar with the term, two-hatters are people who promote the Steps in a professional capacity (a therapist or doctor directing addicted patients to AA, a judge ordering people to the groups) who are also Steppers themselves. Twelve Steps is a religious cult that has infiltrated, at least in the U.S., all levels of society: the healthcare system, the social services system, the justice system, prisons, the workplace, even Hollywood. I debated Supine on the Steps on this thread. He argued that I misunderstood the part about powerlessness. He argued that the powerlessness part meant only a loss of control after consuming alcohol. Here's an excerpt from the Big Book:

"I now remembered what my alcoholic friends had told me, how they had prophesied that if I had an alcoholic mind, the time and place would come — I would drink again. They had said that though I did raise a defense, it would one day give way before some trivial reason for having a drink. Well, just that did happen and more, for what I had learned of alcoholism did not occur to me at all. I knew from that moment that I had an alcoholic mind. I saw that will power and self-knowledge would not help in those strange mental blank spots. I had never been able to understand people who said that a problem had them hopelessly defeated. I knew then. It was a crushing blow."

It's a deceptive tactic. First introduce the idea that one cannot drink without ending up in trouble. If it were just this, the solution would be to never drink again (and for many, that is the solution). Then people are introduced to a new idea; that relapse is essentially something that happens to them.

I am pluralist in the sense that of course people can take many paths and many of them do lead to a sober life. What I object to is the idea of taking a third-person view of addiction. Relapses are choices like any other and I do feel like all addicts should come to terms with that. I don't want people to hide behind pseudo-medical theories just to make themselves feel better about previous bad choices. Twelve Steps, even when it leads to sobriety, leads to a very fragile type of sobriety where addicts are always close to relapse because they are taught to be that way. My hat goes off to the very few who do well in groups. They are surrounded by people working to undermine their confidence and fed a doctrine intended to prevent them from moving on.

You correctly recognized the role of belief in addiction and quitting. The idea of events triggering addiction depends largely on the belief that this sort of stuff really happens. The belief that addiction is caused by a disease makes it much harder to quit. The belief in powerlessness not only makes quitting harder, but makes it harder generally to be self-sufficient. The belief in the concepts of "relapse" or "slip" are built on the assumption that people can't decide to quit and that they will likely use again.

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Re: Freedom and treatments for drug addicts

Post by Lucylu » May 22nd, 2016, 4:25 am

Sanchez wrote:I am pluralist in the sense that of course people can take many paths and many of them do lead to a sober life. What I object to is the idea of taking a third-person view of addiction. Relapses are choices like any other and I do feel like all addicts should come to terms with that. I don't want people to hide behind pseudo-medical theories just to make themselves feel better about previous bad choices. Twelve Steps, even when it leads to sobriety, leads to a very fragile type of sobriety where addicts are always close to relapse because they are taught to be that way. My hat goes off to the very few who do well in groups. They are surrounded by people working to undermine their confidence and fed a doctrine intended to prevent them from moving on.

You correctly recognized the role of belief in addiction and quitting. The idea of events triggering addiction depends largely on the belief that this sort of stuff really happens. The belief that addiction is caused by a disease makes it much harder to quit. The belief in powerlessness not only makes quitting harder, but makes it harder generally to be self-sufficient. The belief in the concepts of "relapse" or "slip" are built on the assumption that people can't decide to quit and that they will likely use again.
I suspect that there are differences in the 12 step program across the world. Perhaps some areas are more moderate and secular than others. Regardless, I think there is more awareness in modern times that people need to be their own advocates, when it comes to their health, their money and their lives in general. Institutions are no longer blindly obeyed. If, however, you feel that strongly about it and don't feel that the world is aware of the truth about the 12 step model, I can only suggest that you write a book or a lecture tour for schools. Perhaps more education around drugs and alcohol in the teen years when people are typically discovering them would be beneficial.

Doctors (where I live) offer referral to a service called Turning Point for 'substance misuse' which offers a variety of services, and doesn't advocate religion or the disease model. I note that their website say things like 'recover from addiction' rather than cope or treat, and they use 'misuse' instead of labeling words like alcoholic etc. There is a definite shift in language, and outlook which is positive. Similarly, the Allen Carr books were popular because they were a breath of fresh air with no obligatory sense of shame, religiosity or touchy-feely stuff.

I think that people should be free to make up their own mind about what approach they prefer but that, crucially, they should be given all the choices and information objectively to begin with eg by their doctor/ a qualified addiction counsellor. Some may still prefer the more religious tone and the support group set up of the 12 steps and I hope they have helped many people improve the quality of their lives.

Again, I think that the best approach is the one which works most consistently and positively for each individual.
"The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts". -Bertrand Russell

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Re: Freedom and treatments for drug addicts

Post by Belinda » May 22nd, 2016, 7:42 am

LucyLu wrote:
I've had a rethink reguarding forcing a drug addicted woman to be sterilised temporarily, however, I think they can be considered a criminal (child abuser) if they are unwilling to take any steps to prevent the same thing happening again. It would be beneficial to give them free optional treatment in a rehab centre. This is unlikely to be taken up, if the woman is a real junky but it should be available, as I feel that rehab should be available for free to all addicts.

Failing that, another option would be a contraceptive IUD that lasts 5-10 years. Society does take away people's freedoms if they are demonstrably harming others but it would be dangerous to put something inside an individual if they may later try to remove it themselves causing themselves harm. There are injections but they wouldn't last anywhere near as long. If, however, she refuses both options then she should be jailed.
I'd classify them as child abusers including during their first episodes of drug abuse when pregnant. The criminality of this sort of child abuse has to depend upon the rights of the foetus outweighing the freedom of the woman carrying the foetus. In the case of recreational drug taking the woman should have no freedom of choice but should categorically not take recreational drugs or voluntarily do anything else that endangers the foetus, including smoking, drinking, or over -eating. However until all pregnant women are aware of their responsibilities under the law and also their moral responsibilities and how to implement those responsibilities the law in a free country has to be very careful not to be unfair.

It would be a good thing if pregnant women were made aware that there was a case for criminalising this particular irresponsibility.

To take an extreme case a little girl of thirteen can become a mother, she might have been raped, she might have learning difficulties which might be caused by bad parenting. It would be wrong to criminalise a child.

To take another case a grown woman might be ignorant about her moral and legal responsibilities in which case the educational system is at fault.

It would be convenient if there were no mitigating circumstances. Nevertheless such circumstances can be taken into account and your suggestion about criminalising drug abusing pregant women is good, LucyLu. I wonder if such a law is already in place. The law should follow current morality and current morality should be cognisant of facts.

A similar case can be made for criminalising a parent who feeds their child an inappropriate diet, as so many do, forcing the child to become fat for life.

I am generally on the side of the child in cases where the adult, including the pregnant woman , is harming the child. The rights of the family and the rights of the individual should not be so sacrosanct that any helpless individual is caused to suffer, or put at serious risk of suffering.All I say is that the law should not be draconian.



LucyLu wrote:

I am somewhere in the middle regarding which model I favour. Partly, I do believe that the will can become diseased in a way; that our psyche is much more real than we give it credit for and that it can become damaged as much as any physical part but again, I take an eclectic approach. It could also be that the will has never been trained/ formed properly during childhood, maybe not given the security and love necessary to feel safe. Perhaps for some it is the opposite, in cases of weak parents and a strong willed child without boundaries.
Volition is the subjective feeling that we have when we reason or simply emote towards an uncoerced decision. Reasoning is done in the upper front of the brain's cortex. Reason is essential for human decision making because we don't depend entirely upon instincts or even upon raw emotions. Like any other faculty such as walking or talking the making of reasoned decisions is only a possibility unless that brain/mind faculty has had opportunity to develop. So again I agree with LucyLu that some people have lacked opportunities to learn moral values and reasoning.

Someone who voluntarily gave up recreational drugs after being addicted did not do so because of some unidentifiable ability. They could make that choice because their strength of character was both native and fostered, sometimes in ways that they don't recognise.

It's no longer fashionable to credit religious faith as inculcator of character strength. Religious faith did at one time not very long ago stand as parent and school in the absence of good parenting, good schooling, and even in the absence of sufficient food. Now that religious faith is finished the state must provide the care that some individuals don't provide for their children.

I agree with LucyLu that some people can make better decisions than others. I also agree with Chavez that for school age children, young adults, and mature adults, i.e. for everybody ,personal responsibility is the first and most important requirement. I also agree with Chavez (if I may say so) that pleasure seeking is the cause of drug addiction.
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Sanchez
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Re: Freedom and treatments for drug addicts

Post by Sanchez » May 23rd, 2016, 10:58 am

Belinda wrote: Someone who voluntarily gave up recreational drugs after being addicted did not do so because of some unidentifiable ability. They could make that choice because their strength of character was both native and fostered, sometimes in ways that they don't recognise.
I feel like this is a point that can be emphasized too much. Addiction blurs the line between being capable and being willing. It leads to the question of whether one is capable of quitting if one doesn't believe he is. It's really dangerous when we make judgments of what people are capable of by looking at what they have achieved so far. At the risk of sounding repetitive, it's largely this line of reasoning that locks people in their drug habits. "If you could quit, you would have done it by now." The problem is that one part of the addict wants to believe that, since that idea promises a lifetime of drug abuse, preferably without blame from others.

I don't think addicts are lacking willpower in any significant way. The problem is not that the will is weak. The problem is that the will is split into two opposite directions. The disease model does nothing to address the real problem and in fact makes things worse by saying that this ambivalence cannot be solved and attempts to do so are symptoms of the disease.

I'm not necessarily opposing your view that our abilities are not our own making. I do oppose the idea that our abilities can be deduced from what we've done so far. In a sense I do agree that strengths sometimes need to be fostered. The cognitive model can do this by debunking the disease myth and getting addicts to consider the idea that their past struggles are no indication of their abilities. While it might be hard to do so without blaming anyone, addicts should be encouraged to seriously consider the possibility that they were always capable, simply not willing to quit.

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