Freedom and treatments for drug addicts

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Helena visconti
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Freedom and treatments for drug addicts

Post by Helena visconti »

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)).
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Re: Freedom and treatments for drug addicts

Post by Wilson »

The problem with saying a drug addict should have the right to make his own decisions is that once addicted, his decisions will be very different from the decisions he would make if he weren't addicted. I assume most addicts don't set out to become addicts, they just want to get high. Once addicted, they have diminished capacity.

I'm not sure how effective most rehab treatments are. They tend to be long term and expensive - and usually fail. So once someone becomes addicted, that person may be, unfortunately, a lost cause. Some will be able to get off drugs, many will be forever addicted until they die. So I have no objection to legalizing the administration of drugs to addicts in government treatment centers. Probably no good answer to the problem.
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Re: Freedom and treatments for drug addicts

Post by Togo1 »

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)).
I think he should have the choice. Absent of some kind of actual crime, which legitimises transferring control of the individual over to another party, what possible reason can we have for removing personal control from a person? Our perception that he's making poor choices isn't really enough - the same would be true of people we felt were not studying hard enough, were dating people likely to make them miserable, were buying a car more expensive than they should for their likely salary, or starting a business that was likely to fail. For society to take control over him, there needs to be some overwhelming reason - harm to society or harm to himself. This is why drug treatment is never made mandatory unless a person has committed crimes, or been hospitalised on multiple occasions, and even the latter is considered dubious.
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Re: Freedom and treatments for drug addicts

Post by Belinda »

Togo1 wrote;
I think he should have the choice. Absent of some kind of actual crime, which legitimises transferring control of the individual over to another party, what possible reason can we have for removing personal control from a person? Our perception that he's making poor choices isn't really enough - the same would be true of people we felt were not studying hard enough, were dating people likely to make them miserable, were buying a car more expensive than they should for their likely salary, or starting a business that was likely to fail. For society to take control over him, there needs to be some overwhelming reason - harm to society or harm to himself. This is why drug treatment is never made mandatory unless a person has committed crimes, or been hospitalised on multiple occasions, and even the latter is considered dubious.
I wholly endorse Togo. Personal autonomy should remain sacrosanct , if only because of the slippery slope which is what I'd I call what Togo has outlined. There are clinical and legal parameters within which persons may have freedom of choice. Those parameters should be examined and revised at intervals so as to keep them in accord with current morality especially current morality put under the microscopes of eminent moral philosophers,.
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Wilson
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Re: Freedom and treatments for drug addicts

Post by Wilson »

Just as a thought experiment, say that scientists develop a treatment that is 90% effective in getting addicts off drugs permanently, and once completed, most are happy to be free of their addictions. But addicts don't want to undergo it, because they can't stand the idea of never getting high again. That would be an example of addicts making bad decisions because of their addiction. Should they be compelled to undergo the treatment, because they will almost surely be better off when completed, even though they don't want to voluntarily submit to it?

Of course no such treatment is available today. It's the principle that I'm asking about.
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Re: Freedom and treatments for drug addicts

Post by Belinda »

I don't think they should be compelled, Wilson. Personal autonomy is holy, and danger to unsafe individuals takes second place to personal autonomy.
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Wilson
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Re: Freedom and treatments for drug addicts

Post by Wilson »

Belinda wrote:I don't think they should be compelled, Wilson. Personal autonomy is holy, and danger to unsafe individuals takes second place to personal autonomy.
I sort of agree with you, but be aware that UNDER THE SCENARIO I POSED your making autonomy sacrosanct would be condemning them to a life of hell when an alternative is available where they would be much happier.

That's the problem I have with "morality by rules" rather than morality by compassion which includes making judgments in individual situations. "Thou shalt not kill" obviously has exceptions most of us would agree with. "Never take away autonomy" is another where there might be valid exceptions. One that's a bit more reasonable is when someone is mentally ill and doesn't want to take medication that would render him capable of good judgment while having the downside of some unpleasant side effects. An obvious example of where most of us would agree that removing autonomy is justified is when a violent criminal would prefer to remain free.

Of course a society has to have rules of law. Way too complicated otherwise. But we need to be willing to make exceptions under specific circumstances.
Sanchez
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Re: Freedom and treatments for drug addicts

Post by Sanchez »

Unfortunately society at large has a completely distorted image of addiction. In reality:

1) There is no reason to think addiction is a disease. Addiction is simply a love/hate-relationship with a pleasurable substance or activity.
2) As a result, there really is no sensible way of treating addictions. Support groups are notoriously ineffective, despite the claims of success they make. The problem with therapy is that it is built on the assumption that addiction is not about pleasure, but is some sort of coping mechanism or caused by underlying issues. There really is no evidence for this and neither does it fit the subjective experience of being addicted. Addicts cling to any excuse they can find and often this includes things their therapist has said. In reality, the sole cause of addiction is the intense pleasure. Rehabs also rarely produce good results. There are medications like Antabus that do pretty much put an end to drinking when taken, which is precisely why so few addicts take them consistently.
3) In reality, addicts don't have diminished capacity. Addictive desire is generated in the lizard brain which doesn't play any role in voluntary movements. In other words, you can't drink, smoke, sniff, inject, or eat anything without deciding to do so. Even relapses aren't caused by any underlying issues. They happen because the addiction is so pleasurable that addicts simply have a hard time making up their mind. They want to quit when things are bad and when they get a little better they decide to resume using.

There is a wealth of evidence showing that most former addicts (myself included) quit on their own, without shrinks, groups, or rehabs. In fact, I think addiction treatment is a part of the problem. It teaches helplessness, loss of control, offers clinical excuses for relapses (actually expects relapses as part of healing) and most importantly, it negates the role of moral judgment. It portrays the addict as a victim and therefore turns his self-indulgence into an innocent act. The addict enjoys this, since it makes further use easier to justify.

In some cases society does have an interest in making sure that some people quit substances completely. However, there is no reason to think that treatment is the way to accomplish it. Because addicts do have control over their use, they can be demanded to sober up. Repeat drunk drivers could be demanded to remain sober as a condition for parole. Society has no right to decide how this is accomplished. In the United States, the assumption is that joining a religious cult is the best remedy in such cases.

The disease model resonates with people for the following reasons:

1) With addicts, because it gives them the right to indulge. It turns a moral problem into a symptom of a disease. Or as Jack Trimpey put it in Rational Recovery: "My attachment to my "disease-of-relapse" (as alcoholism is often referred to) was simply a respectable way of planning to drink in the future".
2) With loved ones of addicts, because it feels better to see the addict as being compelled by some disease, rather than seeing his actions as purely selfish. Apart from their addictive behavior, addicts are usually good people. This makes it very puzzling for families to explain why a good person acts that way.
3) With society at large, it resonates for two reasons. First of all, the self-recovered addicts are a silent majority and rarely heard in mainstream media. The disease model is so popular because of widespread AA-propaganda, written in the 1930s by unapologetic addicts, who never learned how to recover from addiction. Another reason for acceptance is the leftist trend of making every problem a collective one. In some places it's practically a crime to solve your addiction on your own.

So even though, treatment is misguided, society can intervene in extreme cases. Instead of treating the addict, they should be educated. They should be told that there is no evidence for their supposed illness, no loss of control and that independent recovery is commonplace, achieved by millions of people before them. This viewpoint is drowned out by the Twelve Steps-movement and their secular clones. Think of how smoking is viewed. Isn't it weird that ads tell people to quit smoking, but with drugs and alcohol they are simply told to seek help? I dream that someday there won't be a difference between the two. Alcohol and drug addiction should be seen like smoking is seen: not as a disease or a coping mechanism, but as a problem that can be solved independently, cheaply and within a reasonable amount of time.

The last part is important, since one of the problems of treatment is that it teaches addicts that their problems are lifelong. In reality, after some time, addicts can make a commitment to never using again and at that point, there is no legitimate reason to doubt their word. In the mainstream view, this sort of commitment is seen as a bad sign, as denial of the disease, which is considered to be one of the symptoms. There really is no reason why the persons identity should be permanently defined by a period of stupidity.

Not all treatments follow the Twelve Steps mythology, so there are better ones, but the fact remains that independent recovery is the time tested method.
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Re: Freedom and treatments for drug addicts

Post by Belinda »

Sanchez, while I understand your point of view and applaud your success there is perhaps an idea that you have not considered.

Sanchez wrote:
1) There is no reason to think addiction is a disease. Addiction is simply a love/hate-relationship with a pleasurable substance or activity.
2) As a result, there really is no sensible way of treating addictions. Support groups are notoriously ineffective, despite the claims of success they make. The problem with therapy is that it is built on the assumption that addiction is not about pleasure, but is some sort of coping mechanism or caused by underlying issues. There really is no evidence for this and neither does it fit the subjective experience of being addicted. Addicts cling to any excuse they can find and often this includes things their therapist has said. In reality, the sole cause of addiction is the intense pleasure.
There are two justifications for thinking that addiction is a disease. One justification is that people who are concerned to stop drug addiction need to be detached so that they can better apply themselves to solving the problem

The other justification for thinking that addiction is a disease is, according to my slight understanding of drug addiction, that the electro-chemical system in addicts' brains changes to the effect that normal pleasure, or normal absence of mental and physical pain, is obtained only artificially. Thus drug addiction is a life-threatening disability.

Neither of those justifications involve that the addict relinquishes self-control to control by therapists . Both of those justifications include that pleasure-seeking is a basic motive to take drugs.
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Re: Freedom and treatments for drug addicts

Post by Sanchez »

Belinda wrote: There are two justifications for thinking that addiction is a disease. One justification is that people who are concerned to stop drug addiction need to be detached so that they can better apply themselves to solving the problem
If you mean isolation is needed, then we'd expect that rehab would be an effective method. It isn't. Most people resume using pretty soon after leaving. Granted, this is largely because most rehabs are based on the Twelve Steps, or a mix of the Steps and psychological theories that weren't meant for addiction. There are some cases where even involuntary confinement is justified, like violent behavior, psychosis, suicidal behavior, overdose or when medical help is needed to detox safely. However, most addicts don't fall into these categories. Also, these exceptions aren't so much treatment for addiction, but rather about dealing with the consequences of addiction. I get your point and in some cases it might help to be away. I wouldn't mind rehab so much if it really were a place where people just detoxed and made the commitment to change and then leave. This sort of "treatment" would be brief, nothing like the 28 day-rehabs.
Belinda wrote: The other justification for thinking that addiction is a disease is, according to my slight understanding of drug addiction, that the electro-chemical system in addicts' brains changes to the effect that normal pleasure, or normal absence of mental and physical pain, is obtained only artificially. Thus drug addiction is a life-threatening disability.
Normal pleasure seems lame in comparison to addictive pleasure, which makes sober life unappealing. This is especially so if the person has left a trail of destruction behind him and now has to clean that up sober. I'm sure there is a neurological explanation for this. The real problem of the disease model is that it doesn't explain what is actually observed, i.e. that the majority of recoveries are independent. If the brain has changed to the extent that it's not possible to enjoy life sober, how can so many quit and go on to build much better lives? Also, many quit abruptly after decades of use and many of them are people who have received a lot of treatment without much success. There's a Catch-22 in there: you need to fix your brain to be sober and be sober to fix your brain.
Belinda wrote: Neither of those justifications involve that the addict relinquishes self-control to control by therapists . Both of those justifications include that pleasure-seeking is a basic motive to take drugs.
Therapy doesn't necessarily mean giving up control and there are therapists who actually understand addiction. They would approach it like much like smoking is approached; the client only needs a push in the right direction and is on his own afterwards. What the studies have shown is that the most successful types of therapy are ones where the goal is to help the client make up his mind about quitting (Motivational Interviewing), rather than cure the addiction or to deal with any underlying issues.

The disease model is not necessarily about giving up your control to another person. What it is, though, is giving up on the idea that a commitment to abstinence would do any good. It is giving up on the idea that there is really only one person who can keep you sober. It means that addiction is viewed as something addressable only indirectly: by doing certain things, the addict eventually sobers up. This view negates the idea that people can actually choose not to act on their urges, which is a well-established capacity even among addicts. A good therapist could help their clients to see this. I think the disease model is popular partly because in our culture we think it rude to say "This is your problem. You fix it."

Helping addicts is hard, because addicts systematically abuse any support or understanding they receive. To the addict within, support means that using won't result in any moral judgment. Often treatment is something people do instead of quitting, i.e. "I'm working on the problem". This is why support groups are so appealing; that is where you go after everyone is (understandably) fed up with you. There you will meet people who cannot afford to say anything.
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Re: Freedom and treatments for drug addicts

Post by Belinda »

Sanchez wrote:
If the brain has changed to the extent that it's not possible to enjoy life sober, how can so many quit and go on to build much better lives?
My slight understanding is that changes to the brain's physiology correlate with changes in the subject's behaviour. In the case of consumption of mind-altering substances the brain adapts to the substances, and adapts again to being deprived of those same substances. Adaptations of the brain's physiological responses depend upon the health of the brain's anatomy so that if the brain cell bodies have been killed they cannot be reinstated, and there can be permanent damage, but permanent damage can often be cleverly circumvented by re-training.

Therapists of all sorts have to maintain a professional detachment. This means that therapists should be practical, not judgmental.
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Re: Freedom and treatments for drug addicts

Post by Wilson »

Sanchez, I agree with your take on this. I also think calling addiction (including alcohol, cigarette, drug, sex, gambling, and eating) a disease is an attempt to make the addict feel better about himself and to remove the stigma that society has toward these people - with little logical justification. As you said, we never seem to hear the fact that individuals take drugs or drink alcohol or smoke cigarettes or gamble or overindulge in dangerous sex or overeat simply because it's fun - it feels good - it hits our pleasure centers - and that pleasure is more appealing than doing what best for us in the long run. Now it's true that certain people do have addictive personalities - have less ability to resist temptation and to follow society's norms - are more into immediate gratification than delayed gratification - but that's just within the Bell curve of human personality.

It's also true that the symptoms of withdrawal are unpleasant and once hooked, it's harder to give the stuff up - and that's a physiological as well as psychological fact. And so I guess you could stretch the definition of disease to include active addiction, if you were so inclined. But once clean, the tendency to start using again is - in my opinion - a weakness of character. A flaw of personality. That doesn't mean that I don't have sympathy for the individual, just that it ain't a disease.

I suspect that rehab centers do have some success, but probably not nearly enough to justify the incredible cost of them.
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Re: Freedom and treatments for drug addicts

Post by Sanchez »

Belinda wrote:My slight understanding is that changes to the brain's physiology correlate with changes in the subject's behaviour. In the case of consumption of mind-altering substances the brain adapts to the substances, and adapts again to being deprived of those same substances. Adaptations of the brain's physiological responses depend upon the health of the brain's anatomy so that if the brain cell bodies have been killed they cannot be reinstated, and there can be permanent damage, but permanent damage can often be cleverly circumvented by re-training.
My point was that the changes in attitude and mood are too quick to be related to changes in the neural pathways damaged by the addiction. I wasn't talking about the long-term changes over months and years, but rather the sudden change in outlook that can happen within days of quitting. The ability to reclaim one's life comes from knowing that the addiction really is over. I don't know if the cravings will ever vanish completely, so in that sense the brain might never be totally healed.
Belinda wrote:Therapists of all sorts have to maintain a professional detachment. This means that therapists should be practical, not judgmental.
I think it's possible for therapists to be confrontational without being judgmental. That's what a therapist should do with the addicted client. He should point the connection between the addictive behavior and the negative consequences that drove him into the therapy. A drinking problem is defined by those two words; it requires drinking that produces problems. The therapist can point out - without being judgmental - that it is logically impossible to have a drinking problem if one will never drink again. Another way in which therapists should be confrontational would be to challenge the belief that the addiction is outside one's control. Why does the addict feel that he is powerless? Is there really evidence for this? Does the addicts own experience really support this idea?

I think one of the worst things that therapists can do is commit to the idea that the addiction is driven by some underlying issue, or that it is a coping mechanism. The addict will become less motivated to solve those issues (which in some cases are real, although a lot of addicts are pretty much doing fine apart from the addiction). I thought my addiction was driven by anxiety, and you'd think I'd then work on my anxiety. Not really. There was a part of me that really clinged to anxiety, welcomed it, because it had the important role of justifying use. Much later I realized that my anxiety was about nothing except whether or not to use. I'm not saying that no addict has genuine anxiety disorder (which is medical problem, unlike addiction), but quite often addicts cling to all sorts of real or imagined problems to justify their use. Whatever other problems the addict may have, these are better solved sober. Medication doesn't go well with narcotics. Being intoxicated and in the throes of addiction doesn't help gaining insight in therapy. And most importantly, if the addict hasn't quit, there's no way of knowing if the problems are caused by the addiction. Often addicts think they have depression and after quitting find out that it was just the addiction that was depressing them. In those cases, it's a waste of time to treat the depression. First solve the addiction, and then see if there are other problems to work on.
Wilson wrote:It's also true that the symptoms of withdrawal are unpleasant and once hooked, it's harder to give the stuff up - and that's a physiological as well as psychological fact. And so I guess you could stretch the definition of disease to include active addiction, if you were so inclined. But once clean, the tendency to start using again is - in my opinion - a weakness of character. A flaw of personality. That doesn't mean that I don't have sympathy for the individual, just that it ain't a disease.
Withdrawal is overrated. It's dangerous in some cases, when the use has been really intense or prolonged or when there are existing medical conditions and in those cases medical help is appropriate. Most addicts can detox safely on their own and it's not actually nearly as bad as people think. If I had to choose between withdrawal symptoms and stomach flu, I would choose withdrawal symptoms any day. I'll admit that my use wasn't nearly as bad as some others. I have heard even from heroin addicts that withdrawal feels physically about as bad as flu. It's the psychological factors that make withdrawal unpleasant - the addict realizes that he is planning to quit and part of him will rebel against that. There is an extensive mythology surrounding addiction and the public perception of withdrawal is one element in that mythology. What really makes quitting hard is the fact that the addictive substance or activity is simply so pleasurable. It's so pleasurable that the addict - at first - has a hard time imagining that life would be any good without it.

The irony is that it's the disease model that brings the stigma along with it. If addicts have an incurable, lifelong disease, it makes sense to view them as ticking time bombs, waiting to go off. If addiction is viewed, as you say, a weakness of character and a flaw of personality, there is nothing inherently wrong with them that forces them to repeat past mistakes. I was a real prick when I was using. If I really need a label, I'd really want the label of "former prick" rather than "addict" or "recovering addict". The reason why so few people in my life know of my past stupidity is precisely because that sort of behavior is commonly seen as an incurable disease. I fear that people would be totally hysterical around me, afraid they could somehow "trigger" me ("triggers" being another part of the addiction mythology). I hope this doesn't come off as chest-banging. I've disclosed my own history because if I didn't, people would say that I don't know anything. That's how prevalent the Twelve Steps mythology has become: people just take it for granted that addicts are sick and out of control.

You're right about rehabs. Of course some people quit that way, but most resume use after leaving. The cost isn't justified and more importantly, there isn't much informed consent when it comes to addiction treatment. People are still under the illusion that support groups and rehabs are effective and that practically nobody has quit without them, when in fact the reverse is true: quitting on your own is the time-tested method. I would go even further and say that treatment is part of the problem. It's largely the disease model itself that transforms addictions into chronic conditions. It's a self-fulfilling prophecy.
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Re: Freedom and treatments for drug addicts

Post by Belinda »

Sanchez wrote:
It's largely the disease model itself that transforms addictions into chronic conditions. It's a self-fulfilling prophecy.
This and the rest of your post makes sense not least because it comes from someone who has walked the walk.

Sanchez and I have contended over the 'disease model' medicalisation of substance abuse before. It's time to analyse the 'disease model' to find out what it is about it that is bad and what is good.

Sanchez and I agree that some addicts are so damaged that they need medical care and cannot recover any ability to live without parenting, so let's put aside that particular consequence of addiction for the purposes of the 'disease model' for addicts who can take up the reins of intelligent responsibility.

My stance on the matter of the 'disease model' is that it implies for the part of professionals the attitude of professional detachment, which means in practice that the addiction professionals are not judgmental but simply practical. True, the wider society is judgmental towards addicts and Chavez will perhaps tell us if an addict cares about the attitude of the wider society; does an addict feel lonely and isolated as an addict and want to join the non-drug-abusing majority? If not, then there is not much use in any professional's taking that line with her.

My support for, let's call it the 'disability model' , of substance abuse is entirely about the need for professionals working in that field to be non-judgmental. This contention between Chavez and I started in a thread about determinism. I, as a determinist, claimed and claim that in order to be non-judgmental the professional needs to believe that assuming responsibility for oneself depends upon whether or not the addict has strength of character. Character strength does not arise newly formed but is caused either by life experience or genetic inheritance, and if the professional were to believe that the addict can simply choose according to something called 'Free Will' then the professional would be justified in blaming the addict.


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Re: Freedom and treatments for drug addicts

Post by Togo1 »

Belinda wrote:My stance on the matter of the 'disease model' is that it implies for the part of professionals the attitude of professional detachment, which means in practice that the addiction professionals are not judgmental but simply practical. True, the wider society is judgmental towards addicts and Chavez will perhaps tell us if an addict cares about the attitude of the wider society; does an addict feel lonely and isolated as an addict and want to join the non-drug-abusing majority? If not, then there is not much use in any professional's taking that line with her.
It's an interesting point. The Delancy Street Foundation had some success in treating drug addiction as a group, rather than an individual project, precisely because you get that social feedback effect. They saw drug addition as a social, rather than a personal activity.
Belinda wrote:My support for, let's call it the 'disability model' , of substance abuse is entirely about the need for professionals working in that field to be non-judgmental. This contention between Chavez and I started in a thread about determinism. I, as a determinist, claimed and claim that in order to be non-judgmental the professional needs to believe that assuming responsibility for oneself depends upon whether or not the addict has strength of character. Character strength does not arise newly formed but is caused either by life experience or genetic inheritance,
That sounds very much like a judgement to me.

One of the feedbacks that you can get from drug treatment programs is that drug addiction can happen to people who have very strong character, in response to crushing life events. Indeed it's the 'strong' characters that are the most vulnerable, because sustaining a habit for any length of time involves a lot of life skills.
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Fireproof Happiness: Extinguishing Anxiety & Igniting Hope

Fireproof Happiness: Extinguishing Anxiety & Igniting Hope
by Dr. Randy Ross
December 2023

Beyond the Golden Door: Seeing the American Dream Through an Immigrant's Eyes

Beyond the Golden Door: Seeing the American Dream Through an Immigrant's Eyes
by Ali Master
February 2024

2022 Philosophy Books of the Month

Emotional Intelligence At Work

Emotional Intelligence At Work
by Richard M Contino & Penelope J Holt
January 2022

Free Will, Do You Have It?

Free Will, Do You Have It?
by Albertus Kral
February 2022

My Enemy in Vietnam

My Enemy in Vietnam
by Billy Springer
March 2022

2X2 on the Ark

2X2 on the Ark
by Mary J Giuffra, PhD
April 2022

The Maestro Monologue

The Maestro Monologue
by Rob White
May 2022

What Makes America Great

What Makes America Great
by Bob Dowell
June 2022

The Truth Is Beyond Belief!

The Truth Is Beyond Belief!
by Jerry Durr
July 2022

Living in Color

Living in Color
by Mike Murphy
August 2022 (tentative)

The Not So Great American Novel

The Not So Great American Novel
by James E Doucette
September 2022

Mary Jane Whiteley Coggeshall, Hicksite Quaker, Iowa/National Suffragette And Her Speeches

Mary Jane Whiteley Coggeshall, Hicksite Quaker, Iowa/National Suffragette And Her Speeches
by John N. (Jake) Ferris
October 2022

In It Together: The Beautiful Struggle Uniting Us All

In It Together: The Beautiful Struggle Uniting Us All
by Eckhart Aurelius Hughes
November 2022

The Smartest Person in the Room: The Root Cause and New Solution for Cybersecurity

The Smartest Person in the Room
by Christian Espinosa
December 2022

2021 Philosophy Books of the Month

The Biblical Clock: The Untold Secrets Linking the Universe and Humanity with God's Plan

The Biblical Clock
by Daniel Friedmann
March 2021

Wilderness Cry: A Scientific and Philosophical Approach to Understanding God and the Universe

Wilderness Cry
by Dr. Hilary L Hunt M.D.
April 2021

Fear Not, Dream Big, & Execute: Tools To Spark Your Dream And Ignite Your Follow-Through

Fear Not, Dream Big, & Execute
by Jeff Meyer
May 2021

Surviving the Business of Healthcare: Knowledge is Power

Surviving the Business of Healthcare
by Barbara Galutia Regis M.S. PA-C
June 2021

Winning the War on Cancer: The Epic Journey Towards a Natural Cure

Winning the War on Cancer
by Sylvie Beljanski
July 2021

Defining Moments of a Free Man from a Black Stream

Defining Moments of a Free Man from a Black Stream
by Dr Frank L Douglas
August 2021

If Life Stinks, Get Your Head Outta Your Buts

If Life Stinks, Get Your Head Outta Your Buts
by Mark L. Wdowiak
September 2021

The Preppers Medical Handbook

The Preppers Medical Handbook
by Dr. William W Forgey M.D.
October 2021

Natural Relief for Anxiety and Stress: A Practical Guide

Natural Relief for Anxiety and Stress
by Dr. Gustavo Kinrys, MD
November 2021

Dream For Peace: An Ambassador Memoir

Dream For Peace
by Dr. Ghoulem Berrah
December 2021