Why do you say addiction is more like a learning or developmental disorder than a moral failing?
Learning disorders have a couple characteristics; one is they obviously involve learning. And addiction is defined as compulsive behavior despite negative consequences. Negative consequences is synonymous with punishment. It basically means you’re failing to learn from punishment. So that is a problem with learning. The other thing that happens in learning disorders, they’re usually restricted to a specific sort of brain circuit. and not well-advised things to make sure you’ll be with that partner.
What happens in addiction is that reprioritization is now aimed at a drug rather than getting a person in your life.
Why isn’t tough love — whether it’s stigmatizing, arresting, forcing treatment — the best approach to addictions?
There are two things here. We just said they have no brakes, so punishing them for having no brakes isn’t going to create brakes. Second, we’ve just said addiction is defined as compulsive behavior despite negative consequences. So if negative consequences were going to fix it, it wouldn’t exist in the first place.
It’s also cruel and inhumane. The horrifying thing about our addiction-treatment system is we stigmatize and do tough love and put all this pressure on people with addiction who are trying to change and who often want to stop. But then we tell them the way to stop is to go to this center where people are going to scream at you and take away the only thing that gives you any comfort and try to humiliate you. Well, I think I’m going to avoid that and take drugs, thank you very much. Then we blame people with addiction for not wanting to get help.
One of the reasons we need to decriminalize all possession and we need to get the criminal-justice system out of forcing people into treatment is because treatment won’t improve until it has to attract its customers. When the customer is the criminal-justice system, it makes it really easy for providers to get away with lousy treatment because the patient is always blamed. They didn’t work the program. They didn’t do the right thing. They’re the ones going to jail.
Doesn’t evidence support other approaches?
There are two medications that are known to cut the death rate by at least 50 percent. These are methadone and buprenorphine, the brand name is Suboxone. And these medications only work if you take them long term. And that means years not months, and it could be for life.
Basically these medications give you a steady state in your opioid system. Your natural endogenous opioids in your brain are there to make you feel connected and safe and loved. When you are normally attached to people you will feel endorphins when you are hugging them.
What happens when these medications work and you’ve got a person at a regular stable dose is they can drive, they can love, and they can do anything that anybody else can do. But the problem is people confuse addiction with physical dependence and think that because you still need this medication to function you
TUESDAY’S PETS PAGE
You may know that the Tuesday newspaper includes Pet Spot, a page of information about the animals you love. But did you know that now every other week the page includes a local columnist? Karin Spicer writes about her family’s misadventures with Teddy, the cutie pictured here. Look for the column, called “Living In Your Pet’s World,” this coming Tuesday. are still addicted.
This is not true. If that were true I am a Prozac addict at this moment. I need antidepressants to function comfortably in this world.
I don’t think this makes me a worse person than anybody else in this world, and if you want to think that, that’s your problem. That would make people with diabetes insulin addicts.