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Addiction, a disease? or self inflicted?

dartboardio

Some of you may have heard the recent podcast on 98FM, where a woman came onto the radio sharing her story that she was a recovering drug addict, and that addiction IS infact a disease, apparently 'physical, spiritual and mentally'

Same as myself, the presenter Adrian was disgusted that she was trying to compare a self inflicted drug addiction (whether over years or months) was the same as let's say a stroke, or cancer, etc.

What does everybody think of this?

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Wanderer78

djPSB wrote: »

People need to take personal accountability. We all have an addictive trait in us somewhere and need the self control to know when to stop.

For gambling, a lot of it comes down to greed. Not surprisingly, alot of the high profile GAA players who have come out with these problems are not very nice people. One was stealing from parents, families and charities and had over ten incidents of assault. Another is up in court for assaulting his girlfriend.

These lads chased the high life and went bust and didn't care who they hurt on the way. 100% self centered.

They then come public to 'help others'. Who are they trying to cod. They tell their story to try make a few pound for themselves by selling books telling their story. Or by making a career in counseling out of it. Everything evolves around themselves.

May sound crude but that's the reality.

sounds like you need to do a bit more research into all this, id highly recommend chatting to mental health professionals for more info

Capt'n Midnight

I'm not addicted to brake fluid. I can stop anytime.

Capt'n Midnight

There was an ultra marathon from Dublin to Cork a good few years back.

IIRC many of the people involved were previously addicted to drugs or alcohol.

An odd association.

ballsymchugh

Capt'n Midnight wrote: »

There was an ultra marathon from Dublin to Cork a good few years back.

IIRC many of the people involved were previously addicted to drugs or alcohol.

An odd association.

used to work with a rehabilitated alcoholic who spent every weekend doing some 10k or half marathon, and trained every day in between.

alcoholism only became classified as a disease in the US a few decades ago so that treatment could be paid for out of health insurance.

Dravokivich

I think you're doing someone a disservice trying to identify 1 complete anwser to "what causes addiction." There's so many stereotypes behind it and I've seen people trying to conform to them, so they could relieve themselves of the immense pressure envolved in tackling thier various issues that have lead to addiction.

Noel82

Some addictions are "self inflicted" due to life circumstances or experiences they've had to live through where it's easier to get drunk than deal with the problems. Continue it over years and letting the problems build up inside can lead to serious mental problems imo. Alcoholism is a terrible affliction.

nozzferrahhtoo

nkav86 wrote: »

I think to call it a disease though, negates the choice that someone made to take drug and can absolve them of the blame that is there. Rightly or wrongly, that's the best way I can describe my thoughts on it.

Choice is not a part of the definition of disease though. So while it is clear what you want to say here, and you say it clearly, it is not actually a relevant point.

Lung cancer is a disease for example despite the "Choice" involved in starting to smoke cigarettes. Obesity and certain types of diabetes can also be formed based on the "choice" to feed yourself swaths of cola, sweets, crisps and biscuits every day.

What is or is not a disease is not defined by whether it's root causes were formed in or by choice or not. Though, like yourself, I think a lot of the reluctance to use the word "disease" in conjunction with "addiction" very much is couched here....... in the fear that it will remove our ability to allocate initial blame for the condition at the feet of the patient.

dartboardio wrote: »

I completely agree with you there, it certainly doesn't start out as a disease, and if anything, the person using CREATES that 'disease'.. from their own choices. (maybe not choice, maybe they felt they had to) but still doesnt change the fact that it is a conscious decision.

While pedantically accurate in some senses though, I am not sure this is a useful way to look at it. It may have been a conscious decision to START drinking SOME alcohol. But I doubt very much that many people with addictions made any kind of conscious decision to first abuse.... and subsequently become addicted to....... it.

A huge % of people in our country drink alcohol. I would suggest that the "conscious decisions" of those not addicted to it are not all that different to the "conscious decisions" of the people who are if you were able to hold them up side by side and compare them usefully.

djPSB wrote: »

People need to take personal accountability. We all have an addictive trait in us somewhere and need the self control to know when to stop.

You are over simplifying the issue here by speaking of it from the perspective of a "healthy" person that has that self control and the borders on where to stop. But as the ASAM says when they define addiction as a disease..... the processes and development of addiction basically alter the reward structures and decision making areas of the brain and actively impinge upon the very processes you are calling on when discussing their "accountability".

The very motivational hierarchies of the brain you are appealing to here when discussing accountability are exactly the ones that are altered and impaired by the processes of addiction.

So yes, by all means we should not lose sight of accountability by any means. But when a person with addiction issues presents before us for treatment and assistance......... it is only a small part of a much bigger and more important picture........ and the treatment of the disease becomes distinct from the initial causal pathways of it.

djPSB wrote: »

For gambling, a lot of it comes down to greed.

Actually for gambling a lot of it comes down to poor judgement and desperation, not greed. The person is not being greedy when they get into dire straits and debt, rather they get locked into a cycle of simply believing they can recoup their loses eventually. They are not being motivated by greed for more and more money........ they are motivated by a desperation to get back to square 1 and simply recoup the money they lost.

I am not sure there is much benefit to be gleaned from cherry picking 2 or 3 anecdotes of people with such addictions as if to paint the entire world of gambling addiction by the crimes of one girlfriend beating horror. 2 Anecdotes is not, as you claimed, "a lot".

I am not even convinced, as you appear to be, that people who get into a cycle of gambling addiction were ever "chasing the high life" while doing so. Rather it is often a cyclical series of minute abuses of their brains reward mechanisms that probably started out with them putting a little money on a horse "Just because".

djPSB wrote: »

They then come public to 'help others'. Who are they trying to cod.

Yea because it is impossible that people who recovered from addiction might sometimes ACTUALLY genuinely intend to help others. Absolutely unimaginable that that can sometimes be the case, is it?

nozzferrahhtoo

One eyed Jack wrote: »

an attempt to normalise an abnormal mental disorder.

I have never quite understood your need to invent motivations for people you simply disagree with. I guess it is something to do with wanting to bypass their argument by instead inventing some nefarious agenda behind their having made it.

That said I am not clear what you think it even means to be "normalizing addiction". Perhaps you could explain what you think normalizing it means, entails, and consists of.

But the REAL motivation for most people defining it this way has literally nothing with an attempt to "normalize" anything. Rather it is motivated by the simple fact that the treatment of any condition requires accurate diagnosis and classification of it. Only when we really understand what condition a person or people have can we move towards effective treatment plans.

Historically, as the "recovery village" points out, "addiction to alcohol and drugs has been seen as a moral failing. The person addicted was viewed as lacking in willpower". A set of attitudes that is the direct opposite of what is required to understand and treat the condition.

So no, no one is out to "normalize" anything so much as we are out to accurately portray it, understand it, and develop new and ever better treatments for it based on what it actually is, rather than what people like you simply want it to be for the sake of simplicity or judgement or whatever floats your particular boat.

Or put another way, calling it a disease is often motivated not solely by definitions and recognition of how many aspects of it DO match the definition of "disease" (which you are unwilling or unable to provide) but also by the realization that treating it with the "disease model" is the best approach. There is a paper in Science by Leshner for example on not just why we classify it as disease, but why it actually matters.

One eyed Jack wrote: »

Or, y'know, you could just post the definition of disease for me if you think I'm wrong.

Ah the old "Everyone has to cite for their arguments except me" move that you love so well.

Interestingly though, as the "center on addiction" points out.... it is defined as a disease by "most medical associations, including the American Medical Association and the American Society of Addiction Medicine.". The latter for example define addiction as "Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry."

Also the National Institute on Drug Abuse (NIDA) also uses the word "addiction" to define compulsive drug seeking behaviors, though they do note that although the use all the same criteria for this as the DSM.... the DSM prefers to call it "substance use disorder" rather than addiction.

While DrugAbuse.gov tells us that “Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her.”

Leshner wrote in the peer reviewed magazine "Science", and you can source the paper on ncbi.nlm.nih.gov also, that "As with many other brain diseases, addiction has embedded behavioral and social-context aspects that are important parts of the disorder itself. " And while on the subject of magazines it was reported on also in Medical-News-Today why this definition is used in 2011 if you care to go read it.

So if anyone is put out by your own unwillingness to define your lay man terms, then they are welcome to go to these actual medical bodies, and actual scientists, and see how they define theirs.

topper75

RobertKK wrote: »

Some of it is due to genetics.

Could we tease apart the following two things?

weakness to resist a habit (yes genetics may play a part here - possible brain chem issues)
the stupidity to start a habit (not genetics - total personal responsibility issue and absolutely nothing to do with a disease)

Pure tashte

I think it's on a sliding scale, and some people are much more predisposed to intense addiction. Maybe a mental health issue would be a better term?

For instance, if you take cigarettes for example. They are certainly addicted and if you smoke enough of them you'll get addicted. But some people smoke for years and only smoke a few a days or less, and then some people smoke 60+ a day, from using the same product.

nozzferrahhtoo

topper75 wrote: »

Could we tease apart the following two things?
weakness to resist a habit (yes genetics may play a part here - possible brain chem issues)

the stupidity to start a habit (not genetics - total personal responsibility issue and absolutely nothing to do with a disease)

Again a massive over simplification going on there. For many people there is no distinction between the two things on your list.

If, for example, you are genetically disposed to it then that is not something you are likely to know. You are going to start drinking at the same time, and in the same way, as most of your peers most likely.

So one is stupidly "starting a habit". Abuse, dependence, and addiction are often something that happens so incrementally that it sneaks up on one before they even see it. Sometimes they do not even see it even when people around them start to see it. A real "not seeing the woods because all the trees around you are getting in the way" kind of situation.

It would indeed be stupid of anyone to sit down and decide to form a dependence or addiction to something. To sit down and say "this is going to become a problematic habit". But I am not convinced many, if any, people are actually doing that.

I myself have a few addictions, mostly benign and mostly sugar based. I was never "addicted" to alcohol but I think I narrowly missed that bullet myself. My drinking patterns were once a week only, but in slightly ever increasing amounts. I did not see it as a problem until SUDDENLY I realised it potentially was. And I stopped drinking.

Now it has been 14 months since I have had any alcohol and looking back I can NOW see blatantly obvious warning signs of my developing issue that I was, to say the least, absolutely and entirely blind to at the time.

So blatantly obvious that I genuinely can not get myself BACK into the head space of being blind to them. But at the time, that is what I was. Totally. Entirely. Blind.

And I do not, though I suppose self evaluation is a dangerous game, think any of this was due to "stupidity". Rather the changes in my behaviors and alcohol use were so incremental and tiny over the space of a 7 year period that they were simply invisible to me at the time.

Which was not helped by the fact that during that 7 year period I had a 7 month period with zero alcohol and I did not miss it once. So I convinced myself, as many with developing issues do, that I was a "I can stop any time no problem" case and therefore I did not have any alcohol problems. Now I realize that alcohol problems take many forms, some of which do indeed mean you CAN stop any time.

It is so easy to merely hand wave it away with things like "your choice" or "stupid" and so on. But to do so is an over simplification that I think misses the masses of nuance and incremental changes that actually go on in the life of many people who end up with dependency, abuse and addiction problems.

sbsquarepants

My personal 2 cents is that if you can't catch it without being at least partially to blame, it's not a disease.

You may be more inclined to be an addict than the next person - but without you kick starting the whole thing, it never happens. Nobody takes a mouthful of a pint and hey presto they're an alcoholic, or does a line at a party and they're suddenly a coke addict.

Becoming an addict takes time and effort on the part of the addict.

It's like being genetically pre-disposed to gaining weight. That in itself won't make you fat, over eating is what will make you fat. Over indulging will make you an addict. It's your own fault - stop making excuses!

nozzferrahhtoo

sbsquarepants wrote: »

My personal 2 cents is that if you can't catch it without being at least partially to blame, it's not a disease.

I am not sure I am parsing your post right? Perhaps the double negative is throwing me and I am parsing it as meaning exactly the opposite of what it does mean? If so my bad!

But if I am reading the above correctly..... HIV and AIDS is not a disease then?

What about people who drink loads of cola and eat loads of sweets and develop diabetes? Are those forms of diabetes not a disease then?

What about lung cancer caused by cigarettes?

I do not think anyone in the medical industry defines what is and is not a disease in terms of the initial hand the patient has (or has not had) in the causes of it.

Stonedpilot

Some in AA call it a disease despite the main text of the big book not stating this.

She meant its a disease of the mind. Its not whats in a bottle or syringe makes you take it its whats in your head.The disease in her head will always try get her back on drugs. She's powerless as such once she takes thus total absinence is the only option.
Some call it disease others dont. Anyone who gets hung up on it is pathetic.

He should have praised her on being clean and sober. He acted like a pure prick

Trying to explain that to a narcississtic simpleton like Adrian Kennedy impossible.

Staggering how he has a radio show. He has the mind of a spoilt 12 year old and an ego the size of Russia.

Horrible horrible human being.

CruelCoin

RobertKK wrote: »

Some of it is due to genetics.

I don't see it so much as genetics than just plain old "monkey see monkey do"

Nurture, not nature.

sbsquarepants

nozzferrahhtoo wrote: »

But if I am reading the above correctly..... HIV and AIDS is not a disease then?

I suppose that is what I actually said....but it's not what I meant:D

I'll elucidate!

HIV, AIDS, STD's in general - I suppose you normally do play some part in acquiring things like this, and no that doesn't mean they aren't diseases. But it is also quite possible to catch them accidentally without ever endangering yourself. Say via a blood transfusion for example. You don't HAVE to put the effort in.

Diabetes, lung cancer etc. can develop without ever over doing the biscuits or smoking like a chimney.

Addiction however, any and every addiction, REQUIRES the addict to take steps to get themselves addicted. The only exception would be in newborn babies - where their mother has so thoughtfully put in the legwork for them.

They are the only innocent addicts.

So, to my mind - addiction is not a disease, not in the normal meaning of the word disease anyway - it is more a weakness in the personality of the addicted person. If you as an adult find yourself addicted to anything - you brought it on yourself, plain and simple. Don't use the word "disease" to make yourself a victim and absolve yourself of blame. It's your own fault - nobody elses, not genetics, not circumtstance, not the big bad world.....it's you!

If you're lying on your death bed riddled with cancer because you were just unlucky enough for your cells to mess up their division - then you are a victim. If you've destroyed your lungs through your own actions - then you are merely reaping what you've sown.

nozzferrahhtoo

sbsquarepants wrote: »

Addiction however, any and every addiction, REQUIRES the addict to take steps to get themselves addicted.

I am not really getting the distinction you are trying to make.

You recognize that the vast majority of people who get HIV did something themselves that led to it (took drugs, unprotected sex, whatever) but there are SOME exceptions to this like transfusions.

You then go on to say that the vast majority of people with addictions, did something themselves that led to it (actively taking alcohol or whatever for example) but there are SOME exceptions to this (babies of addicted people being the example here).

So..... both the same thing then? In both cases they are VASTLY more often caused by the patient initiating it in some way..... and in both cases there are a set of minority exceptions.

Further, just to be a little extra pedantic since it is what I am apparently known for

when you say "possible to catch them accidentally without ever endangering yourself. Say via a blood transfusion for example. " I do not see that distinction either. Giving or taking a transfusion IS endangering yourself. Undertaking any medical procedure is to endanger yourself. Every medical procedure comes with risks. Risks of complications. Side effects. Infection.

Not meaning to hammer on you too much here as I know you are just giving YOUR PERSONAL definition of "disease" here and not claiming in any way that it is the correct one, the medical one, a useful one, or anything but your own personal one..... so no one can be called "wrong" for making up their own word or their own definition for an existing word.... as long as they are acknowledging that is, in fact, what they are doing.

But it does, I hope you forgive me for saying so, come across strongly like having come to a conclusion first and are attempting to fit the definition to it second. Which is..... not an approach I generally recommend if asked.

But what I would say is that the "choices" (which seem to be the focus of your definition) that an addict made are generally little different to the choices non-addicts made. They start drinking a little, like most of us did. They over time increase how much they drink like most of us did. And some point along the process this went awry. I think you would be hard pushed to analyse, say, 100 random addicts and coherently identify any point in their process where they made a "choice" we can point at and say "There, that was it".

The path to addiction for most, I warrant, is a slow and incremental one that.... for much of the initial stages.... likely map near 1:1 with the same things that go on in the rest of us "normal" people.

nozzferrahhtoo

Sorry for the seperate reply to the same post, but you appear to have added the text below while I was writing my previous reply.

sbsquarepants wrote: »

Don't use the word "disease" to make yourself a victim and absolve yourself of blame. It's your own fault - nobody elses, not genetics, not circumtstance, not the big bad world.....it's you!

Firstly I do not think that that IS the motivation of people who are using the word disease. This sounds like the kind of thing One Eyed Jack would spew out at us. The people who use the word "disease" to describe the issue of addiction have many motivations for doing so. And I have seen little to suggest that absolving themselves or others of "blame" is one of them. People like ASAM are VERY clear why they thing the definition fits. While people treating addiction are VERY clear why the disease model....... if not the word disease itself...... has been very important and relevant in how we treat and view people with addictions.

Secondly though we already have good reasons to suspect there is a genetic element at play here. Some people are simply more prone to addiction and addiction behaviors than others. No one is saying "it is all genetics" of course, but it would be a fools game to discount it's role at all, let alone to discount it entirely.

I think what people have is some idea that a person chooses to drink remarkably heavily, for a sustained period, until they are addicted. A leads to B.

The actual process is more iterative than that. A person starts on their "vice" of choice. Alcohol. Gambling. A drug. Whatever. And as ASAM describe, it modifies a tiny bit the areas of the brain related to reward mechanisms, self control, motivational hierarchies and so forth.

That then feeds back into the usage behavior of the vice of choice.... which feeds into a brain change.......... so on so on. It is a cyclical and iterative process of a level of complexity that is not acknowledged in your descriptions of it. I genuinely suspect very strongly that if you map out the Decisions and choices of people who drink to.... say.... modern average irish standards.......... and people who drink to the point of addiction and dependence......... you are going to be hard pressed to identify much difference between them. And that result, should you test it, should be highly informative to you if you let it be.

I do not think anyone is trying to discount blame entirely from the discussion. It should be part of a much larger picture of course. But the two places blame do not seem to be useful are in treating a person with an addiction, or in defining the meaning of the word "disease". The latter, especially, is not somewhere where blame should have anything to do with it at all.

sbsquarepants

I take your point.

To be honest I suppose what I've done is I've equated the word disease with blameless - which is not correct.

I still don't believe that addiction is an actual disease per se - but the points you make about blood transfusions etc are correct, so i'll withdraw my ill thought out comments entirely.

I think, largely from personal experience, that to become an addict you must ignore quite a few warning signs. You simply can not become an addict without being complicit. When you get to the stage where you are prioritising the buzz of anything over relationships, work, normal everyday life - you need to ask yourself some tough questions. If you don't ask those questions that's not a disease, that's a choice. Sometimes people don't make the hard choices, the allure of the easy route is very strong.

I've taken lots of drugs in my time, I know all to well that it is much more enjoyable to stay partying than sober up and go to work (I've done just that many times) But overall you just have to do what you have to do. Being irresponsible is not a disease, it's a character flaw.

donegaLroad

this is well worth the 5 minutes

https://www.youtube.com/watch?v=ao8L-0nSYzg

[Deleted User]

Its a mixture of a lot of factors it does not fall in to the easy divide of either or. That does not suit a lot of people though they want the simple answer.

The is another larger issue going on and it similar with diagnoses of conductive disorders or the perceived over diagnostics of ASD. There is a moral judgement going on of the person or the parents.

nozzferrahhtoo

sbsquarepants wrote: »

To be honest I suppose what I've done is I've equated the word disease with blameless - which is not correct.

I suspect you are not alone in this. The fact blame and accountability has come up so much in this still short thread suggests that that move is one a lot of people are making.

I feel not only is it the wrong move to make, but an irrelevant one. There is simply no one out there who matters, like the medical industry for example, who are defining "disease" in terms of accountability or blame. It is just not happening.

Rather they define it in terms of A) How it manifests at the level of the body and brain and

the treatment modalities that work on it.

sbsquarepants wrote: »

i'll withdraw my ill thought out comments entirely.

The fact you are considering and acknowledging my points and modifying your discourse in response rather negates your self depreciation of being "ill thought out". Looks to me, more than one or two I could name, that you are very much thinking it all out. That is, at least in my ideal fantasy, what a forum like this is for

To think out loud, and have those thoughts evaluated and molded by the responses of others. We could do with a lot more of you

sbsquarepants wrote: »

I think, largely from personal experience, that to become an addict you must ignore quite a few warning signs. You simply can not become an addict without being complicit.

Read my post #42 (wohoo 42!) above on this one. I myself dodged the bullet of addiction. How close a shave it was I will never know, nor do I really want to know as it kinda terrifies me looking back on it.

But at no point during it did I ignore the warning signs. I was wholly and entirely and blatantly ignorant of them and blind to them. Looking back now I see them as clearly as I see the monitor I am now typing this into.

So I can understand how a person like yourself might not understand how a person with an addiction could miss those signs. I AM (or at least nearly was) that person.... and even I do not understand how I was missing them at the time. So how could I expect you to?

Retrospect is a powerful thing!

But if *I* can not understand how *I* was blind to the signs.......... I genuinely feel for people who never had that experience who are looking from the outside in at addicts and their behaviors. So while I know you are misled in your thinking here...... I genuinely have no tools to adequately convince you of it.

sbsquarepants wrote: »

When you get to the stage where you are prioritising the buzz of anything over relationships, work, normal everyday life - you need to ask yourself some tough questions. If you don't ask those questions that's not a disease, that's a choice.

But as the ASAM say, by the time you get to the point where such questions need to be asked you have what they are calling the "disease". A disease that has modified your behaviors, your reward mechanisms, your motivational hierarchies and more.

Not by ANY means intending to use an insulting phrase to actually BE insulting but it kinda is one of those "Check your privilege" style things. We WITH the capability, and fully functioning motivational hierarchies and so forth, find it very easy to say "They need to ask the hard questions" because we have that capability and privilege. They, in many ways, have had that faculty eroded and it is not mere choice that has them avoiding the questions, or at least the "right" answers to those questions.

yourdeadwright

Its the world we live in these days for people to say its a disease so its not " there fault "
Look life is tuff life is hard people have up and downs are born into worse situation than others , but its up to you as a person to take control of your life to steer your own ship and not get into the situation where addiction can become a problem ,
Addictions come from the choices you make in your life, Even when bad situation happen people always have a choice on what way to tackle it, yes some are shocking situation and you can understand why people end up becoming addicts to alcohol or drugs but even those people had a moment where they decided what path to take , some times they change there mind but addiction already has a hold of them but i'm a firm believer Addiction comes from your own choices you make,
Now I do understand there are rare cases where it's not the person fault , where there born into family where they know nothing else and addiction seems like normal life and other cases they don't have control off, but you get my drift,

sbsquarepants

nozzferrahhtoo wrote: »

But as the ASAM say, by the time you get to the point where such questions need to be asked you have what they are calling the "disease". A disease that has modified your behaviors, your reward mechanisms, your motivational hierarchies and more.

Not by ANY means intending to use an insulting phrase to actually BE insulting but it kinda is one of those "Check your privilege" style things. We WITH the capability, and fully functioning motivational hierarchies and so forth, find it very easy to say "They need to ask the hard questions" because we have that capability and privilege. They, in many ways, have had that faculty eroded and it is not mere choice that has them avoiding the questions, or at least the "right" answers to those questions.

I agree with most of what you say but I'm just not convinced of this part. How is this a disease that has modified their behaviour and not just the normal hardwired pleasure / pain reward circuit of the brain doing it's thing, same as it does for all of us.
Chocolate = feel good therefore eat more chocolate. We consciously have to learn too much chocolate = bad and force ourselves to override the compulsion to eat more of it. Leave a child alone and they'll likely eat it untill they puke!
Replace chocolate with cocaine / alcohol / gambling - how is it any different?

nozzferrahhtoo wrote: »

We could do with a lot more of you .

I'm always telling people this.......you're the first to agree:D

annascott

Some people are more prone to addictive behaviour than others. However, the whole 'disease' label for alcoholics and drug addicts is used as an exemption from any self awareness or responsibility.
Also, there is always the big deal over how long they have been 'clean' for delivered with an attempted air of superiority. Most of us do not allow ourselves to fall that low in the first place but do not go around expecting rounds of applause for it.

topper75

nozzferrahhtoo wrote: »

Again a massive over simplification going on there. For many people there is no distinction between the two things on your list.

I was analysing the situation - therefore of course I'm going to simplifying it. No apologies there.

You are complicating things unnecessarily.

A junkie getting a fix for the umpteeth time is not the same as some dolt seeing somebody else shooting up and stupidly thinking - 'I'll give that a go'. They are very different processes. I think the latter is very much personal responsibility failure and nothing else.

As a further nail in the genetics coffin - I know so many first hand who totally avoided their parents' downfall deliberately. Including relations of my own.

Starting to take **** is NOT a disease. Thinking it is = self-delusion.

nozzferrahhtoo

sbsquarepants wrote: »

How is this a disease that has modified their behaviour and not just the normal hardwired pleasure / pain reward circuit of the brain doing it's thing, same as it does for all of us.

Because it is more than just the pleasure responses of the brain in play. Other areas are affected too. Perhaps a more copious amount of quotation from ASAM, rather than my select quoting, is warranted here. I will include it at the end of this post due to it's length.

But suffice to say / TLDR........ the modifications they are suggesting are occurring are slow, cyclical, iterative, and encompass a lot more than merely the reward centers. Rather they impact entire behavior modules, including those of decision making, self care, and more.

So it gets massively more complex than "X feels good = I want more of X".

Further these people generally do not LEAP from moderate use to crazy over use. Rather in a slow iterative process they simply need a tiny bit more.... then a tiny bit more...... to merely get to the SAME level of satisfaction.

If it were a case they were jumping from a glass of wine to a bottle of whisky a day..... I doubt there would be many addicts. They would recognize that "enough / too much" divide of which you speak. But it rarely happens that way. It is much slower, with each increase being so moderate that the person themselves fails to rate the relevance of it.

In my own case, when I avoided falling into the pit of addiction I was so close to falling into, I progressed over a period of 7 and a half years from a beer once a week on a friday......... to 4 and sometimes even 5 1 liter bottles of wine once a week on a friday. To you, and even to me NOW, that is insane. How I did not notice "Hang on, this is an issue" makes no sense to me now. In fact I now believe the only thing that stopped me being addicted, was that I did only ever drink on a friday. Had it been multiple nights a week....... well I dont wanna think about it

But in the moment(s) each increase was so small it is like those times where you look at your finger nails and go "Crap when did THEY get so long, I did not notice AT ALL". Each increase genuinely seems meaningless and irrelevant in the moment.

sbsquarepants wrote: »

I'm always telling people this.......you're the first to agree:D

Well I am not suggesting a direct cloning program here or anything

At least not one without the potential for some beneficial modifications to the template

Long Definition of Addiction:
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Addiction affects neurotransmission and interactions within reward structures of the brain, including the nucleus accumbens, anterior cingulate cortex, basal forebrain and amygdala, such that motivational hierarchies are altered and addictive behaviors, which may or may not include alcohol and other drug use, supplant healthy, self-care related behaviors. Addiction also affects neurotransmission and interactions between cortical and hippocampal circuits and brain reward structures, such that the memory of previous exposures to rewards (such as food, sex, alcohol and other drugs) leads to a biological and behavioral response to external cues, in turn triggering craving and/or engagement in addictive behaviors.

The neurobiology of addiction encompasses more than the neurochemistry of reward.1 The frontal cortex of the brain and underlying white matter connections between the frontal cortex and circuits of reward, motivation and memory are fundamental in the manifestations of altered impulse control, altered judgment, and the dysfunctional pursuit of rewards (which is often experienced by the affected person as a desire to “be normal”) seen in addiction--despite cumulative adverse consequences experienced from engagement in substance use and other addictive behaviors. The frontal lobes are important in inhibiting impulsivity and in assisting individuals to appropriately delay gratification. When persons with addiction manifest problems in deferring gratification, there is a neurological locus of these problems in the frontal cortex. Frontal lobe morphology, connectivity and functioning are still in the process of maturation during adolescence and young adulthood, and early exposure to substance use is another significant factor in the development of addiction. Many neuroscientists believe that developmental morphology is the basis that makes early-life exposure to substances such an important factor.

Genetic factors account for about half of the likelihood that an individual will develop addiction. Environmental factors interact with the person’s biology and affect the extent to which genetic factors exert their influence. Resiliencies the individual acquires (through parenting or later life experiences) can affect the extent to which genetic predispositions lead to the behavioral and other manifestations of addiction. Culture also plays a role in how addiction becomes actualized in persons with biological vulnerabilities to the development of addiction.

nozzferrahhtoo

topper75 wrote: »

You are complicating things unnecessarily.

Quite the opposite. Addiction is, for many, a complex thing both in terms of the level of behavior, and at the level of the body and brain. Describing it as it is is not complicating it unnecessarily..... rather it is being informed about it necessarily.

topper75 wrote: »

A junkie getting a fix for the umpteeth time is not the same as some dolt seeing somebody else shooting up and stupidly thinking - 'I'll give that a go'.

Yet that is what a large % of us actually do. We grow up watching people getting pissed out of their heads and then we reach an age where we think "Ill give that a go".

When it comes to intravenous drugs however I doubt many people are introduced to it by watching others do it and "giving it a go". More often I think they are invited to do it by a trusted peer or friend in a "lets do this together" kind of way, rather than a "I see what you are doing, and I want to do it too" kinda way.

topper75 wrote: »

As a further nail in the genetics coffin - I know so many first hand who totally avoided their parents' downfall deliberately. Including relations of my own.

That would be a misunderstanding of genetics there though, and a big one at that. A trait being genetic does not guarantee that an off spring will have it. So if part of their parents downfall had a genetic basis......... their avoiding of that same downfall COULD in part be due to them not having the same genetic issue.

It is a common lay man mistake, the fault of our education system and not yours, that something being genetic means that the parents having it means the children should or will too.

So no, your personal anecdotes do not at all undermine the genetic basis for addiction, let alone to the point of bringing coffins into it. Genetics simply does. not. work. that. way.

Read the paragraph about genetics in the citation just above this post.

HalloweenJack

I have seen what addiction can do to people and its far from pretty. I'm no scientist so my ideas are based purely on observation.

When someone destroys their life to the point they lose their family and their job and they still can't improve then something out of the ordinary is at play. Logic/common sense/wjatever you want to call it would suggest you sort yourself out. If, however, you continue doing something that is destroying your life then you need help as you obviously can't do it on your own, its just not in your nature for whatever reason.

While addicts can be incredibly selfish and ignorant of other people's feelings, I believe this is a symptom rather than the cause.

From the addicts I know, a lot seemes to stem from a deeper unhappiness and not knowing how to deal with it. People aren't perfect, there are plenty of people out there with mental health issues abd who just can't deal as easily with life. Some of this shows itself in the form of addictions.

These people need help, not judgement. Sure, it's not nice to see addicts deterioriate as people and turn to crime in extreme cases but it is a symptom of addiction, not them using addiction as a cloak. At the end of the day, they need help because they can't cope with what life has given them.

If a lack of some abstract quality that is something you can't grab on to while a lot of other people seem to have can be considered a disease, then I'd say it's a disease. However, most importantly is that these people need help and sympathy because addiction turns them in to ugly people, they weren't ugly to begin with, life just ****ed them over.

yourdeadwright

annascott wrote: »

Some people are more prone to addictive behaviour than others. However, the whole 'disease' label for alcoholics and drug addicts is used as an exemption from any self awareness or responsibility.
Also, there is always the big deal over how long they have been 'clean' for delivered with an attempted air of superiority. Most of us do not allow ourselves to fall that low in the first place but do not go around expecting rounds of applause for it.

I total agree with this and iv had a family member die from addiction ,