> The consistency that I'm hearing from all across patient groups is gain of control, whereas previously, there was a loss of control… All of a sudden they're able to step back and say, 'oh, well I had this shopping phenomenon that was going on, gambling, addiction, or alcoholism, and all of a sudden, it just stopped,'
- Dr. Gitanjali Srivastava, Vanderbilt Medical Center
Fiddling with our "reward centre" does not seem like it can have a localised effect to a couple of unwanted behaviours. I'm not sure we are braced for how widespread or impactful the other consequences might be especially if a vast percentage of the population take them life.
For example, could they significantly change voting preference? Why wouldn't they? Do we not respond to political messages with our "reward centre"? Will we find political charisma more or less entrancing? Will we find calls for vengeance and punishment more or less attractive? Does tinkering with desire and reward dull our emotional response? Will we find compassionate appeals to help less fortunate more or less attractive? Does "enhanced control" manifest as a political preference for rational altruism or as machiavellian selfishness?
Depends on the molecule. Cannabis can be produced by any teenager in a closet with a grow light. Quaaludes on the other hand are now impossible to come by.
I imagine the reason for the popularity of Quaaludes was easy access. Remove that, and the myriad other substances available become more attractive, be it MDMA, LSD, magic mushrooms, 2-CB, Ketamine, cocaine, heroin, or a number of others.
The interesting thing is the rise of fentanyl in the wake of marijuana legalization. The cartels were making tons of money off illegal marijuana. When marijuana went legal, a lot of that money went away. But the cartels already had this distribution channel and weren't about to go legit. So they found this other way of making money with the existing channels they had.
And China is happily funding fentanyl as low intensity warfare on the united states, supplying the raw materials and likely providing "other" support.
It really does highlight how failed the drug war is. The only effective weapon against rampant cartel violence is decriminalization and legalization.
I just watched Sicaro over the weekend, yeah about 4 years late. The thing is a right wing wet dream take on the drug war, and the interesting thing is it's exactly like the vibe that came out of Vietnam war, another failed war.
"The politicians won't let us use unrestrained violence to win". Of course, both the Vietnam were and even more so the drug war are founded on completely illegitimate policy foundations, and only continue because of budgetary territory defense and a lack of desire of unelected officials to maintain power.
It strikes me as an ideology of hatred towards humans to argue against something so incredibly beneficial for the individual in this way. Yes, being free from addiction will certainly change the way people vote and their political outlook on life, just as exercise and eating healthy will do.
It is not selfish to improve yourself and it does not make you sick that somebody else is healthy. You know very well that people who dedicate themselves to being healthy are very eager to help others as well.
> It strikes me as an ideology of hatred towards humans to argue against something so incredibly beneficial for the individual
It’s not an ideology of hatred to consider unintended consequences.
This is the plot of like 20% of science fiction, where unintended consequences backfire at a societal level.
That might arise from curiosity, imagination, or concern for the future of our species.
There are studies that show when dopamine receptor activity is inhibited in mice, their motivation for basic survival plummets. They will continue to consume food if it placed in their immediate reach, but they will otherwise put forth only the bare minimum effort to survive.
That is to say, there are very real implications of messing with hormone responses, and it’s definitely not a given that it doesn’t backfire spectacularly down the road.
I also think most people would and should choose the quality of life now, even if that has longer term side effects we don’t know about yet.
> It’s not an ideology of hatred to consider unintended consequences.
It seems as an ideology of hatred to sacrifice the well being and health of real humans to prop up the false belief in something called "society", which has never existed and will never exist.
I have nothing against arguments questioning the side effects of the drugs for the individual, but that's another debate.
Should we also argue against exercise and a healthy diet, since these things also have an impact on people's political views?
It strikes me as incredibly naïve to think that we've just stumbled into an absolute cure for addiction, no caveats. That's second coming level of world change from "just take this drug once a day". Being cautious about <insert new thing> is not hatred towards humans.
Yeah, isn’t that how the (most recent) opioid epidemic got started - a pharma company telling everyone their new opioid was way less addictive - almost a sort of miracle cure?
The difference here is everyone involved in the opioid epidemic knew opioids were addictive. They just enjoyed the CYA aspect of it.
It’s like sexual harassment training. Literally no one needs to be “educated” that sexually harassing your coworkers is bad. It’s done to cover the companies ass and for no other reason. The drug companies offered that cover and the rest of the establishment knowingly used it to cover their bad actions. No doctor prescribing hydrocodone thought it was a non-addictive substance.
Perhaps there will be some severe second order long term side effects with GLP-1 drugs. Time will tell, but considering we are nearly 20 years in on these and on 4th and 5th generation therapies I suspect we would have had a small hint of those by now.
I’m extremely cautiously optimistic about these drugs. They seem to be an antidote to the poison that is the modern western lifestyle.
I started Ozempic about 3 months ago, prescribed by a nutrologist, first with the minimal weekly dose of 0.25mg, then 0.5mg, now back to 0.25mg to control my glucose levels (prediabetes). During this period, I lost about 25 lbs, which is fine (but I lose weight easily, just by exercising, so I wouldn't call this phenomenal by itself).
The biggest difference I felt was indeed in gain of control, being more aware of my body and living in the moment. I've been practicing meditation for a long time, and what I can say is that the drug keeps you in a medidative state for longer (most of the week).
The result is that I still like fatty foods and sweets, but I don't crave them. Binge eating has stopped, and all addictive/obsessive behavior, including social network / news sites / porn consumption has stopped.
I am normaly hyperfocused, but my standard m.o. has been peaks of absurdly high performance interspaced with a hiatus of low productivity/creativity. Right now, the the ability to focus on what I want/need to instead of what serendipity brings my way has been awesome.
It's not all rainbows, though. One thing I have to do is to set an alarm to drink water (otherwise I'll spend 6, 8 hours without water and have a headache).
Also, I might be the perfect Ozempic patient as I just entered the prediabetes spectrum with 5.7% glycated hemoglobin and have high muscle mass.
Alcohol, socially. Before I'd have 3 or 4 drinks, now it's 1 or 2. Sometimes I don't feel like drinking at all.
My perception of some foods is different as well. For instance, as I mentioned, fat still tastes good but doesn't attract me as much any more. Fish otoh tastes much better.
Makes sense to me. Im on keto/carnivore, when im strict w no cheating. After about 2 weeks im reorganizing and less interested in videogames. I think, sugar is stressing out the whole system
Root cause is a hormone imbalance, GLP-1 agonists patch a reward center in the brain (scoped to addiction, whether that be food, drugs, alcohol, gambling, etc).
What’s interesting is that we’re about to have a large scale natural experiment around addiction and whether it is chronic due to brain chemistry or more willpower as GLP-1 agonist uptake rate skyrockets in the general population (which should result in addiction reduction at scale).
It'll certainly affect how society views addiction in general. Most people don't have a good picture of addiction, and don't understand that a drug addict can no more stop doing drugs than you can yell at a cripple to get them to stand up. it's a mental disease, not a moral failing, and as we learn more about the brain, we're going to find out that who we are comes down to just getting lucky with chemistry and physics.
The sci-fi future is what if you could go into a clinic and get your personality tuned up. Yes I'd like to add some humor but not sarcasm to my personality. Give me a bit more motivation, and I'd like to like jazz.
I know it's really tired, everyone knows it, and it is repeated constantly:
Drugs affect different people in different ways.
If 20% of ozempic patients have personality changes, that is very significant. Yet you would still have 80% of users going around saying they never had any issues with it and those who are might just be doing it wrong/misunderstanding/confused etc.
100% of patients who have taken ozempic have had a personality change. The change is that they're now on ozempic. This causes many of them to eat less. Which is also a personality change. So the more useful question is how does their personality change, how much does it change, and is it a desirable change, according to them or others.
Always in all circumstances for everyone? I disagree. One can continue to behave hedonistically without reaping the joy it once gave due to adapted thresholds in the brain.
People get so upset when confronted with the fact that humans, like all animals, are largely clockwork machines driven by chemistry.
Like it or not, you (yes, you) are a slave to your internal chemistry. No amount of willpower or happy thoughts will cause your hormones or neurotransmitter levels into the homeostasis you want. If your chemistry is off, your physical and emotional behavior will be off.
You are a sentient pile of molecular machines ticking along because the chemistry happens to work out. There is nothing special about you, you're exactly like every other plant, animal, and fungus on this planet.
So yes, plenty of mental, behavioral, and physical disorders arise from chemical imbalances. If you take this fact, consider what happens when you indtroduce foreign and extremely powerful chemicals into such a complex organic system.
If you come back with the assertion that addiction is a question of willpower, you didn't understand the assignment.
Yes, deep down it is all chemical processes but complex systems can develop emergent behaviors that can not be explained by looking at the lower levels.
A few days ago, this article[0] has been discussed here on hacker news. I shows how the naive theory of chemical imbalances can be harmful for treating Schizophrenia.
> In this vision, mental disorders were best understood as brain dysfunctions that could be traced to abnormal genes. Schizophrenia stemmed from an imbalance of the neurotransmitter dopamine. Depression was a serotonin imbalance. Bipolar disorder was a lithium imbalance. ADHD a deficiency of norepinephrine. These conditions, of course, could be triggered by life events, but they were ultimately biological. It was a reincarnation of the ancient Greek humoral theory, which saw the various forms of madness as imbalances in the four humours: blood, phlegm, yellow bile, black bile.
I recommend reading the whole thing but I really liked this part of linking it to the Greek humoral theory.
In the end of the day, there isn't any scientific evidence that it is "just chemical imbalances". The reality is more complex. Medication has its place and it absolutely can help but it just one tool to help patients.
There is a good reason the brain disease narrative is so tempting: It avoids having to look at environmental factors. It avoids having to talk about how society is driving people mad. It is easier to say someone's brain is broken than having to talk about societal issues. It also leaves patients powerless, giving them the idea that their brain is just "broken" and they can't do anything about it instead of giving them the tools to create a better life for themselves and others.
In the end of the day we are all a parts of interdependent systems that form society. Mental health issues are more often than not societal issues more than individual issues.
> Like it or not, you (yes, you) are a slave to your internal chemistry. No amount of willpower or happy thoughts will cause your hormones or neurotransmitter levels into the homeostasis you want. If your chemistry is off, your physical and emotional behavior will be off.
It’s not that simple – there are feedback effects. There is plenty of evidence that thoughts shape chemistry as well. This is why therapy works, for example.
edit: This is also why you can “hype yourself up” or “talk yourself down”. Those are thoughts/words leading to measurable physical and chemical effects in the body. You really can raise your cortisol just by thinking the right thoughts
Like it or not, you (yes, you) are a slave to your internal chemistry. No amount of willpower or happy thoughts will cause your hormones or neurotransmitter levels into the homeostasis you want. If your chemistry is off, your physical and emotional behavior will be off.
Everything we do impacts brain chemistry. By extension, non-pharmaceutical interventions can change brain chemistry. The mistake is in the notion that said chemistry is invariably statically a-priori "wrong" in every single case people get addicted or depressed (it becomes as such), and acting as though addiction in itself is only relegated to the realm of the abnormal, that "normal" human beings can't be addicted.
And yes, notwithstanding that there are cases where people are, owing to genetics, more susceptible to x/y/z, or where interventions can be insufficient. But that's the first line of defense, and should be.
There's a lot of anecdotes surrounding this but a popular one is rate of morphine abuse during and after the Vietnam war. The rates plummeted.
A really good book on the topic of addiction is the Biology of Desire by Marc Lewis.
I would also caution against any conflation of environmental and behavioral intervention as "willpower". These are not the same things (you didn't say they are, but you didn't give any credence to intervention). Willpower may be highly overrated, but ultimately, you can't "force" someone to rehabilitate in any way shape or form. They have to want to, they have to make the choice, and commit. As for therapy/rehab, some of these have been thoroughly studied. Interventions help (and therapy such as CBT or 3rd-wave CBT), considerably.
I believe there is some truth to what you are saying, but this interpretation is far too extreme. We do not fully understand how any animal works, let alone humans.
"Hypocrite that you are, for you trust the chemicals in your brain to tell you that they are chemicals. All Knowledge is ultimately based on that which we cannot prove."
How do you explain some of the most drastic and lasting changes in many peoples lives coincide with wanting them very deeply? We just happened to want most what we achieve?
there's many ways the causality might be inversed. We tend to tell stories to justify what happened all the time, so the "strong wish" can always be a self-justification. You can also be tricked by your brain to wishing more of something by "programming" (that's positive reinforcement in practice - our brains aren't that different from other mammals). Lots of people who are successful at, say, going to the gym regularly, only do it because they found a way to create that feedback loop.
so it's likely that just "wishing something very deeply" doesn't actually lead to anything, but acting in a way that affects your mental chemistry (be it via creating feedback loops that make your brain crave more of X or simply by taking certain medicine that does it for you) does
yes, you need to be careful. Your brain evolved over ages to value certain things that are detrimental in high volumes: calories, rest and addicting substances, for instance.
Chemical responses can change, but those changes are either very slow and/or constantly fighting your body's natural tendencies. The flip side, though, is when you get the chemical responses to change in a way that you want, they become very sticky.
“Wanting” is almost entirely a hormonal response (to dopamine and a few other chemicals) - you don’t “want” much of anything if your dopamine levels are low. So “wanting” is an indicator, more than a driver. That said, “willpower” (whatever that is) does impact your hormonal production - plenty of research on that, eg around the effects of meditation on the brain
Your internal state is influenced by your environment, and you have the power to control your environment. The idea that you can't control your internal emotional state because it's governed by chemicals is absurd. People do things _all the time_ because it makes them happy.
Not necessarily against your thesis but it promotes a vibe that isn’t solution oriented. For me, I notice that when I meditate that my social media addiction has less of a grip on me because my baseline attention and (seemingly) executive functioning are better.
Now, you could argue “yea, behavior can change neurotransmitters and it is in my framework so what is your point?”
The point is that your framework can easily be take the wrong way to that we are more or less all doomed, us being mechanistically no free will slaves. At least, that’s the vibe that I feel when reading it. I think I am not alone in that.
And while I agree with that, I’d argue that focusing on optimistic interpretations of your framework is much more fruitful. Optimism being characterized as a bias towards positivity while still staying fully grounded in reality.
It has only been recently that I started to do some hardcore meditation (2 hours per day). I kickstarted it by making a deal with a friend: for each hour we miss, we pay 100 euros to each other. So far I haven’t missed anything and am on day 4. I am low-key dreaming of solving meditation motivation and spinning that up into a startup as it has been the biggest problem in my life (one could imagine it being my biggest problem since my username is related to metta meditation).
2 hours is a long time. I’ve dabbled in meditation and find this impressive just 4 days in. Can you give some tips? Are you using guided meditation? Early morning?
I have done some retreats via dhamma.org. I am curious about other retreats too but they do instill some discipline in you.
No guided meditation here.
The necessity for an early morning meditation becomes abundantly clear, as it is much easier to frame that you only have to meditate one hour every if and only if you meditate for one hour immediately after waking.
When my friend overdosed on heroin she was revived with two doses of naloxone. Her drinking was under control for about 2 weeks. Naltrexone is very similar to Naloxone, and is FDA-approved to help people with opioids and alcohol use.
The Sinclair Method uses naltrexone to help people get their alcohol use under control:
Naltrexone is at the heart of the Sinclair Method (TSM)
for Alcoholism. When you take Naltrexone prior to
drinking, it blocks endorphins, the naturally occurring
opiates in the brain, from being released when alcohol
is consumed.
When the endorphins are blocked, there is no “buzz” or
rewarding experience, and the alcohol doesn’t make you
feel the pleasure that drives you to drink excessively.
Over time, your brain learns not to associate alcohol
with pleasure, resulting in reduced cravings and
improved control over alcohol use. Naltrexone must be
taken at least one hour before your first drink.
Very cool, thanks for sharing. Describing it another way:
The goal is to deassociate alcohol with pleasure. One way to do this is to abstain for a long period of time so that the association gradually weakens, but 1) this requires constant willpower and 2) takes a long time for the association to decay.
If you instead take a pill that blocks the pleasure from alcohol consumption, you can undo the association very quickly and with basically 0 willpower (it’s not like your brain currently has an association between taking the pill and experiencing pain).
I have no experience with alcohol dependence, but this is a great confirmation of the reinforcement patterns of the brain.
I don't understand at all what is this "buzz" that people talk about that causes alcoholism. When I drink too much, I feel dizzy and I hate that feeling of not being fully in control. When I do drink moderately, it's because the drink tastes good, period. Some mocktails taste just as good as the real alcoholic version so I'll opt for that. Wines have a much more complex profile so grape juice isn't a substitute, but still I enjoy the taste and aroma of wines, not that it gives me any pleasurable "buzz" (whatever it is).
Your brain has to learn how to be "buzzed", thus the experience is a function of your very complicated physiology and neurochemistry.
If you are susceptible and drink often enough, your brain will begin to associate drinking and its effects with certain activities. The addiction arises when your brain tells you it's a good idea, and you comply.
I tell younger people this, but when you're an alcoholic, you don't realize it until you're not addicted to alcohol. I went through this when I was maybe 20, and when I quit, I was often surprised when and where I suddenly felt the urge to look for a drink. After, I saw it all around me in others. As soon as a remotely stressful situation, and they began pouring themselves drinks, often maintaining a certain level until their day ended. Most of them never got drunk, and many could drink several drinks before they reached a point where they "felt" it.
It doesn't have to be overtly pleasurable to be felt. Sometimes, it's merely the removal of difficult feelings that drives someone.
> As soon as a remotely stressful situation, and they began pouring themselves drinks, often maintaining a certain level until their day ended.
Emotional and physical stress increases the brain's use of glucose.
Alcohol has 7 calories per gram. I think the main use of alcohol in the brain is as acetate (vinegar) - that is, Ethanol is transformed by the liver into acetate, which is one of the brain's alternative fuel sources.
For people with broken metabolisms, ethanol also provides calories to allow their brain to function.
It’s the same feeling you’re reporting, many of us just find it fun to be a bit dizzy. I’m not trying to argue anyone into enjoying drunkenness, but I like spinning around in my chair really fast too.
Its very convenient for big pharma to lump all addictions to a chemical imbalance in the brain.
We have been here before with the first wonder drug "Prozac" back in the late 80's. A cure all for everything.
yet there was no research to support those chemical imbalance claims.
I worked as a methadone dispenser for 15 years and this is not my experience of addiction.
There is no chemical or hormonal imbalance when you become addicted to drugs that relieve you from the psychotic hallucinations you experience daily or the young woman who did not know her boyfriend was a heroin addict and started chasing the dragon with him or even the young stressed out mother who's husband has abandined her who has been told by endless TV advertising that a glass of red wine a day is good for you or the young man who has sufferred sexual and psychological abuse as a child who drinks to forget.
Wegovy a cure for everything from the flu to cancer.
> Its very convenient for big pharma to lump all addictions to a chemical imbalance in the brain.
This is also a lazy argument that tends to get a strong response without being meaningful. It's basically equivalent to saying "it's convenient for big speaker that all music requires sound". Chemicals are the regulation system in most living things. They are necessary and that can't be ignored. Some can be artificially manipulated to get desirable responses, hence "chemical imbalance".
I'm also not sure how your examples are relevant to your argument. #1 is a pretty exceptional case, but hard to take as a representative argument. The rest are all secondary effects from human interaction, drugs are incidental to the outcome you describe.
-----
Ultimately, humans respond to positive and negative reinforcements. This is a pretty primal level thing and can be seen in nearly every other living thing. Do X, receive Y, reinforcement. Living things need these positive reinforcement cycles to thrive. For the most case, these are "mundane" things like talking with other humans, eating normal meals, drinking water, etc, etc. They guide people to keep doing things that make them feel good, even if those things are overall harmful.
GLP-1 drugs are rather exceptional as they seem to temper people's responses to certain reinforcement. Particularly, addictive or addictive-like reinforcements, like overeating. Whether this is the result of a "chemical imbalance" is pretty much just semantics. It's not really meaningful.
They also have some strong, powerful secondary effects, but really only by happen-stance. Patients who eat less, are less likely to develop diabetes. Patients who have less desire to drink alcohol are less likely to develop cancer. Patients who have less desire to do drugs are less likely to become addicts, etc, etc, etc.
But everything a living creature does is chemical. Even the process of that young man who has suffered sexual and psychological abuse as a child, that brain that can't stop ruminating can't stop ruminating because of a chemical feedback loop that the brain is doing natively.
When my mom got diagnosed with pancreatic stage 4 cancer and I couldn't cope with it and I was already in a drug explorer mindset at the time and I started taking her opioids and I became quite addicted (no she wasn't deprived of any of her medications she was fine). This whole process absolutely was chemical imbalance. Years before in high school I stopped taking all of my ADHD medication and then started spiraling out of control dabbling in all sorts of disassociative and psychedelic drugs. If I didn't stop taking my Adderall in high school I wouldn't have gone down any of that path.
It's specifically because the brain is an electrochemical computer that the whole "brain chemistry imbalance" narrative isn't very useful. After all, every feeling you experience and every thought you think is brain chemicals in action.
It's like saying a software bug is an electromagnetic imbalance in the hard drive. Well, technically yes, but there's also more to it than that.
The brain imbalance narrative really is a double-edged sword.
On the one hand, it can help people understand that a condition is real and not imagined, especially other than the sufferer. "Look at this brain scan, it looks different from a healthy person's" is quite tangible and convincing.
On the other hand, it can lead to a sense of helplessness, and notions that because there's a physical element to the mental illness, it's a permanent disability, or to be exclusively treated with pills and injections. That just doesn't follow. Sometimes it's true, but in many cases, lifestyle interventions can help, talk therapy can help.
That's just your projection. A proper neurological diagnosis can absolutely help a patient find a viable path to recovery, as well as enable them to find support groups.
And not every neurological disorder is fixable. And the question of whether this is "sometimes" or "in many cases" is still in the air, unless you can provide solid citations proving otherwise. So there is no need for this kind of judgement.
I'm addressing the words you wrote, mainly this idea that learned helplessness is a significant concern when diagnosing chemical imbalances. Learned helplessness is tangential to a proper diagnosis, there is still CBT and other techniques for developing coping mechanisms around mental health issues, but those cannot be utilized without first receiving a diagnosis.
For example, in the case of ADHD, it s clear that patients have a reduced dopamine receptor count. It's not just a chemical imbalance, it's structural. Medication is the only effective solution for severe cases, and the result is night and day. Knowing this helps me make better decisions around my diagnosis, and also alleviates the great shame and anxiety that come hand in hand with ADHD.
I don't wish to devolve into an argument and I apologize if my initial comment was too aggressive.
It has taken me many years to come to that same realization, which many of us must have learned in school bio class. I continually observe the value of attacking life-problems from this perspective -that behavior is a product of chemical signaling and continuous chemical-reinforcement learning, and our decisions are steered by it and not the reverse. I find that my level of empathy has increased, both for others (like the guy that cut me off in traffic) and for myself and my failures. A willpower-based explanation of the self only leads to resentment, “why can’t i just stop behaving this way it is killing me” or “if they loved me they would change”; knowing that we are all literally enslaved to our chemical neuro anatomy allows forgiveness and openness. I don’t mean to imply that will doesn’t exist and isn’t a powerful force, but it’s not the Layer One protocol like some parts of society claim.
I don't think you have to deny that will or willpower exists, just that willing your brain is an action that requires mental energy and your average adult is mentally exhausted constantly.
Willpower and mental energy are entirely pseudoscientific concepts. They co-opt sciencey language to sound smart, but they have no backing in experiment or observation. What exactly is this "mental energy" being expended on (converted to)? What is it's law of conservation, that we might call it "energy"? Is willpower defined as the consumption of mental energy per unit time, that we might call it "power"?
You could think that maybe willpower/mental energy is a resource you have to consume to suppress natural instincts like overeating or consuming a drug that triggers pleasure in order to achieve some long term goal. But then you find that some people routinely engage in behaviors that contradict basic natural instincts, and in fact find it very hard to stop doing those behaviors (e.g. cutting or other self-harm behaviors, suicidal tendencies). Are they just a font of mental energy?
You can argue the explanation but it's hard to argue the observation— kids are tired after school even with no physical exertion, knowledge workers are tired after work. People need to "decompress" after mentally taxing work, burnout is a thing.
Name it what you like, but your theory does have to account for people's lived experience. Why does studying make you tired? Actively using certain parts of your brain is a limited resource in some respect no matter how you swing it. The rules are super weird so maybe energy is a bad name but it's the best we have right now.
Oh, tiredness due to knowledge work is real, and relatively easily explained: you spend energy (real, physical energy - calories) on computation in your brain. Whether you're learning at school, designing bridges, driving, or what have you, there are measurable outcomes of your work.
But there is no obvious relationship between this and the concept of "expending mental energy" on combating your cravings. It's not at all clear that there is any measurable "effort" involved in not doing something like eating a sweet. Chess masters consume more calories during a tournament. People who avoid eating cake at a birthday party don't.
And yes, I have of course experienced the difficulty with not giving in to a craving. But I'm not at all convinced that it is the same thing as the difficulty of taking a math exam. If anything, my experience is that it's easier to control my cravings after accomplishing a difficult mental task then it is if I've just idly been watching TV all day.
The danger from the article's perspective is, once again, viewing addiction solely as a disease rather than as a symptom of multiple underlying issues. This is similar to how anxiety and depression have been framed as single diseases, when in reality, they can be symptoms of various conditions. Even if we consider addiction a disease, there's often an oversimplified focus on a "single root cause" when, in fact, multiple, independent factors can contribute to addiction. One clear example is the physical dependence on certain drugs, which can be beyond a person's control. On the other hand, many young people start using marijuana under the old, now cliché, mantra that it doesn’t cause physical addiction, as if physical addiction were the only form of addiction possible.
My 2 cents, from someone with a [strong] non-addictive trait but having witnessed people with various addictions, including gambling.
Having experienced my fair share of awful life circumstances, I’ve came away with an opposite understanding.
You can’t boil everything down the chemicals.
Life boils down to choices. Some are easier and some are harder, but as soon as you take away the fact that it’s all a choice, you find yourself in a very dark place where you’re always a victim of your circumstances.
At the end of the day though, whether you believe me or not, your reality will reflect your beliefs. If you believe you can’t, you won’t. If you believe you can, you will.
It’s an unpopular and rather inconvenient truth that we have choice, but accepting that leads to a far better life than believing everything is just chemicals.
Biological determinism is not necessarily full determinism. External circumstances could have been other than they were, and then the biologically determined decision could have changed. Plus, for every deterministic model, the same arguments would also support a world that also includes pure randomness in addition to the deterministic laws.
I'm not making a deterministic leap I'm leaving out vast amounts of information from my story that are way way more personal. Of course there are more things that I know that don't make this a deterministic leap but I don't care to share them.
Do you realize that this basically translates to "had I not stopped taking prescribed amphetamines, I'd never be exploring other drugs"... sounds a little hypocritical to me, and particularly when ADHD-diagnosed-on-prescription drugs fail to note that they been treating themselves with micro-dosing. So then how is Psilocybin or THC microdosing different?
If it's all about the dosage, then we need to focus on a different narrative. Besides, I'm sure a lot of very sane, and very performant people, met lots of these, actually enjoy the regular micro-dosing of alcohol or tobacco...
That is literally exactly the case. I'm not going to pull fake percentages out of my ass here but it's in the medical literature that a person with ADHD who is medicated and treated correctly has less likelihood by a significant factor of drug abuse.
It's not hypocritical. You seem to have a line of thought you couldn't escape from when writing these replies where the bad guy in this scenario is microdosing and tech Bros.
"Very different" is a strong word. They're more similiar than different and both have similiar intermediaries within the body. Thankfully, that difference is largely the difference between long-term debilitating addiction and short-term focus.
Ive taken two different amphetamines and 1 brings on panic attacks and the other doesn't. I call that very different. The molecule doesn't have to be that different in order to be vastly different in what it does to humans.
Two street amphétamines or two prescribed? Sorry not trying to be rude, but you know there seem to be like 4 in Aderall, so how do you tell them apart?
Besides you can be absolutely sure there is very clean stuff out there on the streets.
All I’m saying is that bros are effectively micro-dosing to cater to condition and there are lots of people taking this in very regular manner.
A lot of disease has environmental and intrinsic causes.
Categorizing disease as having a set of characteristics in the body doesn't make it solely rooted within those characteristics.
I think there will always be a desire to solve disease with a single pharmaceutical, as that would be an incredible thing. However the existence of drugs that do not work for everyone doesn't necessitate that the signals for characterizing disease are off or that a pharmaceutical isn't useful to some people.
Organisms are incredibly complex, even those composed of relatively few cells. Thinking there is always some magic bullet to address a biological or emergent phenomenon is probably not the answer, but neither is being dismissive of treatments that don't meet that criteria.
I had a drug and drinking problem in my 20s and the cause of it was just me dealing with unresolved childhood trauma from an abusive parent and years of bullying that left me unable to interact with other human beings unless I was drinking. Taking MDMA (and the self reflection and opening up to people) is what finally let me process it and move on with my life and quit taking drugs and drinking and still be able to function like a normal human being, but I want to be clear -- I didn't have a chemical imbalance that MDMA "corrected". I was abused for years and had trauma to deal with because of that, and MDMA just temporarily opened my eyes to a new way of viewing the world that wasn't clouded by that trauma.
Thinking of all psychological issues as if they're some innate property of the person and not something that's a consequence of _their environment_ is going to lead to bad results. People see that drug addicts are unhappy and think the drug addiction is causing the unhappiness, but that might be reversing cause and effect. Happy people with satisfying lives don't generally develop debilitating drug addictions, and I think that just making people satisfied with living in a bad environment is a bad solution. It's bad for them as an individual and bad for society. Sometimes the solution for depression and other stuff is to just get your shit together and take control of your life -- and drugs can have a role in getting you off your ass and doing something, but I worry about just pushing them as a long term permanent solution.
chemical imbalances are very real, its just that the cures dont actually help you alleviate those imbalances. On a intuitive level, it makes sense that any chemical that you introduce to your body (be it drugs, or even just food) creates an imbalance that your body tries to compensate for, since your bodys main goal is normalizing its internal state. Most pharma drugs are band aids, which dont actually cure the root causes, leading to dependence in order to feel normal. even just an unhealthy lifestyle causes chemical imbalances, it doesnt have to be a drug you take. the detrimental part of this is that some drugs can temporarily cover up the imbalances as well, which leads to people reaching to these drugs to 'feel normal' - this leads to what we would call addiction, because addicts mostly self medicate. the drug doesnt have to be the root cause.
There’s a big difference between psychological addiction and physical dependency.
At some point during addiction your body depends on these substances to operate and stopping becomes much more difficult. Alcoholics need to taper or take benzodiazepines to quit otherwise they may seize or die when going through withdrawals.
I would say anyone who begins drinking to numb the feeling of withdrawals (morning or middle of the night) is beginning the journey of serious alcoholism. That’s not really a craving it’s more of a need at that point.
Both play a role. But in my experience for most common addictions the psychological component is the bigger issue. The physical dependency can't be ignored and is something you have to manage when quitting, but what brings people back is usually the psychological addiction.
Of course this depends on the addiction. With some hard drugs or coffee the physical dependency is the bigger factor
I can only speak for my own drinking, but tapering off is as natural as other forms of long term planning. The drinking tends to fall off the calendar like anything else.
I'm not saying alcoholism isn't a thing, but the way some people discuss alcohol seems like they're blaming the symptoms rather than the root cause. Low impulse control, not seeking novelty enough, and otherwise living a messy life is the actual problem.
More attention should be paid to why people start using in the first place. If someone is using a substance to feel good, it’s because they don’t feel good. Obesity, same thing; people are eating their feelings.
If our schools were better, and more honest, we would explain the biology of addiction well enough that no one who understood the lessen would become addicted.
The lesson is simply this: Any pleasurable experience results in a normal and natural down-regulation by the body of the receptors that are responsible for that experience.
It is impossible to repeat the same dose (whether drug, food, roulette wheel, or skydiving) and have an equally intense experience until enough time has elapsed that the receptors have been up-regulated back to their original levels.
The hallmark of addiction, "chasing the dragon", is therefore pointless and quickly becomez harmful.
The other important lesson, of course, is that quality control is essential. Variations in the drug (concentration, impurities, improperly attached bungee cords) are solely responsible for the non-dragon-related dangers.
By this logic, no emotional arguments should work because they are logically incorrect, right? (This is your first point)
However, since you seem to like logic, let us take it to the extreme - Can you do anything you like? Because, the thing you like will become your dragon.. (This is your second point)
Drug impact variations can also happen because of the state of your body. Hence nothing can be done and should be done (Third point).
Now I am wondering if I am responding to a robot :(
> we would explain the biology of addiction well enough that no one who understood the lessen would become addicted
This is such a misunderstanding of how humans work. Knowing that something will hurt you has never, in the whole history of humanity, stopped some people from trying that thing. And many of the people who do things that they know will hurt them are the exact ones who pushed further than others.
> If our schools were better, and more honest, we would explain the biology of addiction well enough that no one who understood the lessen would become addicted.
Are you asserting that no nurses, doctors, or social workers are affected by addiction? All would have learned its mechanisms during their professional education.
> The lesson is simply this: Any pleasurable experience results in a normal and natural down-regulation by the body of the receptors that are responsible for that experience.
This lesson is reductive and dangerous. It ignores that some responses are stronger than other responses and that some of those strong responses are stronger than conscience willpower.
The growing scientific case for using Ozempic and other GLP-1s to stop addiction -https://news.ycombinator.com/item?id=40357196
https://recursiveadaptation.com/p/the-growing-scientific-cas...
> The consistency that I'm hearing from all across patient groups is gain of control, whereas previously, there was a loss of control… All of a sudden they're able to step back and say, 'oh, well I had this shopping phenomenon that was going on, gambling, addiction, or alcoholism, and all of a sudden, it just stopped,'
- Dr. Gitanjali Srivastava, Vanderbilt Medical Center