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vincentML -> RE: ADDICTS (12/12/2013 10:00:35 AM)


quote:

ORIGINAL: truckinslave

I've never seen anyone treated as a pariah as part of their treatment.

I have often seen both alcoholics and the mentally ill treated as pariahs when they behave outrageously and/or criminally.

I never said they were treated as pariah as part of their treatment.

We are far more tolerant (understanding) of the behavior of the mentally ill than we are of the addicted.




vincentML -> RE: ADDICTS (12/12/2013 10:01:48 AM)


quote:

ORIGINAL: kalikshama

quote:

ORIGINAL: truckinslave

quote:

We treat the schizophrenic. Why the difference?


We treat both.
There are drugs available for the schizophrenic. There are treatment programs available to the alcoholic....


My brother has a host of mental illnesses, including schizoaffective disorder. I have much more sympathy for him than the alcoholics in my life.

Why is that so?




kalikshama -> RE: ADDICTS (12/12/2013 10:11:45 AM)

People can stop drinking. My brother can't stop being mentally ill.

(I don't believe in the disease model for alcoholism.)

http://en.wikipedia.org/wiki/Disease_theory_of_alcoholism#Criticism

Some physicians, scientists and others have rejected the disease theory of alcoholism on logical, empirical and other grounds.[35][36][37][38][39][40]

Some critics of the disease model argue alcoholism is a choice, not a disease, and stripping alcohol abusers of their choice, by applying the disease concept, is a threat to the health of the individual; the disease concept gives the substance abuser an excuse. A disease cannot be cured by force of will; therefore, adding the medical label transfers the responsibility from the abuser to caregivers. Inevitably the abusers become unwilling victims, and just as inevitably they take on that role. They argue that the disease theory of alcoholism exists only to benefit the professionals' and governmental agencies responsible for providing recovery services, and the disease model has not offered a solution for those attempting to stop abusive alcohol and drug use.[41]

These critics hold that by removing some of the stigma and personal responsibility the disease concept actually increases alcoholism and drug abuse and thus the need for treatment.[41] This is somewhat supported by a study which found that a greater belief in the disease theory of alcoholism and higher commitment to total abstinence to be factors correlated with increased likelihood that an alcoholic would have a full-blown relapse (substantial continued use) following an initial lapse (single use).[42] However, the authors noted that "the direction of causality cannot be determined from these data. It is possible that belief in alcoholism as a loss-of-control disease predisposes clients to relapse, or that repeated relapses reinforce clients' beliefs in the disease model."

Read more: http://en.wikipedia.org/wiki/Disease_theory_of_alcoholism#Criticism






kalikshama -> RE: ADDICTS (12/12/2013 10:14:13 AM)

quote:

ORIGINAL: vincentML


quote:

ORIGINAL: truckinslave

I've never seen anyone treated as a pariah as part of their treatment.

I have often seen both alcoholics and the mentally ill treated as pariahs when they behave outrageously and/or criminally.

I never said they were treated as pariah as part of their treatment.

We are far more tolerant (understanding) of the behavior of the mentally ill than we are of the addicted.


I realize this is an anecdote, but my brother has been locked in a maximum security mental health facility since April for a disturbing the peace type incident that would have gotten him a scolding if not for his mental health history and his extremely poor decision to tattoo "psycho" on his cheek, along with his other visible tattoos.




VideoAdminGamma -> RE: ADDICTS (12/12/2013 11:18:23 AM)

Let's stop with the sniping back and forth. Stick to the topic and not each other. A reminder that those that ignore warnings from staff posted in a topic are subject to a three day moderation period without further warnings.

Thanks,
Gamma




truckinslave -> RE: ADDICTS (12/12/2013 11:29:28 AM)

quote:

People can stop drinking. My brother can't stop being mentally ill.


Generally speaking, I'm in agreement with that- the exception being the mentally ill who chose to stop taking their medication.

So much thinking becomes circular... but I like the (genetically based) disease model.

If my alcoholism was the result of psychological.... what word are we looking for?.... weakness? impairment? insufficiency?... why can I not be cured, and thus free to drink?

On the other hand, if my alcoholism is the result of genetics, there is currently no known cure. There is, however, a choice: abstinence or drunkenness. Further, there are programs that help make abstinence (from alcohol and drugs lol), bearable at first and eventually fulfilling.

It seems to me that, unless you think alcoholics can be psychologically cured, the disease model saves lives. Including, imo, mine.




vincentML -> RE: ADDICTS (12/12/2013 1:57:47 PM)

quote:

People can stop drinking. My brother can't stop being mentally ill.

(I don't believe in the disease model for alcoholism.)


Some can and some can't. I'm not sure why but well known changes in brain chemistry seem to be involved.

If you don't believe brain chemistry is changed okay, but if you do understand that addiction causes a dopamine deficiency among other things then it seems an unavoidable conclusion that the brain of the addict is diseased. In schizophrenics by the way there is an excess of dopamine at the synapsis. Just the opposite of the addiction syndrome. Why is the disease model a threat to the well being of the addict but not to the well being of the schizophrenic? Perhaps because there is medical treatment for the schizophrenic but not for the addict?

Here are two YouTube talks that explain the neurochemistry. Each is five short segments. It might be helpful for you. Maybe not. I should point out that the two seem to have different levels of optimism about prognosis. The Psychiatrist speaking before the AA clinic gathering seems to be more pessimistic than the research scientist. Both have a lot to offer by way of explanation. Anyway, yours if you wish to delve further into the topic.

George F Koob, PhD

Dr Manuel Montes









vincentML -> RE: ADDICTS (12/12/2013 2:07:08 PM)


quote:

ORIGINAL: truckinslave

quote:

People can stop drinking. My brother can't stop being mentally ill.


Generally speaking, I'm in agreement with that- the exception being the mentally ill who chose to stop taking their medication.

So much thinking becomes circular... but I like the (genetically based) disease model.

If my alcoholism was the result of psychological.... what word are we looking for?.... weakness? impairment? insufficiency?... why can I not be cured, and thus free to drink?

On the other hand, if my alcoholism is the result of genetics, there is currently no known cure. There is, however, a choice: abstinence or drunkenness. Further, there are programs that help make abstinence (from alcohol and drugs lol), bearable at first and eventually fulfilling.

It seems to me that, unless you think alcoholics can be psychologically cured, the disease model saves lives. Including, imo, mine.

I used to be a big advocate of genetics as a causal agent of many things. Problem is there has been very little evidence to support the model as a stand alone. Some in families but that is only a small percentage. The second problem is that you are ignoring environment and epigenetic modifications of the genome (the instructions that switch genes on and off due to the environment) Simply put, if you clone two trees, plant one in fertile soil and one in arid soil, you will effect their development.




kalikshama -> RE: ADDICTS (12/12/2013 2:11:23 PM)

quote:

If you don't believe brain chemistry is changed okay, but if you do understand that addiction causes a dopamine deficiency among other things then it seems an unavoidable conclusion that the brain of the addict is diseased. In schizophrenics by the way there is an excess of dopamine at the synapsis. Just the opposite of the addiction syndrome. Why is the disease model a threat to the well being of the addict but not to the well being of the schizophrenic? Perhaps because there is medical treatment for the schizophrenic but not for the addict?


Sure, alcoholism can change brain chemistry - so can eating high fat food, and yoga, so I'm not sure how you were connecting changes in brain chemistry to alcohol being a disease.

Will check out the links.






vincentML -> RE: ADDICTS (12/12/2013 2:14:13 PM)


quote:

ORIGINAL: kalikshama

quote:

ORIGINAL: vincentML


quote:

ORIGINAL: truckinslave

I've never seen anyone treated as a pariah as part of their treatment.

I have often seen both alcoholics and the mentally ill treated as pariahs when they behave outrageously and/or criminally.

I never said they were treated as pariah as part of their treatment.

We are far more tolerant (understanding) of the behavior of the mentally ill than we are of the addicted.


I realize this is an anecdote, but my brother has been locked in a maximum security mental health facility since April for a disturbing the peace type incident that would have gotten him a scolding if not for his mental health history and his extremely poor decision to tattoo "psycho" on his cheek, along with his other visible tattoos.

Pity, really. I share your sadness as best I can from this distance.

I certainly don't offer a diagnosis, just a guess: impulsive behavior and poor social judgment are often the result of mal-functioning of the prefrontal cortex. I offer that with great hesitation and acknowledgment of the limits of my understanding.




kalikshama -> RE: ADDICTS (12/12/2013 2:53:22 PM)

That's what Mom says too and she has a MSW and is very involved with his treatment :)




Kana -> RE: ADDICTS (12/12/2013 3:09:59 PM)

quote:

People can stop drinking. My brother can't stop being mentally ill.

(I don't believe in the disease model for alcoholism.)


I have issues with the disease model too, starting with the simple fact that if one never drinks or uses drugs,one cannot become an alcoholic/addict.

That said, it's my belief that alcoholism/addiction is deeply rooted in the psyche of the person and that once triggered,it never truly goes away.
People make the mistake of viewing the person and the illness as separate entities.That's false. They are one and the same.The person is the illness and vice versa. Addiction has to do with how the brain processes inputs, especially at an emotional level.To some extent, that never fades completely-the addict will always suffer from a quasi twisted perspective in that their first filter for anything is how it affects self.
The apocryphal story of this is Bill W,when he was dying,he was lapsing in and out of consciousness/coma.35yearsw/o a drink. Founded AA. A hero to millions.Laying on a hospital bed with really no conscious functions going on and his reptile brain remembered what solved his problems. Three times he came conscious enough to ask for a drink from the attending nurse.
Addiction is brutal stuff.
35 years and his subconscious still knew where to go for the fix.
Fucking amazing.
ETA
quote:

My brother has a host of mental illnesses, including schizoaffective disorder. I have much more sympathy for him than the alcoholics in my life.


You might be shocked by the number of dual diagnosed cases in the halls of recovery-the two most prominent being ADD/ADHD and/or Bi-Polar.
Which, when you think about it, makes buckets of sense.
Take the ADHD kid for instance. He's hyper. Full of energy. Always curious. Always into shit. Usually a risk taker to boot
He grows up with everyone asking in some form of the other,"What's wrong with you?"
Inside, before he's 5, he knows somethings different about him, not in a good way. To compensate,to try to fit in, to try to please, he learns to be what others want to be, to put on masks as demanded,to try and shift his natural disposition into something he's not made to be.
And something he's doomed to fail at trying to be.
Here's the roots of manipulation, deception, shame, inadequacy, self disappointment and distrust of others.
Another part of ADHD is social awkwardness, their brains process shit differently, spit it out strange too-sufferers tend to blurt out awkward things, talk compulsively about themselves, monopolize conversations about things they are excited about/into. Early on, they learn from social feedback that they don't communicate properly so they learn to isolate, to distrust self, to not show themselves emotionally or in other ways to others.
And shockingly, they feel alienated and alone in a world that doesn't accept them. They learn to be suspicious,cynical, jaded,keep their guard up at all times.
No connections there between the roots of addiction or anything, eh?
One can't see how a primary mental illness could lay the roots for addiction?
Bi Polar follows pretty close to the same basic internal pathology. So does schizophrenia.

Me? I try to have sympathy from everyone, man, because the human condition, it kinda sucks. We are all fighting battles nobody else fully understands or comprehends.We all have crosses to carry. And those things, they get damn heavy sometimes.
So I think we all can use, in the words of the Rolling Stones, a little tea and sympathy.







TheHeretic -> RE: ADDICTS (12/12/2013 9:18:09 PM)


quote:

ORIGINAL: kalikshama
(I don't believe in the disease model for alcoholism.)



I'm with you on that. I think it's much better to think of it in terms of a tendency. The strength of the that tendency can vary widely, which gives us people at one end of the spectrum who can get themselves into a problem, and get right back out again fairly easily, people who get to have a hell of a fight before regaining control, and those at the far end, who will be in the fight, or at high risk of complete relapse, their whole lives.






vincentML -> RE: ADDICTS (12/13/2013 2:22:38 PM)

quote:

I have issues with the disease model too, starting with the simple fact that if one never drinks or uses drugs,one cannot become an alcoholic/addict.


Which begs three questions: 1. Why do many people drink and never become addicts? 2. What causes addicts to drink or take drugs initially? 3. How and why does the brain of an addict differ from the brain of a non-addict? There seem to be answers to these questions readily available.

quote:

That said, it's my belief that alcoholism/addiction is deeply rooted in the psyche of the person and that once triggered, it never truly goes away.
People make the mistake of viewing the person and the illness as separate entities. That's false. They are one and the same.The person is the illness and vice versa. Addiction has to do with how the brain processes inputs, especially at an emotional level. To some extent, that never fades completely-the addict will always suffer from a quasi twisted perspective in that their first filter for anything is how it affects self.


From my point of view your comment suffers from the error of mind/brain duality. What is the psyche anyway but the brain in action? Our emotions are functions of the sub-cortex brain. The addict does not filter selfishness of his own volition. Once again you are separating the person from his brain.

There is an abundance of research that suggests addiction is a disease of the brain regardless of how it begins.

quote:

No connections there between the roots of addiction or anything, eh?
One can't see how a primary mental illness could lay the roots for addiction?
Bi Polar follows pretty close to the same basic internal pathology. So does schizophrenia.

Or vice versa? Or some other commonality like growing up in a stressful environment? At least we agree there is a basic internal pathology. To ignore that is folly imo.




Kana -> RE: ADDICTS (12/13/2013 2:47:55 PM)

Well, if pushed, I would say addiction is likely closest to an impulse control disorder,which is certainly a recognized mental illness.




vincentML -> RE: ADDICTS (12/13/2013 2:53:39 PM)


quote:

ORIGINAL: Kana

Well, if pushed, I would say addiction is likely closest to an impulse control disorder,which is certainly a recognized mental illness.


On that we agree. Yep. But the chemistry is pretty complex and compelling. Makes me wonder about the whole issue of free will.




Kana -> RE: ADDICTS (12/13/2013 3:00:36 PM)

quote:

ORIGINAL: vincentML


quote:

ORIGINAL: Kana

Well, if pushed, I would say addiction is likely closest to an impulse control disorder, which is certainly a recognized mental illness.


On that we agree. Yep. But the chemistry is pretty complex and compelling. Makes me wonder about the whole issue of free will.

Which is my number one beef with the disease model. It removes responsibility for recovery from the addict by implying that they aren't also at least in part for their illness.
Addiction is complex stuff. It cuts across the physical, psychological, environmental, emotional and spiritual. It taps into how the brain registers inputs and processes it at an internal level. It has at least as much to do with personality as anything physical.
Simple answers aren't going to be easily found.

The good news is that there is a treatment-addiction doesn't have to be lethal for everyone. Unfortunately, there are some people who for whatever reason can't stop using, no matter what.Those people,I feel for them. They lives the lives of the damned. The walking dead indeed.

ETA
quote:

From my point of view your comment suffers from the error of mind/brain duality. What is the psyche anyway but the brain in action? Our emotions are functions of the sub-cortex brain. The addict does not filter selfishness of his own volition. Once again you are separating the person from his brain.

I didn't say I thought that. In fact, I think, and so stated, the reverse.But I do see a tendency for people to try to separate the addiction and the person,when in sooth,they are one and the same.The person is the addiction and the addiction is the person.
Which is one of the reasons it's such a bitch-it's tough enough trying to convince someone to give up the only thing that makes their life worthwhile (Or so their deluded brain thinks),but then convincing the same person that they are the problem, that it's hardwired into everything they think/do/touch and that the only way to recover is, well, to change everyfuckingthing,-yeah, that's a fun fun conversation to have.




Kirata -> RE: ADDICTS (12/13/2013 5:07:51 PM)


quote:

ORIGINAL: vincentML

Makes me wonder about the whole issue of free will.

Yes well, wonder no more. If we take the reductionist argument against free will as true, then we are immediately obliged to conclude that it is simply the output of a biological "bot," of which there are many, all spewing different and peculiar notions in accord with their differing natures, all of it meaningless because they are unable to do anything else.

You're welcome. [:)]

K.





vincentML -> RE: ADDICTS (12/14/2013 2:47:30 PM)

quote:

Which is my number one beef with the disease model. It removes responsibility for recovery from the addict by implying that they aren't also at least in part for their illness.

No, not at all. Nowhere does the disease model remove responsibility for recovery. That might be true if the disease were thought to be caused by an infectious agent that could be killed off with antibiotics. The disease model for addiction on the contrary shows why recovery is so much more difficult and why the afflicted individual has to work so much harder in behalf of his own recovery. It is not like we will just put a splint on the broken bone and stay off it for a few weeks and let it heal. So much damage has been done to the brain's circuitry and chemical systems to permit a lack of effort by the patient. In some cases, sadly, like in that of a "diseased" heart the damage to the brain is too much for a reasonable expectation of recovery.


quote:

Addiction is complex stuff. It cuts across the physical, psychological, environmental, emotional and spiritual. It taps into how the brain registers inputs and processes it at an internal level. It has at least as much to do with personality as anything physical.


I am hard pressed to understand how you separate personality from the brain unless you think the seat of personality and its development is elsewhere in the body.

quote:

I didn't say I thought that. In fact, I think, and so stated, the reverse. But I do see a tendency for people to try to separate the addiction and the person, when in sooth,they are one and the same.The person is the addiction and the addiction is the person.
Which is one of the reasons it's such a bitch-it's tough enough trying to convince someone to give up the only thing that makes their life worthwhile (Or so their deluded brain thinks),but then convincing the same person that they are the problem, that it's hardwired into everything they think/do/touch and that the only way to recover is, well, to change everyfuckingthing,-yeah, that's a fun fun conversation to have.


Well, no. I didn't say anything was hardwired. That is what the advocates of the genetics model would have you believe. I am saying the brain is anomalous due to the addictive behaviors just like the lungs are fucked over by smoking. We don't blame the lungs for the smoking addiction. I have not been talking about the causes of addiction, but the road to recovery. Causes are another issue. I think you and I are closer than it appears. You say the illness is the person. I agree but add the person is the brain and the brain has been physically altered by the behavior. That's why the addict is in a more perilous position than the flu patient say.





vincentML -> RE: ADDICTS (12/15/2013 8:00:21 AM)

quote:

ORIGINAL: Kirata

quote:

ORIGINAL: vincentML

Makes me wonder about the whole issue of free will.

Yes well, wonder no more. If we take the reductionist argument against free will as true, then we are immediately obliged to conclude that it is simply the output of a biological "bot," of which there are many, all spewing different and peculiar notions in accord with their differing natures, all of it meaningless because they are unable to do anything else.

You're welcome. [:)]

K.



Strange. I posted an answer to this and briefly saw that you had replied, but now both are gone. Can't imagine why. Basically, my answer was that there is more than biology to constrain our Will, and so we are not as free as we tell ourselves we are. Our 'free will' is a illusion.[:)]




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