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Discussion: Drug Abuse and Addiction

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Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby Absenthia on Tue Jul 26, 2016 9:14 pm

While this may be a rather touchy topic, it's also a topic that crosses gender/socio economic status/nationalities. We've all encountered one thing or another talking about drugs from DARE in schools as kids to cable television; and while I can't speak for everyone's experience, I hope to safely assume we all have some knowledge of this.

More recently I was given the opportunity to take a graduate level course in Public Health, in which my final presentation for a grade was to talk about Drugs, Their Abuse, and Addiction. I also examined recidivism rates of users with incarceration, lack of support, and over prescription of controlled narcotics. (this is starting to sound like a Reddit AMA...) But seriously, what are your views on drug abuse and addiction?

Do you feel that it's really that easy to obtain a pain pill prescription that could then be resold on the streets at 10x your cost? Or really any drug for that matter?

Is addiction and abuse a genetic/inheritable trait or does it really have something to do with the environment one is in?

Do you feel that addiction is something that can be totally "cured" or is it something that one has to manage for the rest of their life?

Also food for thought, things like Nicotine, Caffeine, and Sugar act on the brain much in the way Cocaine does; yet these are legal, commonly consumed everyday things.
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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby barney_fife on Tue Jul 26, 2016 11:13 pm

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Nip it in the bud.

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby dealing with it on Wed Jul 27, 2016 3:46 pm

I'll try to keep this in the realm of "Discussion", not "Debate". (Merry Christmas, barney_fife?)

You are right that drug use crosses all boundaries. There's no panacea to cure it. Everyone has a different set of reasaons to use and continue to use drugs.

Nicotine is one of the most addictive drugs there are; I quit smoking 4 years ago and still have urges. But you might think that a drug like ecstasy, which floods the brain with dopamine, would be highly addictive. On paper it's the most pleasurable experience you will ever have. However, I have zero desire to use it again.

I don't think that drug abuse is entirely genetic. There's no history of drug use in my family.

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby Absenthia on Fri Jul 29, 2016 8:18 pm

I think what Barney is referring to is some of the drug use that's popular among "Dead Heads", and while there is drug use, I think that's a different thing altogether I'm not exactly qualified to talk about. So Barney, why don't you fill us in?

Me personally, I've never smoked tobacco or tried things like ecstasy; sure I've tried Marijuana, but that's about the extent of my recreational drug experience. And to be honest? I don't see the huge deal about chasing these awesome highs from the stuff; it's good as a medicinal item, but recreationally? I'm just not into it.

And while there's no known panacea to cure the "harder" addictions, there are things like Suboxone and Methodone which I believe had been used as a way to wean people off things like crack, heroin and meth. But it appears that these things too can lead a person unable to function without that substance.

Also if anyone is wondering where I pull a majority of info from - Drug Abuse.Gov
It's a US site we used in my public health class.

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby FyreT1ger on Sun Jul 31, 2016 3:30 pm

Before I put in my tuppence, there are a couple terms that need to be defined: dependence and addiction.

Dependence isn't the same thing as addiction. Dependence on a drug generally makes an individual's life better when using said drug and worse when not using the drug. This is a common side effect of drugs prescribed for certain mental illnesses or degenerative diseases. The user of the drug has bad reactions related to their illness if they don't take the drug.

Addiction is worse than dependence. It's a psychological and physical need for said drug that tends to collapse the world around the user. An example of a very bad addiction would be an addict turning their child into a prostitute or thief to get the money to pay for their drug of choice. The adult in the situation is harming both themselves and the child for the sake of their next "hit".

My opinion of drug abuse/addiction is that it is a chronic disease that should be treated not punished, though the case of encouraging illegal activity should be punished. Treating drug addiction with other drugs has a better chance of worsening the condition than improving it, so my recommended treatment would be cognitive and behavioral instead of chemical. Because I call it a chronic condition, I don't think it can be completely cured.

I'm not a psychologist or psychiatrist nor hold any professional title, but I do think it is too easy to get any drug in the US particularly. To me it seems to be a doctor's very first reaction to suggest a drug for absolutely any and every problem, which in turn encourages abuse of drugs, and undermines the entire DARE program.

Because of personal experience with just such a doctor that nearly killed me, I don't trust any drug treatments and have a hard time trusting doctors in general. I think because of my personal experience, my environment, there is no likelihood I would have drug abuse/addiction problems whether or not I have any genetic leanings to it, but I'm only one person.

On the other side, there is a higher likelihood for children of drug addicts to have drug addiction problems. That argument could go for both genetic and environmental factors though. Drug addicts tend to socialize with other drug addicts, if they socialize at all. Another problem resulting from drug addiction is the addict may avoid other people, except to get their next "hit" when they run out of the drug of choice.

I've used the phrase "drug of choice" throughout my post, because I don't really believe any drug, legal or illegal, is significantly more or less addictive than another. I think there could be certain traits in different people's personalities that affects how they react to different drugs. This means there could be effects of certain drugs that more strongly influence certain personalities, but not others, to the point of addiction.

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby dealing with it on Thu Aug 04, 2016 4:30 pm

To mention the other side of the issue, I'll point to Erowid, which is where I found all my information (for risk assessment of particular drugs).

In my experience, if you are going to be doing a drug, there's no use trying to stop you. It's a bit like preaching celibacy. Instead, the best you can do is make sure you're informed in how different drugs might affect you.

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby Absenthia on Thu Aug 04, 2016 6:40 pm

dealing with it wrote:In my experience, if you are going to be doing a drug, there's no use trying to stop you. It's a bit like preaching celibacy. Instead, the best you can do is make sure you're informed in how different drugs might affect you.



Pretty much. People have free will, and you also have to factor in cultural experiences too that may/may not lead to opinions on drugs and their use.

Also, that site is a rabbit hole... and a very interesting one at that.

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby dealing with it on Sun Aug 07, 2016 3:27 pm

Absenthia wrote:Also, that site is a rabbit hole... and a very interesting one at that.
In the history and prehistory of human civilization, we are at a unique point. Enthneogens (recreational and spiritual drugs) are brushed with broad strokes as all-bad. Tribal societies use magic mushrooms, salvia, ayahuasca (the spirit molecule), and Peyote cactus in living ritual. They integrate drugs with their culture, and find places where the drugs can be of spiritual benefit. How much do we lose by saying "drugs are bad, m'kay?"

It is only because of the efforts of people like those behind the Erowid site that we don't lose a repository of wisdom to people who think a criminal record is the appropriate response to drug use. It's a frenzy of misinformation, and there's few trustworthy, unbiased, resources.

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby Sara Whitley on Wed Aug 10, 2016 12:21 pm

Alright... Here's how it works. I'll try to break this down. Please try to bear with me.

Let's start with behavior. The individual actions we make. Behavior is almost like a program, and that program is supposed to modify itself through time to maximize the chances of survival and well-being.

This program is made out of smaller actions--finding food, finding friends, retaining shelter, keeping an income, etc.

Each little piece of this program has a circuit of interconnected cells, called neurons, that correspond in the brain. Each time an action is made, it is because this particular circuit of neurons has "fired" or displayed what we call an "action potential." Basically that means electricity has flowed through the circuit and "activated" the behavior. We either think the thought it represents, or perform the muscular action it represents, or both.

These circuits will atrophy over time. Circuits of neurons that don't "fire" often enough will fall into disuse, as the neurons either die out or are reallocated to different circuitry. So, something has to exist in the human brain that has the function of keeping the effective circuits from dying. The circuits that keep us alive and feeling well, something has to keep those circuits alive. Something has to assure this vital circuitry of finding food or valuing sleep doesn't fall into disrepair.

That's where the dopaminergic system comes in. More specifically, a dopamine-rich region of the brain called the substantia nigra. This region isn't the only part of the dopaminergic system but it will suffice for this discussion.

The substantia nigra is designed to learn specifically which behaviors have led to immediate gratification or the satiation of some biological need. It does this by releasing large amounts of the neurotransmitter dopamine, when we feel that immediate satiation. What this does is the large amount of dopamine interacts with a protein called BDNF (brain-derived neurotrophic factor). BDNF will be released into the circuitry that just fired (including the substantia nigra itself). BDNF creates a process known as neurogenesis--new neurons will grow, existing neurons will repair, and the circuitry grows and is solidified. Essentially, by feeling "rewarded," our brains are actually trying to record this behavior into our everyday playbook as advantageous.

A lot of jargon for common sense. But this jargon is important to understand how recreational drugs work.

I say recreational because... typically, by definition, the release of any dopamine has the potential to become pleasurable, and all recreational drugs release some amount of dopamine. While the strength of the drug's dopaminergic effect and environmental factors will assure your mileage will vary (meaning not all people find all recreational drugs to be pleasurable), this is generally true across the board.

Addictive drugs all force the release of dopamine in large amounts by some mechanism or another. However, so do all positively reinforcing behaviors. That's why you'll hear people say that sugar or sometimes just food can be addictive "like cocaine." The drug actually doesn't usually cause the activation of any different "pleasurable" pathways than the sugar does. A recreational drug usually causes the release of dopamine in many parts of the brain, and because this release happens to occur in the substantia nigra as well, then it just so happens that the BDNF will released and the behavior will "accidentally" be recorded as advantageous.

To answer the questions:
Do you feel that it's really that easy to obtain a pain pill prescription that could then be resold on the streets at 10x your cost? Or really any drug for that matter?
1. Yes. It is very easy to obtain addictive drugs. The pain killers are a problem because they are very whimsically prescribed, have a strong dopaminergic effect, and can lead to addiction very quickly. The black market for opioids is pretty robust.
People also tend to know very, very little about drugs and express very little desire to learn. So inflated black market prices is extremely common.

Is addiction and abuse a genetic/inheritable trait or does it really have something to do with the environment one is in?
2. Genetics and your environment will both affect how robust your dopaminergic response to positive stimulus is, as well as the BDNF response from the dopaminergic response. You can probably imagine now the amount of variability in a person's susceptibility to substance abuse, but everyone has dopamine and everyone has a substantia nigra. No one is "immune" to addiction and there is no "addiction" gene.

Do you feel that addiction is something that can be totally "cured" or is it something that one has to manage for the rest of their life?
3. You cannot "cure" your own reward pathways doing their job. Removing the reward pathway obviously isn't an option. As stated, there isn't an "addiction gene" either. Addiction is a reward-feedback circuit. Because it is indeed a circuit, the "cure" is to let that circuitry atrophy over time. Yes, this is possible (inevitable even, given disuse).

Also food for thought, things like Nicotine, Caffeine, and Sugar act on the brain much in the way Cocaine does; yet these are legal, commonly consumed everyday things.
Not a question but I did talk about it. I'll just say one more thing: our legal system that has determined which drug is and isn't prohibited, has some wild inconsistencies with the scheduling vs. the risk of using the drug. I wouldn't use our legal system as a gauge for what is and isn't safe, because the federal government says you can drink till you die but if you take one puff of marijuana you've broken the law.

Source: Neuroscience Major
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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby Absenthia on Thu Sep 15, 2016 11:45 am

Sara Whitley
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That's awesome, thank you so much for your input.

Also, I'm going to be delving further into this over this next semester for an Informatics class, so I'd really like to keep this discussion open.

Police photo in Ohio. <-- I don't know how many people have seen this article, but there's something about the public shaming that just doesn't get us anywhere.

Thoughts?

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Re: Discussion: Drug Abuse and Addiction

Tips: 0.00 INK Postby Sara Whitley on Mon Sep 19, 2016 1:10 pm

No problem. ^_^

Thoughts on public shaming? Well, it's an advantageous behavior in social primates - there are some species of monkey that actually enjoy getting intoxicated from various things in their environment, and it's common for one that becomes "too dysfunctional" to be shunned by the group. So this behavior goes back before humanity.

Concerning humans, public shame is still a relevant deterrent to certain behaviors. Embarrassment is a powerful thing, and it helps assure that we go among our day to day lives with orderly conduct. Uncomfortable as it may be, it exists for a reason.

Concerning drugs, people will often "weaponize" embarrassment or shame as a means of deterring their use, because recreational drug habits usually have an effect on a person's productivity and family. We're getting a little better (due to science education) at determining which drugs are worth "shaming" their users for and which ones are not. We're learning that marijuana is really one of the most benign recreational substances, comparatively, and we're also learning that cigarettes are far more dangerous than we thought. But despite all the cultural confusion, there's just certain drugs... that tend to be so bad, that there's really no controversy over whether or not they destroy someone.

Heroin is one of these drugs. The negative effect it has on individuals, families, and communities can be overwhelming. From an evolutionary perspective, it is absolutely within any community's best interest to deter the use of such a drug. It makes sense to me that public shame will be used as a deterrent here, because the dopaminergic effect of heroin is so strong that you kind of need a powerful social catalyst to challenge the bonds of the resulting neural patterns that form (remember the neuron networks?).

Bear in mind here, despite the fact that some people will advise staying away from all drugs altogether, and that many (particularly among the conservatives) will brand a "drug user as a drug user," -most- drugs don't actually have this status among our society where the public shame is an obvious strategy. It's really only those drugs that are so bad that they tear apart entire communities. We know that there are countless substances, especially nowadays, including synthetic variations of drug classes we used to associate with nature (such as cannabinoids).
For example, there are hundreds of synthetic cannabinoids, used to make a product called "Spice" that targets the same brain receptors as marijuana. There are hundreds of synthetic tryptamines--a psychedelic drug structure that we used to associate with "mushrooms" or "DMT" (natural hallucinogens). And sure, we hear about a spice overdose here or there, or maybe a bad rave following the ingestion of a synthetic hallucinogen--but a lot of it is fear and conjecture. The fact of the matter is we don't really hear a whole lot about spice or synthetic hallucinogens turning people into face-eating zombies.

But synthetic cathinones? This is a drug class that "hit the streets" heavily in the early 2000s with synthetic cannabinoids and hallucinogens. To illustrate that not all drugs are equal--there's no contest here, synthetic cathinones (also known to the public as "Bath Salts") became instantly demonized by society due to its consistently dangerous effects. The reason all the public shame (news of the zombie guy, YouTube videos, etc) over bath salts occurred was because it is disproportionately dangerous. There just comes a point where a drug gets -so- destructive that society has to use all the tools it has to fight it, and that includes shame.

In Russia, desomorphine ("Krokodil") is receiving a lot of the same sentiment because it's basically a super-heroin, injected often with dirty needles in impoverished neighborhoods. Oh, and if you miss the vein, your flesh rots off.

Heroin and the public shaming of heroin users sort of belongs in a special category of drug use. -Most- recreational drugs don't achieve this status. Heroin, Krokodil, Bath Salts, Methamphetamine, public shame here makes sense.
Most other things, I suppose that's debatable. Like said earlier, we've kind of decided that marijuana probably doesn't belong in this category and some people are even saying alcohol probably should (but that's like... a debate all on its own).

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