scarboroughwa Posted March 15, 2016 Share Posted March 15, 2016 Some people say it's a disease. They should try taking a walk around the local cancer ward and talk about their disease. It's a choice, is it not? Link to comment Share on other sites More sharing options...
wixman1884 Posted March 15, 2016 Share Posted March 15, 2016 Choice does not determine whether something is a disease. Heart disease, diabetes and some forms of cancer involve personal choices like diet, exercise, sun exposure, etc. A disease is what happens in the body as a result of those choices. Link to comment Share on other sites More sharing options...
Rev Posted March 15, 2016 Share Posted March 15, 2016 I'd suspect it's rather more nuanced than that, certain people may be more susceptible to addictions because of underlying mental health issues, for example. I know people who are addicts of various kinds, who manage to live perfectly ordinary, useful lives too, it doesn't necessarily cause others harm. Link to comment Share on other sites More sharing options...
SantosHalper Posted March 15, 2016 Share Posted March 15, 2016 I understand you, but I'm not so sure. There's evidence that some people have "addictive personalities", whether it be alcohol, drugs, gambling, food, sex, etc. Then there's the fact that drug abuse and poverty have a tendency to be at least correlated, possibly causally connected. So at least in some cases, I'd dispute whether its a choice, as such. But then here we get into muddy waters when we discuss what we mean by "choice" here. I don't know if you've read The Spirit Level by Wilkinson and Pickett, but there are two chapters in the book that show an extremely strong connection between inequality and drug use (as well as obesity and crime). Put simply, the more unequal the society, the more drug use you see. Is that a coincidence? The authors show that its statistically very unlikely. We can specualte about the reasons for that, but the evidence is convincing. What do you reckon, Scarborough? Link to comment Share on other sites More sharing options...
Mostyn6 Posted March 15, 2016 Share Posted March 15, 2016 some people are slaved onto drugs, especially victims of sex-trafficking. I wouldn't be so quick to judge without knowing circumstances. My cousin was a heroin addict having been given heroin as a 13 year old by his sister's boyfriend and not knowing what it was. 20 years later, he's good. But he has a past he will never shake off. Link to comment Share on other sites More sharing options...
wixman1884 Posted March 15, 2016 Share Posted March 15, 2016 It's not a couple of people throwing an opinion around to claim extra benefits, it's a medical classification. The AMA and the American Society of Addiction Medicine classify addiction as a disease. The suggestion that a medical classification is somehow insensitive to cancer sufferers is a gross over simplication of the issue. There's arguments that the definition falls short, but as @reveldevil says it's significantly more nuanced than 'whether it is or isn't a choice'. Link to comment Share on other sites More sharing options...
SantosHalper Posted March 15, 2016 Share Posted March 15, 2016 Just looking at The Spirit Level now, and the authors suggest that low social and economic status in societies characterised by high levels of inequality leads to those at the bottom of the ladder needing to medicate against the effects of their low status. Of course its much more complicated than this, so I'll précis here, but we research leads us to think that low levels of dopamine and serotonin in the brain are linked to depression and other mental disorders. Low social status apparently leads to low levels of those chemicals in the brain, hence the greater tendency amongst those at the bottom of society to suffer more from depression and needing to self-medicate. But its controversial. Link to comment Share on other sites More sharing options...
Mafiabob Posted March 15, 2016 Share Posted March 15, 2016 25 minutes ago, scarboroughwa said: Some people say it's a disease. They should try taking a walk around the local cancer ward and talk about their disease. It's a choice, is it not? If I could take a pill for the addiction I have... I would.... This is a silent illness that mentally impacts not just the addicted person but some others around them because of there actions... This illness destroys lives... No known cure... We do understand though, that you have to want it ourselves to stop... Very Niave comparing "diseases" as you put it... Addiction is horrible... 99% certain I won't do what I used to do... Got to keep that 1% in check... Instead of looking to provoke debate in the way you have in your OP try and read up on addiction and peoples stories and recovery... May come to a different view Link to comment Share on other sites More sharing options...
Srg Posted March 15, 2016 Share Posted March 15, 2016 Pretty sure there's a few posters on here addicted to drugs. Link to comment Share on other sites More sharing options...
Rev Posted March 15, 2016 Share Posted March 15, 2016 6 minutes ago, Srg said: Pretty sure there's a few posters on here addicted to drugs. I know who you're thinking of, no one cycles that far without drug assistance. No wonder he can't hold down a job. Link to comment Share on other sites More sharing options...
StringerBell Posted March 15, 2016 Share Posted March 15, 2016 Regardless of whether it's considered a disease, choice is still essential to a persons recovery. People have to want to help themselves and choose to recover. I don't like the way people try and **** all over behavioural approaches when they get some medical practitioners on their side as though behaviour has nothing to with addiction at all. For those who work with addicts, the 'disease' is wrapped up in the concept of motivation. Why people categorise the things they do in the way they do has always been interesting to me. Technically from a biological point of view a whale is a mammal. But there's a reason children initially classify them as fish before some smart arse points out their 'error' - they're big sausages that swim around in the sea. So what is addiction technically, and how do we categorise it? And what do we gain from classifying addiction as a disease? There's always a danger you normalise something when you medicalise it and I'm not sure that's always going to be helpful to addicts or the public. Most people in this field take a biopsychosocial approach, as in its probably a mixture of factors. But I don't think calling it a disease is particularly helpful to anyone and although I'm no neuroscientist the logic behind why it's recently been classified as a disease seems a bit sketchy. Addiction (read taking lots of drugs) effects the reward circuitry of the brain. The thing is, so does learning the piano. Link to comment Share on other sites More sharing options...
StringerBell Posted March 15, 2016 Share Posted March 15, 2016 55 minutes ago, SantosHalper said: Just looking at The Spirit Level now, and the authors suggest that low social and economic status in societies characterised by high levels of inequality leads to those at the bottom of the ladder needing to medicate against the effects of their low status. Of course its much more complicated than this, so I'll précis here, but we research leads us to think that low levels of dopamine and serotonin in the brain are linked to depression and other mental disorders. Low social status apparently leads to low levels of those chemicals in the brain, hence the greater tendency amongst those at the bottom of society to suffer more from depression and needing to self-medicate. But its controversial. Chemicals in the brain and depression are linked, and I would imagine social status is linked as well but I don't think they've been able to determine which causes which. It's a bit of a 'which came first the chicken or the egg?' situation at the minute. Link to comment Share on other sites More sharing options...
SantosHalper Posted March 16, 2016 Share Posted March 16, 2016 19 minutes ago, StringerBell said: Chemicals in the brain and depression are linked, and I would imagine social status is linked as well but I don't think they've been able to determine which causes which. It's a bit of a 'which came first the chicken or the egg?' situation at the minute. Yes, its very difficult to determine the direction of causation. As you say, what's causing what here? I might be contradicting myself here, but what's interesting is that there's some evidence to suggest that in some cases its higher social status that leads to a greater dependency on certain drugs. I recently read that people who are classed as "professionals" drink more than "manual workers", and that more "educated" people drink more than the less educated. I've often suspected that higher intelligence, whatever that means, leads to a greater propensity to self-medication. I do have a theory here, by the way... I think that our knowledge of the human brain is at such an early stage that we're going to need decades of more research to determine the links and causal factors here. We're going to need to know more about the extent to which we really do "choose" whether to drink or take drugs, and how environmental factors enter into the equation. It seems to be a combination, but what the percentages are, we can't really say for sure. One thing that we are starting to suspect, however, is that the importance of human agency, and therefore responsibility, can be massively overplayed. I'd point anyone interested in this in the direction of Daniel Kahneman. His book, Thinking, Fast and Slow, is a great read. Link to comment Share on other sites More sharing options...
scarboroughwa Posted March 16, 2016 Author Share Posted March 16, 2016 1 hour ago, wixman1884 said: It's not a couple of people throwing an opinion around to claim extra benefits, it's a medical classification. The AMA and the American Society of Addiction Medicine classify addiction as a disease. The suggestion that a medical classification is somehow insensitive to cancer sufferers is a gross over simplication of the issue. There's arguments that the definition falls short, but as @reveldevil says it's significantly more nuanced than 'whether it is or isn't a choice'. Absolutely, but I understand that it wasn't long ago that since homosexuality was regarded by medical associations as a mental health issue and something that could be cured. Also, if you picked up a telephone and swore beyond all doubt in your mind that you were talking to god, and that he/she was on the other end telling you to do things (i.e. how to live your life), and you acted upon these conversations then you would probably be involuntarily admitted. However, if you do this in a group on a Sunday for your entire life... it's ok, that's religion. I believe that at some time in the future (certainly not in my lifetime or the one after that) this will be considered as being a mental health issue. What I am trying to say is that, with all due respect, I do not agree with what a certain body/association may say, no matter how well credentialed. I/we've all met enough Profs and Phd's to realise that that they're not always right. Some are outright bonkers, just like the rest of us. Yes, there may be predisposition and deviancy resulting from psychological issues/traumas although is drug addiction a disease? I'm not so sure. Link to comment Share on other sites More sharing options...
scarboroughwa Posted March 16, 2016 Author Share Posted March 16, 2016 1 hour ago, Mafiabob said: If I could take a pill for the addiction I have... I would.... This is a silent illness that mentally impacts not just the addicted person but some others around them because of there actions... This illness destroys lives... No known cure... We do understand though, that you have to want it ourselves to stop... Very Niave comparing "diseases" as you put it... Addiction is horrible... 99% certain I won't do what I used to do... Got to keep that 1% in check... Instead of looking to provoke debate in the way you have in your OP try and read up on addiction and peoples stories and recovery... May come to a different view Sorry to hear that Mafiabob, addiction can be a terrible thing no doubt about that. However, I'm questioning categorising drug addiction as a disease. Glad to say I've had the pleasure of working with a lot of drug addicts so I've a reasonable understanding. Link to comment Share on other sites More sharing options...
SantosHalper Posted March 16, 2016 Share Posted March 16, 2016 4 minutes ago, scarboroughwa said: Absolutely, but I understand that it wasn't long ago that since homosexuality was regarded by medical associations as a mental health issue and something that could be cured. Also, if you picked up a telephone and swore beyond all doubt in your mind that you were talking to god, and that he/she was on the other end telling you to do things (i.e. how to live your life), and you acted upon these conversations then you would probably be involuntarily admitted. However, if you do this in a group on a Sunday for your entire life... it's ok, that's religion. I believe that at some time in the future (certainly not in my lifetime or the one after that) this will be considered as being a mental health issue. What I am trying to say is that, with all due respect, I do not agree with what a certain body/association may say, no matter how well credentialed. I/we've all met enough Profs and Phd's to realise that that they're not always right. Some are outright bonkers, just like the rest of us. Yes, there may be predisposition and deviancy resulting from psychological issues/traumas although is drug addiction a disease? I'm not so sure. Sorry Scarborough, but I think you're going a bit too far here. Are you familiar with DSM-5? If not, you should really take a look. Just because a few profs and PhDs are bonkers (please be gentle, I am myself both a prof and a PhD) doesn't men that serious research isn't being done in the area of addiction. Our knowledge of how these things work is far from perfect, but the more research is done, the more addiction appears to be a disease. And this is not quackery -- this is serious research that shows the same repeated results. Hence it has the status of science. The research seems to show that most times, the decision to take drugs is a "choice", whatever that means. But then subsequent choices are impaired. Drug use results in physical changes the brain, and people with already additive personalities may find it extremely difficult to get themselves out of a vicious downward spiral. Link to comment Share on other sites More sharing options...
scarboroughwa Posted March 16, 2016 Author Share Posted March 16, 2016 2 hours ago, SantosHalper said: I understand you, but I'm not so sure. There's evidence that some people have "addictive personalities", whether it be alcohol, drugs, gambling, food, sex, etc. Then there's the fact that drug abuse and poverty have a tendency to be at least correlated, possibly causally connected. So at least in some cases, I'd dispute whether its a choice, as such. But then here we get into muddy waters when we discuss what we mean by "choice" here. I don't know if you've read The Spirit Level by Wilkinson and Pickett, but there are two chapters in the book that show an extremely strong connection between inequality and drug use (as well as obesity and crime). Put simply, the more unequal the society, the more drug use you see. Is that a coincidence? The authors show that its statistically very unlikely. We can specualte about the reasons for that, but the evidence is convincing. What do you reckon, Scarborough? Lots in there Santoshelper and I'll look up the book. How many of the upper echelon are drinking four or more cups of coffee per day, have done for years and cannot, or do not want to, modify this behaviour despite having tried? Or prescription drugs? Or Coke? If you're talking about old men lying in back alleys drinking methylated spirits (simplistic point of reference, I know) then yes, but that's all they can afford i.e. lower socio economic status , and they are also very visible. Have a look at our current, and horrible scourge on society; methylamphetamine. Countless, countless users in there, and not many 'poor' users amongst them. At least, not until it gets to the end of the line. Link to comment Share on other sites More sharing options...
scarboroughwa Posted March 16, 2016 Author Share Posted March 16, 2016 11 minutes ago, SantosHalper said: Sorry Scarborough, but I think you're going a bit too far here. Are you familiar with DSM-5? If not, you should really take a look. Just because a few profs and PhDs are bonkers (please be gentle, I am myself both a prof and a PhD) doesn't men that serious research isn't being done in the area of addiction. Our knowledge of how these things work is far from perfect, but the more research is done, the more addiction appears to be a disease. And this is not quackery -- this is serious research that shows the same repeated results. Hence it has the status of science. The research seems to show that most times, the decision to take drugs is a "choice", whatever that means. But then subsequent choices are impaired. Drug use results in physical changes the brain, and people with already additive personalities may find it extremely difficult to get themselves out of a vicious downward spiral. Yes, fully up on the DSM. Going a bit too far with which part? It was all a bit aside from conventional thinking. Link to comment Share on other sites More sharing options...
SantosHalper Posted March 16, 2016 Share Posted March 16, 2016 Yeah, sorry, I wasn't clear about that, so I'll try to explain. I thought that your comments on homosexuality and religion were straying into territory that's not directly relevant here, although I understand your points on both. (I am a hardcore atheist myself.) You mention coffee, leading up to more serious drugs and ask about people who "cannot, or do not want to" change their behaviour. But that's the crux of the issue. Some do not want to change, and others cannot. You seem to be rather dismissive of the "cannot" side of the argument, i.e. those who cannot give up a drug. If I've misunderstood you, then I apologise, but you've said more than once that addiction is not a disease. If so, then that's where we beg to differ. The latest DSM from 2013 says that drug addiction is a disease. Now, I'm not an expert, but if that's what the evidence shows, then I'll go along with that until proven otherwise. That's the nature of science. I'll take your word on methylamphetamine abuse. That's an amphetamine, yes? You're right to call me out on this -- there may be not many "poor" users of the drug, and I don't mean to say that only poor people use drugs. As I said in a later post, there seems to be a correlation between high income and high intelligence and the use of certain drugs. Okay, Scarborough, I think I'm losing the thread of my argument here. Have I answered any of your questions? This is such a fascinating and complicated issue. Cheers for bringing it up. But, basically, if you're saying addiction isn't a disease, then I disagree. Link to comment Share on other sites More sharing options...
SantosHalper Posted March 16, 2016 Share Posted March 16, 2016 Funnily enough, this was in the Guardian today, on alcohol and addiction: http://www.theguardian.com/commentisfree/2016/mar/16/why-humans-get-drunk-google Link to comment Share on other sites More sharing options...
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