[ExI] addiction

Wed Apr 6 23:10:19 UTC 2022

In what way, Henry, is willpower not circular?  And if addiction is a brain
disease, how can talk therapy fix that?  I strongly believe that the
psychological addiction is way more powerful than the physical one.  All
behaviors of any kind come from the brain, I think, and if I acquire a
liking for daffodils, my brain is changed, so just measuring brain changes
shows very little, it seems to me. Maybe at best hypotheses to test   bill
w

On Wed, Apr 6, 2022 at 6:03 PM Henry Rivera via extropy-chat <
extropy-chat at lists.extropy.org> wrote:

> This is a can of worms.
>
> I hesitate to speak up because it’s complicated, unresolved among subject
> matter experts to some degree, and hard to explain briefly. But how can I
> not speak up—my dissertation was on willpower, I’ve run two drugs treatment
> programs including one system of which I currently have clinical and
> administrative oversight, I teach and train on this subject, I’m abreast of
> the latest literature, I’ve worked in this field for 23 years
> professionally.
>
> Darin’s response is closest to correct. Will knows what he’s talking about
> too.
>
> The simplest way to describe what most people refer to as addiction is the
> inability to control use. There are people who functionally are unable to
> control their use of some chemicals despite negative consequences. Few
> would disagree about that. I see these people in my professional life and
> in my personal life, but maybe I’m unique in that sense. I’ll have to say
> trust me if you have no personal knowledge of this.
>
> Volkow from NIDA has been promoting the idea for a while now that the data
> support that addiction is a “brain disease.” She means a disorder
> characterized an inability to stop use despite catastrophic consequences,
> in some cases, and caused by a combination of a faulty/hijkacked “go” or
> reward system and a faulty “stop” or control system. Some are born
> predisposed to this and others develop it solely from their environment
> (aka it’s learned). There are efforts to find biomarkers and genetic
> determinants of things like “alcoholism.” The best we’ve found so far is
> twin and relative studies showing things for example like the risk of
> alcohol dependence in relatives is increased about 2-fold. This is the
> standard model in the field at the moment and promoted by NIDA.
>
> The contrasting view expressed at the start of this thread and pushed by
> plenty people may acknowledge some of the above but adds more weight to the
> willpower aspect in the end, dismissing so-called addiction as a failure of
> willpower or morals. There’s variations on this with some people being
> downright a-holes and extremely judgmental and others who leave a little
> room for a different perspective or experience outside their own e.g. “I
> could stop but I could see how it might be harder for someone else,
> especially if they are dope sick.”
>
> Interestingly, at least to me, my colleague Carl Hart who I mentioned in
> another thread who wrote the book Drug Use for Grown Ups disagrees with
> NIDA on this one. He doesn’t put it all on willpower however. You can see
> his position in his TedTalks or read about it, but briefly I’ll quote from
> another article
> https://psmag.com/news/addiction-is-not-a-brain-disease:
> “Some people think that [the addiction-as-disease narrative]is more
> compassionate,” says Carl Hart
> <https://psychology.columbia.edu/content/carl-hart>, chair of the
> psychology department at Columbia University, who has spent decades
> studying how drugs affect the brain and behavior. Unfortunately, Hart writes
> *, *there’s not much to support the theory that addiction is a disease of
> the brain, and it has done more harm than good.
>
> The problem, as Hart explains, is that, if addiction arises from the
> effects of drugs on the brain, there are two paths to a solution: eliminate
> the drug from society (via restrictive policies and law enforcement) or
> look for a fix within the brain. But there are several problems with these
> approaches:
>
> 1. *Relying on law enforcement to remove drugs from communities has led
> to rampant discrimination*.Viewing drug use as a chronic medical
> condition has not prevented drug use from being a criminal justice problem.
> Roughly 20 percent <https://www.prisonpolicy.org/reports/pie2016.html> of
> the people in our nation’s prisons and jails were locked up for non-violent
> drug offenses. And black Americans are significantly more likely than
> whites to be incarcerated for drug offenses, despite equivalent or
> sometimes lower rates of drug use.
>
> 2. *The drugs themselves are probably not to blame*.Indeed, drugs have
> the same neurochemical effects on the brain of every user, but only a small
> subset of people actually become addicted. And despite decades of research
> with increasingly powerful brain imaging technologies, there is still no
> scan that can discriminate between addicted and casual drug users, or make
> predictions about who will go on to abuse drugs. “To date,” Hart writes,
> “there has been no identified biological substrate to differentiate
> non-addicted persons from addicted individuals.”
>
> Rather than a disease, addiction is more likely a learned behavior.
> Both the NIDA position and Hart’s are supported by the data to some
> degree. We will need more data and more research before there is a
> consensus. The result lies probably somewhere in between. It may also be
> nuanced such that for some people it is more learned and for others more
> biological. It may be different for different chemicals. We just don’t know
> yet.
>
> An introductory article about the topic of things like porn addiction,
> shopping addiction etc is
>  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328289/#!po=1.38889
>
> An important takeaway for you all:
> Addiction is treatable whatever the etiology. We can help people develop
> better self-control, develop better and alternative coping strategies,
> reduce risk of relapse, and find less risky ways of using drugs (like
> controlled drinking strategies) for people who don’t want to stop using.
>
> Ultimately Hart is correct too that most users of addictive substances
> don’t become addicted. So getting rid of or controlling access to
> substances that people enjoy is not a rational solution in my humble but
> expert opinion. We will as a society however need to help that small
> percentage that will have problems controlling their use despite negative
> consequences. Telling them to “try harder,” humiliating them, and shaming
> them doesn’t work however. Embarrassingly, we tried that as a field in the
> 1970s and 80s.
>
> -Henry
>
> On Apr 6, 2022, at 4:35 PM, Darin Sunley via extropy-chat <
> extropy-chat at lists.extropy.org> wrote:
>
> 
> Complex behaviors can be executed via psychological
> compulsion/"irresistible impulse".
>
> Handwashing being the canonical example.
>
> On Wed, Apr 6, 2022 at 2:27 PM Will Steinberg via extropy-chat <
> extropy-chat at lists.extropy.org> wrote:
>
>> Yes, food addiction is a crisis right now and yet people have decided to
>> enable it with "healthy at any size" movements.   I didn't see any "healthy
>> at any dose of dope" movements around when I was a junkie...
>>
>> On Wed, Apr 6, 2022, 3:06 PM spike jones via extropy-chat <
>> extropy-chat at lists.extropy.org> wrote:
>>
>>>
>>>
>>>
>>>
>>> *>…* *On Behalf Of *Will Steinberg via extropy-chat
>>> *Subject:* Re: [ExI] addiction
>>>
>>>
>>>
>>> >…Willpower is complicated.  I do think addicts need personal
>>> responsibility to heal, but so do stroke victims trying to relearn how to
>>> speak or move their arm.  Would you say they simply aren't trying hard
>>> enough?  It's fucking hard
>>>
>>>
>>>
>>>
>>>
>>>
>>>
>>> Thanksgiving at my grandparents’ house with my uncle was like Homer at
>>> the Frying Dutchman:
>>>
>>>
>>>
>>> https://www.youtube.com/watch?v=1kzb6uf0U0k
>>>
>>>
>>>
>>> Oh that lad enjoyed his food.
>>>
>>>
>>>
>>> spike
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