<div dir="ltr"><div class="gmail_default" style="font-family:comic sans ms,sans-serif;font-size:large;color:#000000">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 </div></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Wed, Apr 6, 2022 at 6:03 PM Henry Rivera via extropy-chat <<a href="mailto:extropy-chat@lists.extropy.org">extropy-chat@lists.extropy.org</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div dir="auto"><div dir="ltr"><span style="color:rgb(0,0,0)">This is a can of worms. </span></div><div dir="ltr"><span style="color:rgb(0,0,0)"><br></span></div><div dir="ltr"><span style="color:rgb(0,0,0)">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. </span></div><div dir="ltr"><div dir="ltr"><div dir="ltr" style="color:rgb(0,0,0)"><div dir="ltr"><div dir="ltr"><div dir="ltr"><br></div><div dir="ltr">Darin’s response is closest to correct. Will knows what he’s talking about too. </div><div dir="ltr"><br></div><div dir="ltr">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. </div><div dir="ltr"><br></div><div dir="ltr">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<span style="color:rgb(33,33,33);font-family:BlinkMacSystemFont,-apple-system,"Segoe UI",Roboto,Oxygen,Ubuntu,Cantarell,"Fira Sans","Droid Sans","Helvetica Neue",sans-serif;background-color:rgb(255,255,255)"> risk of alcohol dependence in relatives is increased about 2-fold.</span><span style="color:rgb(33,33,33);font-family:BlinkMacSystemFont,-apple-system,"Segoe UI",Roboto,Oxygen,Ubuntu,Cantarell,"Fira Sans","Droid Sans","Helvetica Neue",sans-serif;background-color:rgb(255,255,255)"> </span><span style="font-family:BlinkMacSystemFont,-apple-system,"Segoe UI",Roboto,Oxygen,Ubuntu,Cantarell,"Fira Sans","Droid Sans","Helvetica Neue",sans-serif;background-color:rgb(255,255,255)"><font color="#000000">This is the standard model in the field at the moment and promoted by NIDA. </font></span></div><div dir="ltr"><span style="font-family:BlinkMacSystemFont,-apple-system,"Segoe UI",Roboto,Oxygen,Ubuntu,Cantarell,"Fira Sans","Droid Sans","Helvetica Neue",sans-serif;background-color:rgb(255,255,255)"><font color="#000000"><br></font></span></div><div dir="ltr"><span style="font-family:BlinkMacSystemFont,-apple-system,"Segoe UI",Roboto,Oxygen,Ubuntu,Cantarell,"Fira Sans","Droid Sans","Helvetica Neue",sans-serif;background-color:rgb(255,255,255)"><font color="#000000">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.”</font></span></div><div dir="ltr"><span style="font-family:BlinkMacSystemFont,-apple-system,"Segoe UI",Roboto,Oxygen,Ubuntu,Cantarell,"Fira Sans","Droid Sans","Helvetica Neue",sans-serif;background-color:rgb(255,255,255)"><font color="#000000"><br></font></span></div><div dir="ltr"><span style="font-family:BlinkMacSystemFont,-apple-system,"Segoe UI",Roboto,Oxygen,Ubuntu,Cantarell,"Fira Sans","Droid Sans","Helvetica Neue",sans-serif;background-color:rgb(255,255,255)"><font color="#000000">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 </font></span></div><div dir="ltr"><a href="https://psmag.com/news/addiction-is-not-a-brain-disease" target="_blank">https://psmag.com/news/addiction-is-not-a-brain-disease</a>:</div><div dir="ltr"><span style="color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px;text-align:center">“Some people think that [the addiction-as-disease narrative]is more compassionate,” says </span><a href="https://psychology.columbia.edu/content/carl-hart" rel="noopener" style="font-family:merriweather,serif;font-size:16.2px;text-align:center;box-sizing:border-box;color:rgb(0,0,0)" target="_blank">Carl Hart</a><span style="color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px;text-align:center">, chair of the psychology department at Columbia University, who has spent decades studying how drugs affect the brain and behavior. Unfortunately, Hart writes</span><em style="color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px;text-align:center;box-sizing:border-box">, </em><span style="color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px;text-align:center">there’s not much to support the theory that addiction is a disease of the brain, and it has done more harm than good.</span></div><div dir="ltr"><p style="box-sizing:border-box;margin:30px 0px;padding:0px;max-width:100%;color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px">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:</p><p style="box-sizing:border-box;margin:30px 0px;padding:0px;max-width:100%;color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px"><span style="text-align:center;box-sizing:border-box">1. </span><strong style="text-align:center;box-sizing:border-box">Relying on law enforcement to remove drugs from communities has led to rampant discrimination</strong><span style="text-align:center">.Viewing drug use as a chronic medical condition has not prevented drug use from being a criminal justice problem. Roughly </span><a href="https://www.prisonpolicy.org/reports/pie2016.html" rel="noopener" style="text-align:center;box-sizing:border-box;color:rgb(0,0,0)" target="_blank">20 percent</a><span style="text-align:center"> 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.</span></p><p style="box-sizing:border-box;margin:30px 0px;padding:0px;max-width:100%;color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px"><span style="text-align:center;box-sizing:border-box">2. </span><strong style="text-align:center;box-sizing:border-box">The drugs themselves are probably not to blame</strong><span style="text-align:center">.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.”</span></p><p style="box-sizing:border-box;margin:30px 0px;padding:0px;max-width:100%;color:rgb(51,51,51);font-family:merriweather,serif;font-size:16.2px">Rather than a disease, addiction is more likely a learned behavior. </p></div><div dir="ltr">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. </div><div dir="ltr"><br></div><div dir="ltr">An introductory article about the topic of things like porn addiction, shopping addiction etc is</div><div dir="ltr"> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328289/#!po=1.38889" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328289/#!po=1.38889</a></div><div dir="ltr"><br></div><div dir="ltr">An important takeaway for you all:</div><div dir="ltr">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. </div><div dir="ltr"><br></div><div dir="ltr">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. </div><div dir="ltr"><br></div><div dir="ltr">-Henry </div></div></div></div></div><div dir="ltr"><br><div dir="ltr"></div><blockquote type="cite">On Apr 6, 2022, at 4:35 PM, Darin Sunley via extropy-chat <<a href="mailto:extropy-chat@lists.extropy.org" target="_blank">extropy-chat@lists.extropy.org</a>> wrote:<br><br></blockquote></div><blockquote type="cite"><div dir="ltr"><div dir="ltr">Complex behaviors can be executed via psychological compulsion/"irresistible impulse".<div><br></div><div>Handwashing being the canonical example.</div></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Wed, Apr 6, 2022 at 2:27 PM Will Steinberg via extropy-chat <<a href="mailto:extropy-chat@lists.extropy.org" target="_blank">extropy-chat@lists.extropy.org</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div dir="auto">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...</div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Wed, Apr 6, 2022, 3:06 PM spike jones via extropy-chat <<a href="mailto:extropy-chat@lists.extropy.org" target="_blank">extropy-chat@lists.extropy.org</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div lang="EN-US"><div><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal"><u></u> <u></u></p><div style="border-right:none;border-bottom:none;border-left:none;border-top:1pt solid rgb(225,225,225);padding:3pt 0in 0in"><p class="MsoNormal"><b>>…</b> <b>On Behalf Of </b>Will Steinberg via extropy-chat<br><b>Subject:</b> Re: [ExI] addiction<u></u><u></u></p></div><div><div><p class="MsoNormal"><u></u> <u></u></p></div><div><p class="MsoNormal">>…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<u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">Thanksgiving at my grandparents’ house with my uncle was like Homer at the Frying Dutchman:<u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal"><a href="https://www.youtube.com/watch?v=1kzb6uf0U0k" rel="noreferrer" target="_blank">https://www.youtube.com/watch?v=1kzb6uf0U0k</a><u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">Oh that lad enjoyed his food.<u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">spike<u></u><u></u></p></div></div></div></div>_______________________________________________<br>
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