General discussion

IS Addiction a Disease?

Addictions Are About Behavior, Not Disease
(part 1)

Addiction is Not a Disease (Part II)

For those inclined to make presumptions about Ilana Mercer based on my posting her work, take a quick moment to familiarize yourself with her views on this issue. She's a libertarian.

If I can dig it up, she wrote an excellent column on legalizing drugs a while back that I'm pretty much in total agreement with. So far no luck, but off to look some more.

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(NT) (NT) Good articles.
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More here ...

... who is the source she quotes:

I find of particular interest the utter FAILURE of rehab which should at least be dealt with honestly before we divert more public funds to fund it. I was surprised at how ineffective it is. I'm also personally knowledgeable of many that have been in rehab only to perpetually relapse while I've known others that just quit destructive behavior without all the fanfare. So anecdotally, at least, this seems to jive with the study.

Evie Happy

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Everything that happens revolves around...

money.What i've been saying for many years that there is a monetary motive for the medical establishment to labled individuals addicted to alcohol and drugs a disease

With all the rehabs that sprung up over the years,a coincidence,I think not.Who benefits financially from this so called new disease,well lets see,maybe the AMA.


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Not to mention a steady stream of customers ...

... when rehab is court ordered diversion. Doesn't matter what the success rates are when you don't have to actively convince people to choose YOUR program because it has worked for X%, has a Y% success rate, etc.
The President Bush in this article is Bush-41. Money, money. Who says we're not spending enough on treatment in the ''war on drugs'' anyway?

In his parting comments today, Patrick Kennedy urged support for Medical Parity -- IOW, treat addiction as a disease that insurers must pay for rehab for. And we wonder why health insurance gets more expensive?

Evie Happy

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The liberal view...

as I understand it (not that I believe in it...):

Everything undersirable is somebody else's fault. Therefore, it is a social imperative to find the guilty and punish them. Often it is difficult to definitively find them and "convict" them, so it is the government's duty to make everything right again. Meanwhile, those adversely affected by whatever is regarded as undesirable are merely innocent victims. Ergo, addiction is necessarily a disease.

Now that my social commentary is ended, there are clear physiologic changes that occur in some addictions which result in different neurologic response of the affected person, which in turn lead to more addictive behaviors. Sometimes there is a genetic component that once a physiologic trigger has been activated, the addiction is easier and easier to fall into. It can work both ways simultaneously, such as the alcoholic who can hold his liquor better than most, but during sobriety a single swig can knock him off the wagon. It's a tough nut to crack. Behaviors are voluntary, but addictions are a bear to beat. That leaves the rest of society needing to be at once firm and understanding. Coddling them is, in their language, co-dependence.


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One is too many; a thousand isn't enough

There is a genetic component to addiction. The person doesn't have to act on that however. Once he/she does, it's difficult to stop.

One thing I do hate is to have someone say he killed or hurt someone while under the influence so it wasn't his fault.


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I believe the genetic component ...

... is another thing accepted as fact that has never been proven.

I don't think anyone contests the physical addiction that someone can develop to some substances. However if that was all there was, a "crash" detox program would be all that was needed.

I think in some ways this current case of Kennedy highlights how this whole genetic thing gets used to make excuses. You can't blame him really because both of his parents have had the same problem? Seems to be a theme ...

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It's certainly been proven in rats, Evie.

And the odds are very high (not just logically, but based on family histories) that the same is true of humans. There are polymorphisms (sequence variations) to receptors that affect how much of a ligand it takes to trigger a response. Those with very low tolerance to (or as in the case of alcohol for American Indians and many Orientals who lack the alcohol-detoxifying enzyme, inability to properly metabolize) the drug in question are much more easily affected than normal, and in rat tests of addictive behavior, much more easily addicted. But there's also evidence for ''cross-talk'' between different receptor pathways, which probably partially explains the ''addictive personality,'' though there are doubtless other genetic factors at work there that are at least years away from being understood.

The situation with addiction today is exactly parallel to the general situation with mental illness a couple of decades ago, when ''having a nervous breakdown'' was seen as a sign of weakness of will. We now know there are very real neurochemical imbalances, some caused by genetic defects, that are responsible for most mental disorders -- being weak-willed has nothing to do with it. The situation with addiction is similar but not identical. It's definitely a form of mental illness, but there is some element of willpower involved. However, genetic susceptibility, and the physiological changes caused by exposure to the addictive substances themselves, make it very much easier for a susceptible minority to ''resist temptation'' than for the majority. And it's the height of self-righteousness for those without such extra susceptibility to say ''I can resist the temptation; so should they!'' Imprisoning the addictive is akin to locking the insane up in a mental institution -- it should be a last resort when necessary to protect society and the patients themselves from physically dangerous behavior. Unfortunately, as it was for the mentally ill until a couple of decades ago, locking the addicted up is our first response, not the response of last resort. Just another reason why the ''war on drugs'' with its "blame the victims" mentality is a dismal failure, both effectively and morally.

-- Dave K, Speakeasy Moderator
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The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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A nit to pick

Decor is "oriental". People are Asian.


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Even in the rats

the extra susceptibility was very slight and then only detectable as an aggregate. The influence of such genetic predispositions is slight or even negligible compared to the effect of learned behavior.

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That's not accurate, DR...

... but I don't have access to good search facilities on the weekend to find the papers to refute it.

-- Dave K, Speakeasy Moderator
click here to email

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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To equate substance ABUSE ...

... with organic mental illness is, frankly, offensive.

There is even less evidence of an "addiction gene" than there is for a gay gene.

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The genetic component is overplayed

they have yet to identify a single or limited number of genetic factors which show direct causation of eassily-addicted behavior.
There probably is some genetic influence, but considering the effect of a person's environment, it will probably be negligible.

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How about the apparent high susceptibility

of the American Indian population to alcholism?

Or would that be just to the conditions existing as they were pushed onto reservations and marginalized (for a time anyway) as human beings?

I'm not aware of any change in the belief I learned that they seemed to as a people, not just a family, to alcholol abuse?

However, I am willing to believe that the "it's inherited, I can't help it" line is abused to excuse other failures.


click here to email

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Ummm ...

... welfare state? There's no inherent genetic link that I'm aware of. For the Irish neither.

Evie Happy

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You can find similar populations

if you focus on lower income, depressed portions of any racial group. Such populations share many of the same stresses, plus, as alcohol use grows, it becomes a learned behavior for children.

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As apparently the only card carrying liberal here any more,

you're wrong. I do just love how the Right feels it is perfectly proper for it to define liberalism in the most pejorative terms possible and then, having set up their straw man, knock it down with a few half reasoned arguments.

Personal responsibility is paramount in liberalism because liberalism does not believe in banning everything. However, unlike the Right, we don't close our eyes to contributory factors, or blame those who are disadvantaged for their disadvantages. Liberalism does believe that some government action is warranted where the contributory factors pile up, hence affirmative action and a number of other programs like pensions and aid to the destitute.

Alcoholism runs in families, as one can see from the Kennedy clan, so there must be something genetic and neurochemical going on. They even marry alcoholics which is also part of the complex. Now if neuro-chemical imbalances that you are born with are diseases, schizophrenia, depression, etc. or other genetically based diseases like asthma or diabetes are diseases, then alcoholism and substance abuse are too.


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(NT) (NT) Alcoholism in families is a learned behavior
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To paraphrase Evie...

if it's learned behavior than I should be a wife beating drunk.

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Oh please,

as a social worker you know that the rate of childern of wife beaters becoming wife beaters themselves is HIGH. Not every drunk parent produces drunk children

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your just taking her side

because she played the "lesbian" card

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Don't paraphrase me please

It IS far more a learned behavior -- particularly when one is coddled and never faces true consequences of one's bad behavior -- than anything genetic.

Kennedy at first denied there had been any contact, but after learning that police possessed surveillance videotape, he apologized to the guard. Kennedy has avoided criminal charges by agreeing to enter a program for those with no previous criminal records.

He's had his free "strike" apparently! This guy is a menace to society. Two accidents in less than a month. Why doesn't he get a driver for crying out loud!

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I partially agree with your expressed view here...

the atmosphere you are raised in can lead to repetition of your parents behavior... but I can't guarantee not to paraphrase a "straight" line like the one you made. Wink

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My, my we are full of ourselves

Dave Konkel

The list could go on, but don't want to interrupt your rant.

Great science there about genetic component. You don't suppose any environments inherent in how the family deals with problems (pay off, cover up, never own up) has ANYTHING to do with why young Patrick first got hooked on cocaine? Dream on.

You simply cannot compare chemical dependence to a physiological disease like diabetes with a clearly identifiable organic cause.

He is bipolar. Too bad his family hasn't gotten him the help he needs to deal with that. It would involve not drinking at ALL for starters. There's nothing about a bipolar that makes them crave alcohol.

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there are certain personality disorders...

that are similar to bipolar disorder in symptoms. If you are talking about patrick... he has mentioned a sleep aid. Could this be one of the same sleep aids that have been recently documented to cause sleep eating, sleep walking and other atypical, nocturnal behaviors?

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That drug doesn't cause

drunk congressmen to crash their autos at 2 am

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I am personally angry

about the fact that a sobriety test was not performed. Personally I think that the Capital police should (and probably will) be investigated.

Unfortunately, discussion of sobriety (he says with a wink) is just conjecture. Sad

But if we are discussing bipolar then you have to say that there are similar symptomologies caused by other disorders.

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What's your point -- that he's been misdiagnosed?

If he's bipolar or anything related, he should not be drinking at all. He's known to be a regular at at least a few DC bars.

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did not say he was misdiagnosed

did not say he was misdiagnosed but I was not aware that he had been diagnosed as bipolar. Has he been?

Only reason why I mention diagnosis at all is because bipolar, along with schizophrenia are illnesses that have become generic terms. To paint someone as a "bipolar" or a "schizo" because of erratic behaviors does a disservice to people who really suffer from such maladies who have sincerely attempted treatment.

My one incident of asking for political correctness... but only on the behalf of some fine individuals whom I know.

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You guys could save a LOT of posts ...

... if you would just use Google on occasion to educate yourselves before posting conjecture.

That is his diagnosis. According to him. Along with, apparently, "garden variety" depression.

Why is he having the attending physician for Congress treat him? Given his history, he should be doubly careful what he takes for any malady. And he DEFINITELY shouldn't be out drinking socially on a regular basis. I don't think he takes his mental illness seriously. He may look young still, but he's no kid anymore. Time to grow up.

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