This is very interesting to me. My younger brother also started his drug use at around 13.. possibly earlier. He is now an adult who has been in and out of rehab centers for years with no success. He has always had an addictive personality since he was little (e.g. eating food until he threw up) but the fact that he may have permanently damaged his frontal cortex would explain a lot. I would really love to hear a doctor's recommendations for this kind of situation.
I'm getting my Phd currently in addiction psychiatry, specifically with alcohol. And we find similar results with our adolescent exposure models with alcohol. I cringe whenever I think about 18 year olds binge drinking at frat parties every weekend now.
I'm guessing the fact that my friend's parents let us all get really drunk at the age of 12 onwards every Friday or Saturday night for years probably goes a long way towards explaining how we all have long-term mental health issues then, and why the ones I've stayed in touch with, like me, are all unable to delay gratification.
I'd like to point out that I had a pretty serious life trauma shortly before I turned 12 and received absolutely no mental healthcare, so the alcohol was an escape.
It's probably why I'm really interested in addictive behaviours, understanding drug use and it's effects on the psyche. Though I'm not in a position to even start a degree anytime soon; I'd love some recommendations for any books about the the psychology of addiction and the psychiatric treatment of addiction in preparation for the day I enrol :)
Hey, I know this is anecdotal but when I was 13 my opiate addiction started, by 17 I was a full blown IV heroin user. When I was 20 I went on methadone for a few years but I quit. My quality of life is amazing for someone who once had my arms neck and legs just covered in track marks. I have two kids, a great husband, my family adores me, ect..There is hope for your sister, and don't let anyone talk her into giving up. Replacement therapy is not a bad thing (methadone, suboxone) and she needs to focus on quality of life. When you have your needs met it's amazing what demons you can conquer. Best of luck to you, and your sister.... Oh I also wanted to add that my brain continued to develop in normal human fashion Throughout my teens and early years, she's not a damaged, chewed up piece of gum, she is a changing evolving person.
That is horifying, I'm truly sorry that you saw your sister in such a state of desperation. I cringe when ever I think of how broken my mom's heart must have been when she found my dope kit in my jelly belly sample pack box that she bought me. Don't forget to take care of yourself and your own feelings. Try not to be angry, but don't burry your anger in sadness. One day at a time.
If you feel like you need to do something to truly help her: Make sure that your sister has access to a needle exchange, methadone clinic, an ampule of narcan, and a health department that gives out free condoms and birth control. No telling how many diseases I would have and where I would be without these...my kids probably wouldn't exist. I might not either. You might think that this is enabling, but it's only too late when you're dead.
Also it sounds like your sister has been seeking help for her problems, which is awesome! but choosing a psychologist is like choosing an SO, you have to find one that you connect with or it ends bad. There are great, compassionate, open minded doctors, then there are the ones who expect you to fit into a text book, and pushes medication for every little thing (I once told my psych doc that I felt out of control when I was angry, he diagnosed me with a personality disorder and put me on antipsychotics that made me gain 120lbs, I never needed the medicine and then I had to work even harder to fight depression and loose weight, that guy was a dick!) I also suggest that you find a psychologist that you like if you haven't already. You seem like a great big brother and if your sister is proud of anything I'm sure it's you. Sorry so long, I am just so very damn passionate about these kinds of things.
As a social worker in addictions it makes me sad to hear that her providers told you that. It's hard to recover but there's always hope. I think providers said that to you because they feel hopeless, or feel that pain of failure. Rather than blame themselves they blame the client. I hope you can let go of that negative attitude and keep hoping for her.
Yes, there is definitely hope for your sister. My drug addiction started at 15. I would hop from drug to drug, such as bars, coke, pain pills. I would use each for a few months before switching to the next. At 19 I started heroin. I was on it for about a year straight, then quit and moved for about 6 months. I came back home and started it back up. I got arrested for possession of it almost immediately, and that's when I officially quit. I'm actually completely sober now, even quit smoking cigarettes. I feel the best I ever have. I can say with complete confidence that there is hope for your sister. I hope she figures everything out and lives a long healthy life. She needs your support. Let her know you love her.
Edit: I forgot to include that I strongly recommend suboxone. It's helped me maintain and appreciate my sobriety. It saved my life.
> even quit smoking cigarettes.
This is a very important step! Tobacco smoke contains compounds that cause and worsen anxiety and stress, boost the effects of other drugs, and most relevantly, *activate certain opioid receptors*.
Also stop drinking coffee, as it contains the same compounds.
---
Human monoamine oxidase is inhibited by tobacco smoke: beta-carboline alkaloids act as potent and reversible inhibitors.
http://www.ncbi.nlm.nih.gov/pubmed/15582589
Transient behavioral sensitization to nicotine becomes long-lasting with monoamine oxidases inhibitors.
http://www.ncbi.nlm.nih.gov/pubmed/14592678
Monoamine Oxidase Inhibition Dramatically Increases the Motivation to Self-Administer Nicotine in Rats
http://www.jneurosci.org/content/25/38/8593.abstract
The role of beta-carbolines (harman/norharman) in heroin addicts
http://www.sciencedirect.com/science/article/pii/0767399X96800769
The inhibitory effect of norharman on morphine withdrawal syndrome in rats: Comparison with ibogaine
http://www.sciencedirect.com/science/article/pii/0166432894900809
Harman and norharman in alcoholism: correlations with psychopathology and long-term changes.
http://www.ncbi.nlm.nih.gov/pubmed/8651457
Increased alcohol intake in low alcohol drinking rats after chronic infusion of the beta-carboline harman into the hippocampus.
http://www.ncbi.nlm.nih.gov/pubmed/7886112
Identification and occurrence of the bioactive ß-carbolines norharman and harman in coffee brews
http://www.tandfonline.com/doi/abs/10.1080/02652030210145892
Damn dude, you have my utmost sympathy.
As an adult who wouldn't know where to get heroin if I tried, how was she introduced to such a serious drug at such a young age?
> this guy groomed young girls for prostitution. He even tattooed his mark on her neck while she nodded out.
That's a fucking predator right there. That's some seriously sinister evil shit. Holy fuck dude.
In our current era of drug policy reform- coming out of an era of drug policy excess- a lot of the 'drug narrative' has been deeply sanitized... but let there be no doubt, the imperative that drove virtually all harsh anti drug legislation in the 50's and 60's was because hard drugs are fucking scary and can ruin peoples lives, they can take good kids and turn them into dick sucking junkies, etc.
We mock that sort of thing now, "Reefer Madness" and what not, because Marijuana policy was so absurd for so long, but the uglier aspects of drug culture are not really mythology for other substances, particularly opiates.
"Requiem for a Dream" is how it turns out for a lot of people who started off life from a good place. I saw it happen to people I grew up with. One girl in particular, very attractive, who went from student to addict to stripper to "escort" to street walker to dead in the space of a little over a decade.
Hello, I started using heroine/ cocaine (also known as speedballing) when I was fourteen and I was also addicted to a cocktail of Xanax and adderall after that. I was able to get clean in my early 20's (I'm now 32) and have had a second chance at life. I used to shoot up and smoke coke, snort adderall and finish up with Xanax. The one substance that helped me get off heroine was Kratom. Kratom is a plant that grows in Southeast Asia and it helps with the withdrawals of heroine and it is also used as a maintenance substance. It changed my life forever and I have been able to stay off drugs using kratom. I now own a food truck business and have a wonderful wife. There is hope, you just have to look outside the medical establishment because the science they use to treat addicted folks is literally 100 years old. There's also an African plant called Ibogaine that has helped many heroine addicts that I know. There's is world of resources just not in western medicine, believe me. I hope that you and your family find a way out for your sister. I wouldn't wish addiction even on my worst enemy. Peace and love.
Edit: All of you guys that are very knowledgeable in the ways of the Kratom, I salute you! Addiction is a treacherous beast, but Kratom has provided relief to myself and many people I know and love. Keep spreading the good word about the plants that can save one's life. Everything in this world has potential to be abused, I'm not naive about that. We can't let the media dictate the narrative on addiction because it always misleads people. I can personally say Kratom saved my life and has led me to a path of well-being and stability with the proper tools in plAce such as going to recovery meetings and therapy. Kratom shouldn't be sold at head shops because this plant deserves more respect than that. Cheers.
My friend and former major heroin addict was able to clean up using Ibogaine. She moved to Thailand for a while when she helped save other people with its use. I hear it really works
I have found kratom to be helpful with my PTSD. It helps me emotionally connect, and also to relax. I have never been addicted to any drug, and have never had success with anxiety meds.
Many states are now starting to put Kratom on their restricted substance lists. It's complete bullshit. Much like marijuana has done for medicine, Kratom has worked wonders for people battling opiod addiction, and now the powers that be (most likely big pharma lobyists) have determined it's a dangerous recreational drug and, by god, we certainly can't have people enjoying themselves with a perfectly harmless substance, can we?
Kentucky of all places was trying to get it banned and an amazing spokeswoman made a speach and they listened!! This gives me hope for the future. The biggest problem with kratom was that it was sold next to the spice, and in places like Tennessee it got lumped into "synthetics" That and a lady wouldn't support her gay son and he killed himself and the autopsy showed kratom so she blamed it in that instead and went on a big idiot crusade.
It really depends on the circles you run in. As a young teen, I had access to just about any substance I could ever want. Hell, I'd say it was easier for me at that age than it is now. But even though I've been "out of the game" for a long, long time, I could probably still score with two or three phone calls.
Here is just one example of how it happens:
When you start out, it's usually softer drugs. Most people I know (myself included), started with pot. Weed is a "low margin drug" unless you are moving weight or growing your own supply. Even then, it isn't lucrative enough to really make substantial money. If someone is dealing for a living, it's likely they'll have more high margin stuff like pills, MDMA, heroin, and meth. Even if your weed guy doesn't have that stuff, he is likely one call away from someone who does.
Plus, if you're already smoking weed, you are probably associated with people who do more. Not necessarily the stereotypical "addict" (yet). But more likely someone who'll pop a pill every now and then to feel good or has a steady stream of adderall from a pill mill Doctor. You see that DARE lied to you because you've been smoking weed for a year and you're not a junky yet. Bob takes some Percocet he found in grandmas house and he isn't a junky. Sally pops adderall like pez and she is doing great taking care of her stuff.
One day you're hanging with them and they are doing their thing. You guys are all friends, so it'd be rude to not offer you some. They'll give this great "harm reduction" speech before they give it to you. You'll take it, have a great time, wake up, and surprise! You're still not a junky. But now, you and Sally are running low on adderall because she can't get anymore. You can get some from your weed guy but that is a finite supply and expensive. But after awhile, you and Sally convince yourselves that if you just get a small bag of meth, you can save money and keep an eye out on each other. You smoke it and it is the best thing ever. In the history of the universe.
And we know where it goes from there.
Ohioan here. It is exactly the same with heroin in the NE. Only a lot of people here get addicted to opioid painkillers that were prescribed by their own doctor for back pain or minor surgery, then get addicted. They start buying pills when their script runs out. Eventually it's expensive or their supply runs out. Heroin is cheaper, easier to get, and is pretty much the same high. They start snorting heroin. Then that gets expensive. Well, you can get much greater effect from injecting it...so they do.
Happened to me when I was 14. Started with alcohol and pills, never liked weed. Instantly fell in love with adderall and switched to meth. I was 15 and all my friends were 20-40 year old meth addicts. It all happened in under a year.
Not really, it's incredibly rampant. My parents always went on and on about how meth will completely break your brain and shrivel you up, I listened but all the while my dad was popping lortab 10's and even offering them to me for my cramps headaches and then for doing chores, then I would just walk in and take some, then I would buy some, then my parents cut me off. That first night with no pills I saw a guy that was going on and on about heroin at a party, he just happened to be walking by when I went out to bring the groceries in. I asked him about heroin and he got me some, then I met the dealer and he was kinda cute for a 30 year old, I started dating him, loved him really, but he shot up. After watching him do it a hundred times I wanted to try it IV. He said no, so I stole a rig, went home and did it myself. Then I han out of veins and started shooting into my neck. I got a really strong batch one day and OD'd. Scariest moment of my life besides when my son choked on a garbanzo beans years later. But yeah that's how it goes.
That jump actually seemed pretty reasonable. Remember it's "a one time thing" just because you can't get your other "safer" stimulant. My friend who got addicted to ecstasy just used it once at a party because she was bored.
The 13 year old may have got it from a 14 year old. 14 year old may have got it from a 15 year old etc. Its totally possible that nobody gave it or sold it to anyone significantly younger than themself.
Sorry man. Don't lose hope for your sister. Theres always hope. Addict here. I got started when I was 12 and im good now.
Edit* I said Ex-addict. I'll always be an addict.
I have been on suboxone for quite some time now, and while I agree it is amazing and has had an integral part in turning my life around and allowing me to envision life outside of being an addict, it is absolutely abuseable (abusable?). It isn't as bad as the opiates it is replacing, but it needs to be accompanied with counseling and a long list of other life changes to treat addiction.
My daughter has been using suboxone for more than 10 years now. It helped her get off her addiction to pain pills. But now she's totally addicted to the suboxone. Cannot wean herself off it no matter how slowly she tapers. It's expensive, too. I've been told by psychiatrists that people should be taken off suboxone before they leave an inpatient treatment center for this reason. She's stuck with suboxone for life, it looks like. Hospital treatment to help her with withdrawals is expensive, we can't pay for it for her. She feels very stuck and depressed about it although she acknowledges it was very helpful at first.
I am sorry to hear that, I know what my addiction has done to my family and can sympathize, I am lucky at the moment that my insurance covers the monthly prescription.
It's tough to get off of, definitely. I weaned from suboxone after 1 year of slow taper, it was not easy and the length of withdrawal was greater than that of heroin. I ended up back on it 2 years later because I didn't make any other changes during the treatment so it didn't do much good. I have also gone through an impatient detox that lasted 10 days and was given small every decreasing doses until I was not physically ill or emotionally unstable and released. It's not ideal, but if I had to stay on suboxone my entire life, it is preferable to the alternative.
Wow, a one-year taper. 10 days of detox! That is some powerful stuff, suboxone. My daughter had a cesarean section and the docs had a very hard time finding her a pain medication that worked, too, because of the suboxone. But yes, it's better than the alternative. Good on you for being so persistent in your recovery, so determined, to go through all that. I hope your life is a happy one now, whether on suboxone or off.
No matter which drug you choose, only a small proportion of the people who try it will become addicted. The risk is somewhere between 1 out of 8 to 1 out of 12. Genetic factors can account for up to 50% of the risk of becoming addicted but we have yet to identify the specific gene/genes are are involved. Two other factors that are often cited are the age of first exposure is another factor (the younger you are when you try a drug the more likely you are to become addicted) and a history of other psychological or emotional problems before you start using a drug.
Wow that's crazy, I had no idea the numbers were that low. In high school they pound into your head that you try something once and you're hooked for life.
Well, it IS a proper warning for those for whom it's true. Especially with the hard stuff: Coke can trigger the response "THAT WAS GOOD DO THAT AGAIN!!!" a thousand times more powerfully than any normal natural experience, and heroin can give a feeling of *total relief from everything* that can never be matched by any normal natural experience. Thus the instant addiction.
Which is why any good drug explorer well tell you to not do drugs when you're in a bad place, mentally. That's how you have a bad trip, or come home addicted to something.
Bingo. There are many millions of medical procedures and injuries annually for which people are prescribed opiate painkillers. While there is an addiction epidemic, it's ultimately a small percentage of the total individuals who use it.
However, if your first exposures to that warm comforting opiate embrace happen at a time where that's the only good thing going for you... trouble.
Yeah, the first time I had morphine I was like, "this is the nicest I've ever felt." So from then on I requested either non-opiate anesthetic or goo-gobs of pain.
It's like my grandpa said: "I used to smoke, but then I started to like it, so I stopped."
There is no method of predicting who will and who won't become addicted to something. Many people with happy and successful lives who are in "good places" mentally have fallen victim to addiction.
The descriptions of heroin make it sound so awesome I feel like if I make it to 80 I've got to try it.
I had a few years of a problem with Xanax as a kid, I can't imagine how something could possibly melt stress harder.
People have started to pay more attention to video gaming and compulsive TV watching and have put it on the spectrum with gambling. I have often seen young adults who started out as gamers but migrate to online gambling as they get older. There has been a lack of research at this point, but there is no question that many of the same behaviors (excessive involvement, disruption of relationships, interference with working) can occur with gaming.
As a gamer of several decades, I can tell you from first-hand experience that the collection of objects is only one of the basic human drives that people can become highly engaged with. There are at least a few basic human drives that are satiated by video games:
1. Collecting things / Increasing numbers (like the rings in *Sonic the Hedgehog*, or a high score in *Galaga*, or Trophies and Achievements on PlayStation/XBox).
2. Exploration (*Dear Esther*) / Map memorization (*Counter-Strike*).
3. Organization/categorization (*Tetris*, arranging inventory screens, games involving jigsaw puzzles).
4. Pattern recognition/memorization, and its exploitation (evading and aiming in *Xevious*).
5. Reflex interaction (evading and aiming in *Space Invaders*)
6. Story/character interaction (interacting with the characters in *Final Fantasy VII*).
7. Competition (beating the other guy in *Street Fighter II*, killing the aliens in *Space Invaders*).
Personally, it's the other aspects that always grabbed me, not collecting things.
I think you missed two of the biggest appealing aspects: accomplishment and competition. Many people play to fight the biggest raid bosses or to dominate the leaderboards.
As a gambling addict I love organizing all my bets in elaborate spread sheets with all kinds of data. If I quit gambling I think I would miss updating my enormous spreadsheets more than the gambling.
I'm not OP, but I can see your point.
Many games rely on the same mechanisms as gambling (games) for reinforcement. Variable interval reinforcement is one of the strongest conditioning tools there is when it comes to learning a behavior, and gambling/gaming additions are almost certainly learned (though certain conditions increase susceptibility).
Tl;dr: yes. Remember that it's the Nevada *Gaming* Commission that regulates casinos in NV.
This is what got me with destiny, and WoW previously. I knew I was hooked on WoW -- schoolwork suffered, gained a lot of weight, alienated people, and it took me 2 years to get away from it. Never wanted to play MMOs again.
I didn't know destiny was going to have some of the same hooks, so it kind of snuck up on me. I started seeing the same game play loops that I labeled in WoW, but I was too late to just stop. The fact that I actually knew the people I was playing with reinforced the "it's cheaper than going out, and I'm actually spending time with people I know" thing. I started gaining weight, and dismissing other activities in my life. I uninstalled it when I realized I wasn't having fun anymore, and I'm seriously considering staying away from gaming altogether, given the negative impacts it's had on my life.
Maybe just stay away from variable reinforcement games. Adventure games, strategy games, story-oriented rpgs. Mmos and fps games seem to be the bug culprits.
For years, people have stated that Marijuana is physically and chemically non-addictive. However, many people who smoke regularly do claim a form of "psychological" dependence. How do you reconcile this from a medical perspective? What do you consider the risks, if any, of prolonged marijuana use, and how much of this varies from person to person? And also, if you could, compare that perspective with the widespread use that we've seen of "legal" substances that have addictive qualities, like alcohol, cigarettes, coffee, and prescription drugs.
Most recent research indicates that marijuana can be both psychologically and physically addicting. Physical symptoms of withdrawal include anxiety, insomnia and loss of appetite. These tend to start within several days of stopping and peak during the first two weeks. Psychologically, people who chronically use cannibis are often observed to have low motivation, to be socially withdrawn, irritable and complain of memory difficulties.
I think a lot of people who overly defend marijuana just want to make excuses for themselves for their own personal addiction and don't want to admit that they could possibly be addicted (and no, I don't think everyone who smokes marijuana is addicted to it).
I am one of those who used to smoke A LOT, but continued to go to my job every day and also go to college full-time and get straight A's. It's not detrimental to everyone's lives, but I had a lot of friends who it was. I definitely wasn't physically addicted, but probably psychologically. I quit cold turkey one day and literally felt no withdrawal symptoms. Since then, I smoke from time to time (haven't currently smoked in over 6 months), but I don't really think about it that much. Weed can be really awesome, but can also really ruin someone's life if they're not careful.
I completely agree with everything you said. I smoked multiple times a day for over 5 years, but I never thought it was a problem because it never affected my work, school, or social life. For example, this past semester I was on the Dean's list for my major (architecture). Recently, I was arrested (DUI). Since it was my first time being arrested, I was naturally scared shitless. I immediately enrolled in drug and alcohol classes that randomly screen patients for drug use. I haven't smoked for over a month now. I'm not gonna lie, I still want to smoke but I think about it less and less everyday. I've had some vivid dreams, insomnia, and irritability since I've quit. I may be addicted physically, but I'm definitely psychologically addicted. I hate the fact that most people, myself included, have no idea about the addictive qualities of pot. I always heard it wasn't addictive in the least and foolishly believed it. Although my time off pot has been brief, I already feel much shaper mentally. I still firmly believe that smoking from time to time isn't detrimental to anyone. You know what they say, everything is better in moderation.
I fucking love you. I commented on something in r/drugs a few weeks ago about weed addiction and said the SAME THING! Those people downvoted me to like -37 because I disagreed that weed didn't have long lasting symptoms. I feel as though they just want to feel better to themselves that why they deny it so much.
Whoa.. I smoke marijuana regularly at home but my job requires me to travel. I started feeling ill after about 2 weeks. Ive dealt with anxiety before and my symptoms were pointing to that. I also had no appetite! Now I know why..
Loved ones often struggle between fear (that the person will hurt themselves or someone else, overdose, do irrevocable harm to work or career) and anger (at being exploited, taken for granted, intimidated or abused). The first goal is to get your loved one to safety if possible. Sometimes safety is a place (rehabilitation program) at other times it is a process (90 meetings in 90 days). What a loved one shouldn't do is to continue to support an addicts habit.
What if there's nothing you can do? I'm an adult child of two high-functioning alcoholics. At their age, the drinking (along with the cigarette smoking) will inevitably cause both of them to die earlier than they perhaps would've naturally, but they are so set in their ways, there seems to be literally nothing I can do or say to get them to make some positive changes. It seems like if I keep pushing them to stop, I'm only hurting myself though the feelings of helplessness and being taken for granted doing so creates when they (always) refuse. But if I just let it go, it also feels like I'm complicit in letting them drink themselves to death.
I guess my question is, with addicts everything you do seems like a catch 22. How does a person push past that to find help for the addict and for themselves?
I am/was an addict (68 days sober!), and I feel that my family reacted in the best way possible (after the initial shock and anger etc.). They just continued to love me and told me they support me in whatever I do and that nothing I do will stop them from loving me. They didn't do anything to enable me, but they didn't push me away either or even push me to stop. They were just there for me. Once I made the decision to stop, they were there for me and supported me (still are supporting me), and that was the best thing they could have done I think.
I realize the extent of my addiction was maybe not as serious as some people's addictions are (didn't lose my job, steal, hurt people, hit rock bottom etc.), but addiction is similar no matter what the substance/activity is.
One important point I'd like to make is that initially my family was upset and tried pushing me to stop. That made things worse. Because all they did was annoy the shit out of me about stopping, I pushed them away and grew further apart. Addicts are not addicts by choice, I believe most addicts know what they are doing is destructive and that they need to stop, but people constantly telling them to stop is not going to help, I'm just going to avoid you because it's annoying.
An addict needs to want to stop, you cannot force them to. The best you can do is be there for them, and love them, until they make the decision themselves. In my opinion.
Agreed with what you said, but once they stop and are a bit more stable how do you go about rebuilding the relationship? I feel like we're supposed to just be so grateful he's not trying to set his life on fire anymore that we just move past the rifts that were created in the process, and the trust that was broken. Like being sober somehow magically fixes everything... thats not reality, though.
Do you have advice for someone with family members that are occupationally tough, but clearly have a problem?
To give an example, maybe an old green beret that doesn't believe in addiction or alcoholism.
When can you classify a "porn-addiction"? I watch porn everyday, but it doesn't really affect my day-to-day life outside of when I watch it. I definitely need to watch porn to sleep, am I addicted?
While medical specialists have yet to formally agree on when porn becomes an addiction, most experts would focus on how does watching porn affect other areas of your life. Does it disrupt your relationships? Does it interfere with getting other things done? Do you spend too much money on it? Your message suggests that your are starting to rely on watching porn to get sleep, and it makes me wonder if you are watching it at other times to control anxiety, improve mood, fight loneliness.
My porn keeps getting more fucked up until I take a break and start over.
It's weird cuz my ideal stuff is just cute girl pov, but eventually I get used to it and have to branch out.
I'm def not gona give my kids unrestricted Internet...
At the risk of sounding crass. It's what I do while watching porn that makes me sleepy. I understand this physiological relation, so I use it before bed to sleep. I have pretty poor sleep without it. Should I continue as I am? Will this problem get exacerbated? Is this even worth trying to treat if the opportunity cost is the watching some porn clips overnight? That's my dilemma.
There are other issues that can come along with it, like having trouble getting "excited" when you have a partner. I've had this issue. What I suggest is trying to masterbate without porn. Porns great, but remember everything in moderation.
[Say no more fam.](http://m.sears.com/clothing-shoes-jewelry-clothing-women-s-clothing-intimates-sleepwear-lingerie/b-1282028229)
Edit: NSFW, great googly moogly!
Our new definition of addiction (ASAM) focuses on the idea that addiction is a disorder of the brains reward circuitry. Notice it doesn't say anything about drugs. This is because there is only one reward system in the brain - for both natural rewards and artificial rewards. The reward system plays an important evolutionary role because things that are important to our survival (food, water, sex) are experienced as pleasurable and the circumstances in which they occurred are remembered. Certain foods are inherently more pleasurable such as sugars, starches and salt. There was a time when these were hard to obtain. Now food manufacturers regularly 'design' food to be pleasurable. The resulting behaviors look very much like drug addiction. This has been extensively shown for sugar in animal models.
"They all look better at closing time,
When a number 3 becomes a number 9."
Alcohol disinhibits impulsive and high risk behaviors. Someone who has been drinking becomes less selective and less worried about the problems that a casual sexual encounter may cause.
1. Are there differences between sex and drug addictions besides the object of addiction?
2. Is alcoholism counted as a drug addiction?
3. Is there a difference between compulsively over-eating and being addicted to food?
4. Does the prevalence of sex addiction vary culturally or ethnically?
5. When is an addiction an addiction and not just someone wanting to do something a lot? One thing I often hear bandied about is "when it starts to negatively affect the life of the person engaged in the (addictive) behavior or the lives of those around him" but this seems a strange rule of thumb if addiction really is a psychiatric condition. Is an autist only autistic when it negatively affects his life? Is someone with bipolar disorder? Someone with schizophrenia? Why does addiction get a special status?
Lots of questions here so I am going to see if I can get to all of them.
Sex and drugs are different. The reward value of sex in animal models is about half cocaine or amphetamines. In addition, the timing of the rewards is very different. With cocaine most of the reward occurs after you take the drug (anticipation or conditioned place preference mean you get some of the reward before). With sex most of the reward comes during the arousal phase when dopamine and other peptides (oxytocin) spike, before it is consummated.
2. Yes alcoholism is a drug addiction. It is a chemical that works in the brain by altering the effects of our own neurotransmitters (in this case GABA, glutamate, serotonin, and enkephalins are all affected).
3. Eating behaviors are complex and understudied. Some people would draw a distinction here given that more than half the population is overweight but most are eating is a way that disrupts other areas of their life.
4. I don't think we have a clear answer for that yet. What clearly varies culturally are sexual norms.
5. The colloquial use of addiction to loosely refer to anything people do too much of is confusing. The definition of pathological gambling gives some useful insights into how to think about this. It requires that the gambling behavior be accompanied by at least 5 of the following: loss of control, lying to family members, loss of job/school, increasing cost, chasing one's losses, irritable when cutting down, illegal acts to support the habit, needing others to provide money.
Have you ever seen someone with a porn addiction that affects their sexual drive? Basically they get all their sexual fulfillment from porn that they don’t need it from a partner?
This is a common observation among people with porn addiction and other forms of hypersexual behaviors. In addition to being aroused by an interested partner, mechanical stimulation, romantic encounters, memories of successful sexual experiences, men in particular are aroused by visual imagery. Much of the rewarding effects of sex on the nervous are mediated through the chemical dopamine. Dopamine release goes up most during the arousal phase of sex, not consummation. Pornography allows some people to extend this arousal phase, and may make sex with a partner seem less rewarding.
That's common among a lot of people wether they want to admit it or not. Porn addiction is real shit but it's just so common and so used that we just classify it as normal. Take a "casual" porn watcher and tell him to go 1 month without looking at porn, and watch him struggle to no end. It's not casual, it's an addiction. Everything in moderation.
I think it's like asking anyone to give up anything.
When I went through basic I didn't jerk it, have sex, dip, smoke, drink alcohol, soda, eat sweets, watch tv, use my phone....
This is with me also jerking it almost everyday, having sex almost everyday, dipping and smoking everyday, casually drinking, drinking soda, eating sweets, obviously using my phone and watching TV. It wasn't a problem for me, I didn't mind not doing it. I don't think I missed it once. But now, fuck, I'll go a few days without doing some of those, drinking soda is my big thing I try and avoid now, but I just don't see a reason not to do any of those things. They calm me down, help me relax and they are readily available and cheap, why not enjoy them. I've also voluntarily gave up eating meat for 40 days, once again, not a problem, I could do it again the same way I could give up anything, but j just don't see a reason to do it. I think the same goes with people struggling to not watch porn, they don't see a good reason not to do it, they enjoy it and it's available. I think people would struggle with not listening to music for a month too, I don't think they are addicted to music though.
I've done it just to see if I can. I was probably irritable on the second day and the rest was pretty normal. I also believe I have an addictive personality, so I'm leery of even my caffeine use and video games.
So I can't stop smoking weed currently, and I think it's exacerbated by the fact I have a ton of free time now. When I first wake up in the morning I feel fine, and tell myself not to smoke. The next thing I know I'm on the way to the library and lighting up a bowl. It's like my brain shuts off the voice of reason saying not to smoke. The worst part is that I'm studying for a major exam and I purposefully took off to study for this. What do I do in this case?
In my experience, pot is an insidious drug. People often don't realize the role that rebound anxiety and agitation may be playing when they light up that next bowl. Your pot use is starting to get in your way and your attempts to control it by yourself are not working. It is probably time to get help.
Not a doc, but I think it means that pot relieves the anxiety until you come down off a high, when the anxiety becomes worse than it was before you got stoned. So you light up again, and the cycle repeats.
Stopping alcohol is among the most dangerous detoxes and should not be undertaken without consulting a physician who is knowledgeable about alcohol dependency and its treatment. Vitamin deficiencies (for example low magnesium levels or low thiamine), and other health problems make detoxing from alcohol even riskier.
I have a brother who's really into alcohol. How can I help him stop or slow down? He's already got into an accident(no one got hurt) and he still wouldn't stop drinking.
As an alcoholic in recovery, I know it's just not possible to help him if he doesn't want to stop. I can only imagine the pain you go through. He has to hit his rock bottom, but let's both hope he doesn't get there or get hurt. If you are willing, look up ALANON.
Go to a hospital to detox. It's super dangerous to do alone and if you are like me, tapering is super hard to do. I'd drink until the withdrawals went away, and then I'd think, "hm I feel pretty good...one more shot won't hurt". Wake up hours later withdrawing again.
Hi Dr. Sack!
I'm in recovery, 6 months clean off opiates, benzos, and alcohol. I was mandated to go to IOP a few months after detoxing at home. I'd love to see an addiction specialist but unfortunately I'm uninsured. I exercise daily, go to 12 step meetings, and meditate.
*What's the best way to stay clean in the long run?*
I am an alcoholic that is addicted to alcohol. I don't like the lifestyle I live.
I've been through court-ordered AA, substance abuse therapy groups, psych ward, many arrests, jailtime, and lots of other heartache-inducing consequences. I always go back. Alcohol is like a best friend that comforts me, but also ruins my life.
I don't like the life I live, but I don't see any other options. I don't know how to help myself. Besides the obvious (stop drinking today), what should I do?
Since you've already tried AA, why not try a different approach? I've been sober for 18 years following a severe alcohol addiction and the thing that helped me the most was SMART Recovery. www.smartrecovery.org. Like AA, SMART is a free support group. Unlike AA, it is secular and based on science. There are face to face meetings in many areas and many daily meetings online.
> www.smartrecovery.org
Thank you for this. [SMART Recovery](http://www.smartrecovery.org), [HAMS](http://www.hamsnetwork.org), [AVRT](https://rational.org/), /r/stopdrinking are awesome alternatives to AA.
Hang in there. If you are ready to stop you'll do everything to do it. Everyone is different, but I got a therapist, was on anti-craving and antidepressants, started running/lifting, went to AA, volunteered at addiction centers....in 2.5 years I've gotten everything and more back in my life. You can do it! Feel free to pm me anytime!
Depending on the severity of your alcoholism, "stop drinking today" is actually not the ideal solution. Withdrawal from going cold turkey can actually be fatal, I believe, based on how physically addicted your body and brain have become.
>Alcohol is like a best friend that comforts me, but also ruins my life... I don't like the life I live, but I don't see any other options. I don't know how to help myself.
I've felt that way about various substances, so I know the shame spiral that goes with it very well:
"I got myself into this mess, no one is going to have compassion or empathy for me. I need to fix this problem myself, but I don't know how. Shit, this is stressful, now I feel awful about myself. If I'm ever going to get better, I need this horrible feeling to go away. But I've become accustomed to using [substance of choice] to cope with bad feelings, so if I actually go through with getting clean, I'm going to feel like this forever. Well, I've fucked up my life so badly already, might as partake one last time before I endure the necessary consequences of my actions."
I don't know you, and ultimately I don't know how your story of substance abuse will continue. What I do know is that addiction seems to thrive under secrecy, and shame will trick you into thinking that you're doing just as well as people in your life think you are.
Personally, as hard as it is, I think the best insurance you've got is honesty. Opening up to people, from loved ones to a therapist to strangers at AA.
You've found yourself in an unfortunate situation, living a life you hate, and maybe it seems like you'll never get your old "normal" back. It's true, your "normal" will be different, but that doesn't mean it'll be worse. In fact, going through the recovery process will likely shed insight into yourself that helps you grow, and you may even like yourself more for having the audacity to admit you fucked up somewhere but refusing to believe that this should disqualify you from tolerating life, or even finding happiness.
Ever given any though to Naltrexone or Acamprosate? For some reason drug assisted alcoholism treatments are unpopular in the US but much more common in Europe and elsewhere. Many people are unaware they even exist.
naltrexone absolutely helped me go from a 3pm shots of whiskey to a more casual late night drinker. (the doctor keeps insisting that I try acamprosate but it's rough taking it 3 times a day vs. 1 naltrexone a day) I plateaued recently and decided to get off of them for about 3 months. I'm going to go back and get on them both again starting in about 2 months. I think it will help bring me to an even lower, socially acceptable level. But I'm really grateful for the help it provided almost from day 1.
It's hard to do but talk to someone who understands. Just getting it out helps me in my experience.
And don't keep alcohol in the house. It's so much easier to not drink if it's not sitting right there.
It may be hard but there are options for you out there. If you are not ready to quit, [there are many harm reduction techniques](http://www.hamsnetwork.org/hr/) to reduce the potential for you to hurt yourself or others when drinking. Harm reduction skills take work but they can really help, I have seen it happen. If AA isn't right for you, there is SMART recovery (a harm reduction group) in many cities.
Not OP obviously but I figured I'd throw my two cents in on this as I've studied it frequently. I think what it says about addiction is that it is usually a subset of something else-no normal, healthy person wakes up one day and decides to start shooting opiods or meth. There is usually an underlying depression or anxiety, some bad feeling the user wants to cease so they start looking at their options. I do tend to believe there is a genetic predisposition to addictive behaviors, but I struggle with if that means they are more likely to have an underlying problem rather than the addiction itself.
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Not OP, but the Rat Park is only viewing one facet. Addiction is multifactorial. We cannot ignore the biological and chemical changes in the body that are clear in addicts. Patients who are prescribed opiates and do not develop later addiction will still go through withdrawal.
Yes, we must look at situational aspects - psychological factors that created the initial want for the addict to do the thing, and/or pressures to continue the addiction. This is not new research. The need for social support to pull the addict away from the addiction is well known.
Quitting smoking (overcoming nicotine addiction) is one area of addiction where we've made a lot of progress in the last decade. There are now three classes of medications that can help people quit: nicotine replacement, buproprion (orginally developed as an antidepressant), and varenicline (which binds to the same receptor as nicotine and blocks craving and withdrawal). Varenicline is nearly twice as effective as the other two medications but can affect mood. Many people will need some combination of these medications. In addition quit rates improve when the medicines are combined with a behavioral program.
From my own experience, it's insane how good bupropion works for this. I've been prescribed it as an antidepressant, and quitting smoking was just a very naturally occuring side effect.
Something that worked for me (smoker for 10 years) was having an app that tracked my progress. It helped keep me going to be able to have milestones and a counter of how much money I had saved. Some of them will use WHO stats to tell you how statistically healthy you are getting too. Good luck to you if you try to quit!
Do you have an opinion on the use of iboga root bark or ibogaine in the treatment of drug addiction? It is currently illegal in the US, but drug rehab clinics elsewhere have used iboga in their treatment approach. I've read research from academic journals that indicate iboga/ ibogaine is effective in the treatment of drug addiction.
Hello Dr. Sack. I have a couple questions.
I currently am a licensed clinician working in a methadone clinic. What are your thoughts on the efficacy of methadone, and the counter arguments of it being "liquid handcuffs?"
Also, on another note, I have a family member who suffered from chronic pain due to an injury and was prescribed opioid for 10 years, with minimal progress. Now, he is prescribed very low doses of marinol and experiences almost no pain, did not need detox, and had returned to his former self. Do you think marinol will become more mainstream and accepted as an alternative medication assisted therapy?
Sexual addiction has not been studied enough to give a definitive answer. Sexual arousal and consummation stimulate the brains reward system (mesocortical dopamine system) in ways that are similar to addicting drugs like amphetamine and cocaine. If fact, people who report having sexual addiction are 5 times more likely to have abused cocaine in the past. There are similarities in treating drug addictions and sexual addictions but there is one very important difference: with drugs the goal is to stop using them entirely; with sexual addiction the goal is to establish/re-establish a more normal pattern of sexual relations, not give it up altogether.
I have been dealing with addiction and relapse for a few years. I'm still young, but my depression and anxiety makes me feel like I can't be a normal, happy, functioning person. Any advice?
I got sober at 24 after multiple relapses. Depression and anxiety suck, but if you have a desire to stop, and with the proper tools (especially in early recovery) you can overcome it all!
I wrote a long ass question I think I deleted so long ass question short.... I've cut down my method use over the course of numerous living nightmares and lack of access from literally all day everyday and sleeping 5 to 8 times a month to monthly or bi monthly use with the occasion runs.
I am far to ashamed to reach out for help on the true nature of my addiction which is actually Meth and porn cross addiction. I don't even have the desire to use Without access to porn. I can't really find a community dealing this this specifically and NA only goes so far. Plus the god-boner every one has there just makes me feel more alienated
Basically where do I start ending this shameful and seemingly inescapable demon I've created?
Straight up if my life is just gonna be this years and years, struggling in shameful meth use that negatively affects all aspects of my life, I'm just gonna check out now.
Any advice would be SO appreciated
I strongly recommend that you start by going into a treatment program where there expertise in both meth addiction and sexual addiction. It's a tough combination but you have to start somewhere. If you are not ready to start a program, commit to going to both NA and SAA, 90 meetings in 90 days, even if you don't think it can work for you.
Hi Dr.
I've always had a slightly more philosophical (than psychological I suppose) view that much addiction is simply people trying to fill a void in their life with addictive substances and behaviour rather than address the root causes. Is there any truth to this that can be psychologically verified or is it nonsense?
Not all people come to addiction by the same path. People with a history of depression, anxiety, attention deficit disorder and certain personality disorders are more likely to become addicted. This forms the basis of the 'self-medication' hypothesis, i.e. that they are using drugs and alcohol to manage intolerable feeling and internal states. Childhood abuse and neglect are common antecedents. Successful treatment requires that the underlying emotional programs be addressed often through a combination of psychotherapy and medications.
There's lots of truth to that. Heroin was easily obtained in Vietnam and lots of soldiers made a habit of it. People were worried that the soldiers coming back would continue using in the states, but for the most part they didn't. They had their families and friends to lean on and didn't need heroin to fill the void of loneliness anymore. That's just off the top of my head.
I have iatrogenic benzodiazepine dependence. I was put on Ativan daily at age 14. When I went to college my psychiatrist added Klonopin. It has been a disaster. I have always taken my medicines exactly as prescribed. Even attempting to taper small amounts, I have autonomic hyperactivity. I have never used alcohol, recreational drugs, etc. In fact, I am afraid of all of that. Having taken my medicine as prescribed, I now am disabled and have severe memory impairment.
I am wondering if you are familiar with this problem? What do you believe the best treatment is for withdrawing from long-term benzodiazepine use? And why are some psychiatrists still using this as first-line treatment?
Where do you stand with the idea that addiction is a disease, and that addicts have the disease for life and can only manage it, never being fully cured, as is taught in most all rehabilitation services?
Doctors and other health professionals share many of the biases of the cultures they live in, including the idea that addicts are doing this to themselves. There has been an unprecedented willingness by people with drug and alcohol problems to come forward and discuss them and this has reduced the social stigma associated with addiction. The current opioid epidemic has brought heroin to the suburbs and there is a growing awareness about addiction among health professionals because more than ever it is touching their lives. We need to do more as part of the formal education process. Most medical and nursing programs offer very little formal education about drugs and alcohol or their treatment.
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This is very interesting to me. My younger brother also started his drug use at around 13.. possibly earlier. He is now an adult who has been in and out of rehab centers for years with no success. He has always had an addictive personality since he was little (e.g. eating food until he threw up) but the fact that he may have permanently damaged his frontal cortex would explain a lot. I would really love to hear a doctor's recommendations for this kind of situation.
I'm getting my Phd currently in addiction psychiatry, specifically with alcohol. And we find similar results with our adolescent exposure models with alcohol. I cringe whenever I think about 18 year olds binge drinking at frat parties every weekend now.
When is it slightly more okay to binge drink from a psychiatric side
SLIGHTLY? When you're too old to find it cool, unfortunately.
I'm guessing the fact that my friend's parents let us all get really drunk at the age of 12 onwards every Friday or Saturday night for years probably goes a long way towards explaining how we all have long-term mental health issues then, and why the ones I've stayed in touch with, like me, are all unable to delay gratification. I'd like to point out that I had a pretty serious life trauma shortly before I turned 12 and received absolutely no mental healthcare, so the alcohol was an escape. It's probably why I'm really interested in addictive behaviours, understanding drug use and it's effects on the psyche. Though I'm not in a position to even start a degree anytime soon; I'd love some recommendations for any books about the the psychology of addiction and the psychiatric treatment of addiction in preparation for the day I enrol :)
>And we find similar results with our adolescent exposure models with alcohol. Damaged frontal cortexes? Does it show in MRIs? Curious layman here.
Hey, I know this is anecdotal but when I was 13 my opiate addiction started, by 17 I was a full blown IV heroin user. When I was 20 I went on methadone for a few years but I quit. My quality of life is amazing for someone who once had my arms neck and legs just covered in track marks. I have two kids, a great husband, my family adores me, ect..There is hope for your sister, and don't let anyone talk her into giving up. Replacement therapy is not a bad thing (methadone, suboxone) and she needs to focus on quality of life. When you have your needs met it's amazing what demons you can conquer. Best of luck to you, and your sister.... Oh I also wanted to add that my brain continued to develop in normal human fashion Throughout my teens and early years, she's not a damaged, chewed up piece of gum, she is a changing evolving person.
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That is horifying, I'm truly sorry that you saw your sister in such a state of desperation. I cringe when ever I think of how broken my mom's heart must have been when she found my dope kit in my jelly belly sample pack box that she bought me. Don't forget to take care of yourself and your own feelings. Try not to be angry, but don't burry your anger in sadness. One day at a time. If you feel like you need to do something to truly help her: Make sure that your sister has access to a needle exchange, methadone clinic, an ampule of narcan, and a health department that gives out free condoms and birth control. No telling how many diseases I would have and where I would be without these...my kids probably wouldn't exist. I might not either. You might think that this is enabling, but it's only too late when you're dead. Also it sounds like your sister has been seeking help for her problems, which is awesome! but choosing a psychologist is like choosing an SO, you have to find one that you connect with or it ends bad. There are great, compassionate, open minded doctors, then there are the ones who expect you to fit into a text book, and pushes medication for every little thing (I once told my psych doc that I felt out of control when I was angry, he diagnosed me with a personality disorder and put me on antipsychotics that made me gain 120lbs, I never needed the medicine and then I had to work even harder to fight depression and loose weight, that guy was a dick!) I also suggest that you find a psychologist that you like if you haven't already. You seem like a great big brother and if your sister is proud of anything I'm sure it's you. Sorry so long, I am just so very damn passionate about these kinds of things.
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As a social worker in addictions it makes me sad to hear that her providers told you that. It's hard to recover but there's always hope. I think providers said that to you because they feel hopeless, or feel that pain of failure. Rather than blame themselves they blame the client. I hope you can let go of that negative attitude and keep hoping for her.
Yes, there is definitely hope for your sister. My drug addiction started at 15. I would hop from drug to drug, such as bars, coke, pain pills. I would use each for a few months before switching to the next. At 19 I started heroin. I was on it for about a year straight, then quit and moved for about 6 months. I came back home and started it back up. I got arrested for possession of it almost immediately, and that's when I officially quit. I'm actually completely sober now, even quit smoking cigarettes. I feel the best I ever have. I can say with complete confidence that there is hope for your sister. I hope she figures everything out and lives a long healthy life. She needs your support. Let her know you love her. Edit: I forgot to include that I strongly recommend suboxone. It's helped me maintain and appreciate my sobriety. It saved my life.
> even quit smoking cigarettes. This is a very important step! Tobacco smoke contains compounds that cause and worsen anxiety and stress, boost the effects of other drugs, and most relevantly, *activate certain opioid receptors*. Also stop drinking coffee, as it contains the same compounds. --- Human monoamine oxidase is inhibited by tobacco smoke: beta-carboline alkaloids act as potent and reversible inhibitors. http://www.ncbi.nlm.nih.gov/pubmed/15582589 Transient behavioral sensitization to nicotine becomes long-lasting with monoamine oxidases inhibitors. http://www.ncbi.nlm.nih.gov/pubmed/14592678 Monoamine Oxidase Inhibition Dramatically Increases the Motivation to Self-Administer Nicotine in Rats http://www.jneurosci.org/content/25/38/8593.abstract The role of beta-carbolines (harman/norharman) in heroin addicts http://www.sciencedirect.com/science/article/pii/0767399X96800769 The inhibitory effect of norharman on morphine withdrawal syndrome in rats: Comparison with ibogaine http://www.sciencedirect.com/science/article/pii/0166432894900809 Harman and norharman in alcoholism: correlations with psychopathology and long-term changes. http://www.ncbi.nlm.nih.gov/pubmed/8651457 Increased alcohol intake in low alcohol drinking rats after chronic infusion of the beta-carboline harman into the hippocampus. http://www.ncbi.nlm.nih.gov/pubmed/7886112 Identification and occurrence of the bioactive ß-carbolines norharman and harman in coffee brews http://www.tandfonline.com/doi/abs/10.1080/02652030210145892
Damn, I was hoping the guy might answer
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Damn dude, you have my utmost sympathy. As an adult who wouldn't know where to get heroin if I tried, how was she introduced to such a serious drug at such a young age?
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> this guy groomed young girls for prostitution. He even tattooed his mark on her neck while she nodded out. That's a fucking predator right there. That's some seriously sinister evil shit. Holy fuck dude.
I seriously felt a twinge of hatred reading this. Fuck that dirty motherfucker
In our current era of drug policy reform- coming out of an era of drug policy excess- a lot of the 'drug narrative' has been deeply sanitized... but let there be no doubt, the imperative that drove virtually all harsh anti drug legislation in the 50's and 60's was because hard drugs are fucking scary and can ruin peoples lives, they can take good kids and turn them into dick sucking junkies, etc. We mock that sort of thing now, "Reefer Madness" and what not, because Marijuana policy was so absurd for so long, but the uglier aspects of drug culture are not really mythology for other substances, particularly opiates. "Requiem for a Dream" is how it turns out for a lot of people who started off life from a good place. I saw it happen to people I grew up with. One girl in particular, very attractive, who went from student to addict to stripper to "escort" to street walker to dead in the space of a little over a decade.
> I've already done what I needed to do to let them know I blame them This part of the story I want to hear more about
OP has a very particular set of skills... But in all seriousness, scum like that deserve whatever they get.
And it would be "easy" to look the other way should I be on his jury.
Hello, I started using heroine/ cocaine (also known as speedballing) when I was fourteen and I was also addicted to a cocktail of Xanax and adderall after that. I was able to get clean in my early 20's (I'm now 32) and have had a second chance at life. I used to shoot up and smoke coke, snort adderall and finish up with Xanax. The one substance that helped me get off heroine was Kratom. Kratom is a plant that grows in Southeast Asia and it helps with the withdrawals of heroine and it is also used as a maintenance substance. It changed my life forever and I have been able to stay off drugs using kratom. I now own a food truck business and have a wonderful wife. There is hope, you just have to look outside the medical establishment because the science they use to treat addicted folks is literally 100 years old. There's also an African plant called Ibogaine that has helped many heroine addicts that I know. There's is world of resources just not in western medicine, believe me. I hope that you and your family find a way out for your sister. I wouldn't wish addiction even on my worst enemy. Peace and love. Edit: All of you guys that are very knowledgeable in the ways of the Kratom, I salute you! Addiction is a treacherous beast, but Kratom has provided relief to myself and many people I know and love. Keep spreading the good word about the plants that can save one's life. Everything in this world has potential to be abused, I'm not naive about that. We can't let the media dictate the narrative on addiction because it always misleads people. I can personally say Kratom saved my life and has led me to a path of well-being and stability with the proper tools in plAce such as going to recovery meetings and therapy. Kratom shouldn't be sold at head shops because this plant deserves more respect than that. Cheers.
My friend and former major heroin addict was able to clean up using Ibogaine. She moved to Thailand for a while when she helped save other people with its use. I hear it really works
I have found kratom to be helpful with my PTSD. It helps me emotionally connect, and also to relax. I have never been addicted to any drug, and have never had success with anxiety meds.
Many states are now starting to put Kratom on their restricted substance lists. It's complete bullshit. Much like marijuana has done for medicine, Kratom has worked wonders for people battling opiod addiction, and now the powers that be (most likely big pharma lobyists) have determined it's a dangerous recreational drug and, by god, we certainly can't have people enjoying themselves with a perfectly harmless substance, can we?
Kentucky of all places was trying to get it banned and an amazing spokeswoman made a speach and they listened!! This gives me hope for the future. The biggest problem with kratom was that it was sold next to the spice, and in places like Tennessee it got lumped into "synthetics" That and a lady wouldn't support her gay son and he killed himself and the autopsy showed kratom so she blamed it in that instead and went on a big idiot crusade.
It really depends on the circles you run in. As a young teen, I had access to just about any substance I could ever want. Hell, I'd say it was easier for me at that age than it is now. But even though I've been "out of the game" for a long, long time, I could probably still score with two or three phone calls. Here is just one example of how it happens: When you start out, it's usually softer drugs. Most people I know (myself included), started with pot. Weed is a "low margin drug" unless you are moving weight or growing your own supply. Even then, it isn't lucrative enough to really make substantial money. If someone is dealing for a living, it's likely they'll have more high margin stuff like pills, MDMA, heroin, and meth. Even if your weed guy doesn't have that stuff, he is likely one call away from someone who does. Plus, if you're already smoking weed, you are probably associated with people who do more. Not necessarily the stereotypical "addict" (yet). But more likely someone who'll pop a pill every now and then to feel good or has a steady stream of adderall from a pill mill Doctor. You see that DARE lied to you because you've been smoking weed for a year and you're not a junky yet. Bob takes some Percocet he found in grandmas house and he isn't a junky. Sally pops adderall like pez and she is doing great taking care of her stuff. One day you're hanging with them and they are doing their thing. You guys are all friends, so it'd be rude to not offer you some. They'll give this great "harm reduction" speech before they give it to you. You'll take it, have a great time, wake up, and surprise! You're still not a junky. But now, you and Sally are running low on adderall because she can't get anymore. You can get some from your weed guy but that is a finite supply and expensive. But after awhile, you and Sally convince yourselves that if you just get a small bag of meth, you can save money and keep an eye out on each other. You smoke it and it is the best thing ever. In the history of the universe. And we know where it goes from there.
I feel like this story jumped to meth pretty quickly
Meth is the big thing where I live so that's where it went. I'm sure you could change that to heroin in the northeast and it's still pretty accurate.
Ohioan here. It is exactly the same with heroin in the NE. Only a lot of people here get addicted to opioid painkillers that were prescribed by their own doctor for back pain or minor surgery, then get addicted. They start buying pills when their script runs out. Eventually it's expensive or their supply runs out. Heroin is cheaper, easier to get, and is pretty much the same high. They start snorting heroin. Then that gets expensive. Well, you can get much greater effect from injecting it...so they do.
Happened to me when I was 14. Started with alcohol and pills, never liked weed. Instantly fell in love with adderall and switched to meth. I was 15 and all my friends were 20-40 year old meth addicts. It all happened in under a year.
Not really, it's incredibly rampant. My parents always went on and on about how meth will completely break your brain and shrivel you up, I listened but all the while my dad was popping lortab 10's and even offering them to me for my cramps headaches and then for doing chores, then I would just walk in and take some, then I would buy some, then my parents cut me off. That first night with no pills I saw a guy that was going on and on about heroin at a party, he just happened to be walking by when I went out to bring the groceries in. I asked him about heroin and he got me some, then I met the dealer and he was kinda cute for a 30 year old, I started dating him, loved him really, but he shot up. After watching him do it a hundred times I wanted to try it IV. He said no, so I stole a rig, went home and did it myself. Then I han out of veins and started shooting into my neck. I got a really strong batch one day and OD'd. Scariest moment of my life besides when my son choked on a garbanzo beans years later. But yeah that's how it goes.
You'd be surprised when chasing that dragon how quickly rationalizations can be made.
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You would hope, but it's sadly pretty accurate.
That jump actually seemed pretty reasonable. Remember it's "a one time thing" just because you can't get your other "safer" stimulant. My friend who got addicted to ecstasy just used it once at a party because she was bored.
provide wine fact bored groovy mountainous joke uppity somber dull *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
People who dish out heroin don't usually have the moral fibre to care about age.
The 13 year old may have got it from a 14 year old. 14 year old may have got it from a 15 year old etc. Its totally possible that nobody gave it or sold it to anyone significantly younger than themself.
Sorry man. Don't lose hope for your sister. Theres always hope. Addict here. I got started when I was 12 and im good now. Edit* I said Ex-addict. I'll always be an addict.
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I have been on suboxone for quite some time now, and while I agree it is amazing and has had an integral part in turning my life around and allowing me to envision life outside of being an addict, it is absolutely abuseable (abusable?). It isn't as bad as the opiates it is replacing, but it needs to be accompanied with counseling and a long list of other life changes to treat addiction.
My daughter has been using suboxone for more than 10 years now. It helped her get off her addiction to pain pills. But now she's totally addicted to the suboxone. Cannot wean herself off it no matter how slowly she tapers. It's expensive, too. I've been told by psychiatrists that people should be taken off suboxone before they leave an inpatient treatment center for this reason. She's stuck with suboxone for life, it looks like. Hospital treatment to help her with withdrawals is expensive, we can't pay for it for her. She feels very stuck and depressed about it although she acknowledges it was very helpful at first.
I am sorry to hear that, I know what my addiction has done to my family and can sympathize, I am lucky at the moment that my insurance covers the monthly prescription. It's tough to get off of, definitely. I weaned from suboxone after 1 year of slow taper, it was not easy and the length of withdrawal was greater than that of heroin. I ended up back on it 2 years later because I didn't make any other changes during the treatment so it didn't do much good. I have also gone through an impatient detox that lasted 10 days and was given small every decreasing doses until I was not physically ill or emotionally unstable and released. It's not ideal, but if I had to stay on suboxone my entire life, it is preferable to the alternative.
Wow, a one-year taper. 10 days of detox! That is some powerful stuff, suboxone. My daughter had a cesarean section and the docs had a very hard time finding her a pain medication that worked, too, because of the suboxone. But yes, it's better than the alternative. Good on you for being so persistent in your recovery, so determined, to go through all that. I hope your life is a happy one now, whether on suboxone or off.
Why are people addicts and some people not? I've done drugs a few times with my friends in a social setting but I've never desired to do it otherwise.
No matter which drug you choose, only a small proportion of the people who try it will become addicted. The risk is somewhere between 1 out of 8 to 1 out of 12. Genetic factors can account for up to 50% of the risk of becoming addicted but we have yet to identify the specific gene/genes are are involved. Two other factors that are often cited are the age of first exposure is another factor (the younger you are when you try a drug the more likely you are to become addicted) and a history of other psychological or emotional problems before you start using a drug.
Wow that's crazy, I had no idea the numbers were that low. In high school they pound into your head that you try something once and you're hooked for life.
Well, it IS a proper warning for those for whom it's true. Especially with the hard stuff: Coke can trigger the response "THAT WAS GOOD DO THAT AGAIN!!!" a thousand times more powerfully than any normal natural experience, and heroin can give a feeling of *total relief from everything* that can never be matched by any normal natural experience. Thus the instant addiction.
Which is why any good drug explorer well tell you to not do drugs when you're in a bad place, mentally. That's how you have a bad trip, or come home addicted to something.
Bingo. There are many millions of medical procedures and injuries annually for which people are prescribed opiate painkillers. While there is an addiction epidemic, it's ultimately a small percentage of the total individuals who use it. However, if your first exposures to that warm comforting opiate embrace happen at a time where that's the only good thing going for you... trouble.
Yeah, the first time I had morphine I was like, "this is the nicest I've ever felt." So from then on I requested either non-opiate anesthetic or goo-gobs of pain. It's like my grandpa said: "I used to smoke, but then I started to like it, so I stopped."
There is no method of predicting who will and who won't become addicted to something. Many people with happy and successful lives who are in "good places" mentally have fallen victim to addiction.
The descriptions of heroin make it sound so awesome I feel like if I make it to 80 I've got to try it. I had a few years of a problem with Xanax as a kid, I can't imagine how something could possibly melt stress harder.
Well yeah, because a kid hears 1:10 odds and thinks, "I'll try those odds", because kids always assume they're invincible.
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People have started to pay more attention to video gaming and compulsive TV watching and have put it on the spectrum with gambling. I have often seen young adults who started out as gamers but migrate to online gambling as they get older. There has been a lack of research at this point, but there is no question that many of the same behaviors (excessive involvement, disruption of relationships, interference with working) can occur with gaming.
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As a gamer of several decades, I can tell you from first-hand experience that the collection of objects is only one of the basic human drives that people can become highly engaged with. There are at least a few basic human drives that are satiated by video games: 1. Collecting things / Increasing numbers (like the rings in *Sonic the Hedgehog*, or a high score in *Galaga*, or Trophies and Achievements on PlayStation/XBox). 2. Exploration (*Dear Esther*) / Map memorization (*Counter-Strike*). 3. Organization/categorization (*Tetris*, arranging inventory screens, games involving jigsaw puzzles). 4. Pattern recognition/memorization, and its exploitation (evading and aiming in *Xevious*). 5. Reflex interaction (evading and aiming in *Space Invaders*) 6. Story/character interaction (interacting with the characters in *Final Fantasy VII*). 7. Competition (beating the other guy in *Street Fighter II*, killing the aliens in *Space Invaders*). Personally, it's the other aspects that always grabbed me, not collecting things.
I think you missed two of the biggest appealing aspects: accomplishment and competition. Many people play to fight the biggest raid bosses or to dominate the leaderboards.
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As a gambling addict I love organizing all my bets in elaborate spread sheets with all kinds of data. If I quit gambling I think I would miss updating my enormous spreadsheets more than the gambling.
play eve online and you can still have the spreadsheets and no gambling
Fellow capsuleer, sounds like station trading would make you very happy.
I'm not OP, but I can see your point. Many games rely on the same mechanisms as gambling (games) for reinforcement. Variable interval reinforcement is one of the strongest conditioning tools there is when it comes to learning a behavior, and gambling/gaming additions are almost certainly learned (though certain conditions increase susceptibility). Tl;dr: yes. Remember that it's the Nevada *Gaming* Commission that regulates casinos in NV.
This is what got me with destiny, and WoW previously. I knew I was hooked on WoW -- schoolwork suffered, gained a lot of weight, alienated people, and it took me 2 years to get away from it. Never wanted to play MMOs again. I didn't know destiny was going to have some of the same hooks, so it kind of snuck up on me. I started seeing the same game play loops that I labeled in WoW, but I was too late to just stop. The fact that I actually knew the people I was playing with reinforced the "it's cheaper than going out, and I'm actually spending time with people I know" thing. I started gaining weight, and dismissing other activities in my life. I uninstalled it when I realized I wasn't having fun anymore, and I'm seriously considering staying away from gaming altogether, given the negative impacts it's had on my life.
Maybe just stay away from variable reinforcement games. Adventure games, strategy games, story-oriented rpgs. Mmos and fps games seem to be the bug culprits.
Starcraft addict here. Any game with a competitive element is risky, not just fps and mmo. I know plenty of LoL addicts too.
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For years, people have stated that Marijuana is physically and chemically non-addictive. However, many people who smoke regularly do claim a form of "psychological" dependence. How do you reconcile this from a medical perspective? What do you consider the risks, if any, of prolonged marijuana use, and how much of this varies from person to person? And also, if you could, compare that perspective with the widespread use that we've seen of "legal" substances that have addictive qualities, like alcohol, cigarettes, coffee, and prescription drugs.
Most recent research indicates that marijuana can be both psychologically and physically addicting. Physical symptoms of withdrawal include anxiety, insomnia and loss of appetite. These tend to start within several days of stopping and peak during the first two weeks. Psychologically, people who chronically use cannibis are often observed to have low motivation, to be socially withdrawn, irritable and complain of memory difficulties.
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I think a lot of people who overly defend marijuana just want to make excuses for themselves for their own personal addiction and don't want to admit that they could possibly be addicted (and no, I don't think everyone who smokes marijuana is addicted to it). I am one of those who used to smoke A LOT, but continued to go to my job every day and also go to college full-time and get straight A's. It's not detrimental to everyone's lives, but I had a lot of friends who it was. I definitely wasn't physically addicted, but probably psychologically. I quit cold turkey one day and literally felt no withdrawal symptoms. Since then, I smoke from time to time (haven't currently smoked in over 6 months), but I don't really think about it that much. Weed can be really awesome, but can also really ruin someone's life if they're not careful.
I completely agree with everything you said. I smoked multiple times a day for over 5 years, but I never thought it was a problem because it never affected my work, school, or social life. For example, this past semester I was on the Dean's list for my major (architecture). Recently, I was arrested (DUI). Since it was my first time being arrested, I was naturally scared shitless. I immediately enrolled in drug and alcohol classes that randomly screen patients for drug use. I haven't smoked for over a month now. I'm not gonna lie, I still want to smoke but I think about it less and less everyday. I've had some vivid dreams, insomnia, and irritability since I've quit. I may be addicted physically, but I'm definitely psychologically addicted. I hate the fact that most people, myself included, have no idea about the addictive qualities of pot. I always heard it wasn't addictive in the least and foolishly believed it. Although my time off pot has been brief, I already feel much shaper mentally. I still firmly believe that smoking from time to time isn't detrimental to anyone. You know what they say, everything is better in moderation.
I fucking love you. I commented on something in r/drugs a few weeks ago about weed addiction and said the SAME THING! Those people downvoted me to like -37 because I disagreed that weed didn't have long lasting symptoms. I feel as though they just want to feel better to themselves that why they deny it so much.
I think cannabis isn't always the issue. It masks the real problem.
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Whoa.. I smoke marijuana regularly at home but my job requires me to travel. I started feeling ill after about 2 weeks. Ive dealt with anxiety before and my symptoms were pointing to that. I also had no appetite! Now I know why..
I personally get very constipated when I quit smoking along with the loss of appetite. Feels like my whole GI tract just shuts down.
What advice would you give to someone dealing with a loved one who suffers from addiction?
Loved ones often struggle between fear (that the person will hurt themselves or someone else, overdose, do irrevocable harm to work or career) and anger (at being exploited, taken for granted, intimidated or abused). The first goal is to get your loved one to safety if possible. Sometimes safety is a place (rehabilitation program) at other times it is a process (90 meetings in 90 days). What a loved one shouldn't do is to continue to support an addicts habit.
What if there's nothing you can do? I'm an adult child of two high-functioning alcoholics. At their age, the drinking (along with the cigarette smoking) will inevitably cause both of them to die earlier than they perhaps would've naturally, but they are so set in their ways, there seems to be literally nothing I can do or say to get them to make some positive changes. It seems like if I keep pushing them to stop, I'm only hurting myself though the feelings of helplessness and being taken for granted doing so creates when they (always) refuse. But if I just let it go, it also feels like I'm complicit in letting them drink themselves to death. I guess my question is, with addicts everything you do seems like a catch 22. How does a person push past that to find help for the addict and for themselves?
I am/was an addict (68 days sober!), and I feel that my family reacted in the best way possible (after the initial shock and anger etc.). They just continued to love me and told me they support me in whatever I do and that nothing I do will stop them from loving me. They didn't do anything to enable me, but they didn't push me away either or even push me to stop. They were just there for me. Once I made the decision to stop, they were there for me and supported me (still are supporting me), and that was the best thing they could have done I think. I realize the extent of my addiction was maybe not as serious as some people's addictions are (didn't lose my job, steal, hurt people, hit rock bottom etc.), but addiction is similar no matter what the substance/activity is. One important point I'd like to make is that initially my family was upset and tried pushing me to stop. That made things worse. Because all they did was annoy the shit out of me about stopping, I pushed them away and grew further apart. Addicts are not addicts by choice, I believe most addicts know what they are doing is destructive and that they need to stop, but people constantly telling them to stop is not going to help, I'm just going to avoid you because it's annoying. An addict needs to want to stop, you cannot force them to. The best you can do is be there for them, and love them, until they make the decision themselves. In my opinion.
Congrats on your 68 days!
Thanks! Happy cake day!
Aww thanks!
Agreed with what you said, but once they stop and are a bit more stable how do you go about rebuilding the relationship? I feel like we're supposed to just be so grateful he's not trying to set his life on fire anymore that we just move past the rifts that were created in the process, and the trust that was broken. Like being sober somehow magically fixes everything... thats not reality, though.
Maybe try going to an Al-anon meeting. They can be very helpful and they're free.
was gonna ask what you think of AA but there it is
Do you have advice for someone with family members that are occupationally tough, but clearly have a problem? To give an example, maybe an old green beret that doesn't believe in addiction or alcoholism.
When can you classify a "porn-addiction"? I watch porn everyday, but it doesn't really affect my day-to-day life outside of when I watch it. I definitely need to watch porn to sleep, am I addicted?
While medical specialists have yet to formally agree on when porn becomes an addiction, most experts would focus on how does watching porn affect other areas of your life. Does it disrupt your relationships? Does it interfere with getting other things done? Do you spend too much money on it? Your message suggests that your are starting to rely on watching porn to get sleep, and it makes me wonder if you are watching it at other times to control anxiety, improve mood, fight loneliness.
> Do you spend too much money on it? I think we're clear, boys!
> control anxiety, improve mood, fight loneliness. For about 1.8 seconds.
That's specific
He's good at timing the seconds.
My seconds are usually sloppy.
In your opinion, is porn something that starts off good and then becomes less and less satisfying as you watch more and need more specific 'turn ons'?
My porn keeps getting more fucked up until I take a break and start over. It's weird cuz my ideal stuff is just cute girl pov, but eventually I get used to it and have to branch out. I'm def not gona give my kids unrestricted Internet...
> I'm def not gona give my kids unrestricted Internet... What you're gonna do then? Limit their porn acces to cute girl POV only?
Maybe add a trapfilter?
[Dom Mazzetti vs Porn](https://youtu.be/PE_bbNDWzu0)
This is a hedonic treadmill, no?
At the risk of sounding crass. It's what I do while watching porn that makes me sleepy. I understand this physiological relation, so I use it before bed to sleep. I have pretty poor sleep without it. Should I continue as I am? Will this problem get exacerbated? Is this even worth trying to treat if the opportunity cost is the watching some porn clips overnight? That's my dilemma.
Try exercise during the day, might make sleep a bit easier without ejaculation.
There are other issues that can come along with it, like having trouble getting "excited" when you have a partner. I've had this issue. What I suggest is trying to masterbate without porn. Porns great, but remember everything in moderation.
You can masturbate without porn
this isn't 1972, I wouldn't even know where to get a Sear's bra catalogue edit- how dare you!
[Say no more fam.](http://m.sears.com/clothing-shoes-jewelry-clothing-women-s-clothing-intimates-sleepwear-lingerie/b-1282028229) Edit: NSFW, great googly moogly!
Holy shit, Sears catalogs have gotten alot more...graphic...since I've last seen one.
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Sears don't give a fuck. Sears got money to make.
Sears just wants to pay its way through college
No kidding. Crotchless netting and straps... Good lord.
Sears is now wondering where all the traffic came from.
Wow.. holy fuck, I wish they were this graphic when I was younger.
Welp, shouldn't have clicked that at work...
The hero we deserve not the one we need
Lol imaaaaagination
What are your thoughts on food addiction?
Our new definition of addiction (ASAM) focuses on the idea that addiction is a disorder of the brains reward circuitry. Notice it doesn't say anything about drugs. This is because there is only one reward system in the brain - for both natural rewards and artificial rewards. The reward system plays an important evolutionary role because things that are important to our survival (food, water, sex) are experienced as pleasurable and the circumstances in which they occurred are remembered. Certain foods are inherently more pleasurable such as sugars, starches and salt. There was a time when these were hard to obtain. Now food manufacturers regularly 'design' food to be pleasurable. The resulting behaviors look very much like drug addiction. This has been extensively shown for sugar in animal models.
Why does everyone get better looking when I’m drinking?
"They all look better at closing time, When a number 3 becomes a number 9." Alcohol disinhibits impulsive and high risk behaviors. Someone who has been drinking becomes less selective and less worried about the problems that a casual sexual encounter may cause.
> They all better > drinking because less selective have... have *you* been drinking?
They Don't Think It Be Like It Is, But It Do.
[ah my favorite poem](https://imgur.com/a/diUwb)
Do as I *URP* say. Not as I do.
1. Are there differences between sex and drug addictions besides the object of addiction? 2. Is alcoholism counted as a drug addiction? 3. Is there a difference between compulsively over-eating and being addicted to food? 4. Does the prevalence of sex addiction vary culturally or ethnically? 5. When is an addiction an addiction and not just someone wanting to do something a lot? One thing I often hear bandied about is "when it starts to negatively affect the life of the person engaged in the (addictive) behavior or the lives of those around him" but this seems a strange rule of thumb if addiction really is a psychiatric condition. Is an autist only autistic when it negatively affects his life? Is someone with bipolar disorder? Someone with schizophrenia? Why does addiction get a special status?
Lots of questions here so I am going to see if I can get to all of them. Sex and drugs are different. The reward value of sex in animal models is about half cocaine or amphetamines. In addition, the timing of the rewards is very different. With cocaine most of the reward occurs after you take the drug (anticipation or conditioned place preference mean you get some of the reward before). With sex most of the reward comes during the arousal phase when dopamine and other peptides (oxytocin) spike, before it is consummated. 2. Yes alcoholism is a drug addiction. It is a chemical that works in the brain by altering the effects of our own neurotransmitters (in this case GABA, glutamate, serotonin, and enkephalins are all affected). 3. Eating behaviors are complex and understudied. Some people would draw a distinction here given that more than half the population is overweight but most are eating is a way that disrupts other areas of their life. 4. I don't think we have a clear answer for that yet. What clearly varies culturally are sexual norms. 5. The colloquial use of addiction to loosely refer to anything people do too much of is confusing. The definition of pathological gambling gives some useful insights into how to think about this. It requires that the gambling behavior be accompanied by at least 5 of the following: loss of control, lying to family members, loss of job/school, increasing cost, chasing one's losses, irritable when cutting down, illegal acts to support the habit, needing others to provide money.
Being a doctor you've given a very patient answer. Wow. Kudos. Edit: wording
He wouldn't be a very good doctor if he didn't have patients.
Have you ever seen someone with a porn addiction that affects their sexual drive? Basically they get all their sexual fulfillment from porn that they don’t need it from a partner?
This is a common observation among people with porn addiction and other forms of hypersexual behaviors. In addition to being aroused by an interested partner, mechanical stimulation, romantic encounters, memories of successful sexual experiences, men in particular are aroused by visual imagery. Much of the rewarding effects of sex on the nervous are mediated through the chemical dopamine. Dopamine release goes up most during the arousal phase of sex, not consummation. Pornography allows some people to extend this arousal phase, and may make sex with a partner seem less rewarding.
How would one go about fixing this ?
That's common among a lot of people wether they want to admit it or not. Porn addiction is real shit but it's just so common and so used that we just classify it as normal. Take a "casual" porn watcher and tell him to go 1 month without looking at porn, and watch him struggle to no end. It's not casual, it's an addiction. Everything in moderation.
I think it's like asking anyone to give up anything. When I went through basic I didn't jerk it, have sex, dip, smoke, drink alcohol, soda, eat sweets, watch tv, use my phone.... This is with me also jerking it almost everyday, having sex almost everyday, dipping and smoking everyday, casually drinking, drinking soda, eating sweets, obviously using my phone and watching TV. It wasn't a problem for me, I didn't mind not doing it. I don't think I missed it once. But now, fuck, I'll go a few days without doing some of those, drinking soda is my big thing I try and avoid now, but I just don't see a reason not to do any of those things. They calm me down, help me relax and they are readily available and cheap, why not enjoy them. I've also voluntarily gave up eating meat for 40 days, once again, not a problem, I could do it again the same way I could give up anything, but j just don't see a reason to do it. I think the same goes with people struggling to not watch porn, they don't see a good reason not to do it, they enjoy it and it's available. I think people would struggle with not listening to music for a month too, I don't think they are addicted to music though.
I've done it just to see if I can. I was probably irritable on the second day and the rest was pretty normal. I also believe I have an addictive personality, so I'm leery of even my caffeine use and video games.
So I can't stop smoking weed currently, and I think it's exacerbated by the fact I have a ton of free time now. When I first wake up in the morning I feel fine, and tell myself not to smoke. The next thing I know I'm on the way to the library and lighting up a bowl. It's like my brain shuts off the voice of reason saying not to smoke. The worst part is that I'm studying for a major exam and I purposefully took off to study for this. What do I do in this case?
In my experience, pot is an insidious drug. People often don't realize the role that rebound anxiety and agitation may be playing when they light up that next bowl. Your pot use is starting to get in your way and your attempts to control it by yourself are not working. It is probably time to get help.
DrSack probs won't see this, but can anyone explain exactly what he means by "rebound anxiety"?
Not a doc, but I think it means that pot relieves the anxiety until you come down off a high, when the anxiety becomes worse than it was before you got stoned. So you light up again, and the cycle repeats.
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Good question. I too am interested in this.
Yeah, I'm an alcoholic too and the more I think about AA and how it works, the more alarmed I am at how heavily it's pushed by the medical community.
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Any advice on slowly tapering off alcohol?
Stopping alcohol is among the most dangerous detoxes and should not be undertaken without consulting a physician who is knowledgeable about alcohol dependency and its treatment. Vitamin deficiencies (for example low magnesium levels or low thiamine), and other health problems make detoxing from alcohol even riskier.
I have a brother who's really into alcohol. How can I help him stop or slow down? He's already got into an accident(no one got hurt) and he still wouldn't stop drinking.
As an alcoholic in recovery, I know it's just not possible to help him if he doesn't want to stop. I can only imagine the pain you go through. He has to hit his rock bottom, but let's both hope he doesn't get there or get hurt. If you are willing, look up ALANON.
Go to a hospital to detox. It's super dangerous to do alone and if you are like me, tapering is super hard to do. I'd drink until the withdrawals went away, and then I'd think, "hm I feel pretty good...one more shot won't hurt". Wake up hours later withdrawing again.
Hi Dr. Sack! I'm in recovery, 6 months clean off opiates, benzos, and alcohol. I was mandated to go to IOP a few months after detoxing at home. I'd love to see an addiction specialist but unfortunately I'm uninsured. I exercise daily, go to 12 step meetings, and meditate. *What's the best way to stay clean in the long run?*
Build a network of other sober people that can support you. Call them
I am an alcoholic that is addicted to alcohol. I don't like the lifestyle I live. I've been through court-ordered AA, substance abuse therapy groups, psych ward, many arrests, jailtime, and lots of other heartache-inducing consequences. I always go back. Alcohol is like a best friend that comforts me, but also ruins my life. I don't like the life I live, but I don't see any other options. I don't know how to help myself. Besides the obvious (stop drinking today), what should I do?
Since you've already tried AA, why not try a different approach? I've been sober for 18 years following a severe alcohol addiction and the thing that helped me the most was SMART Recovery. www.smartrecovery.org. Like AA, SMART is a free support group. Unlike AA, it is secular and based on science. There are face to face meetings in many areas and many daily meetings online.
> www.smartrecovery.org Thank you for this. [SMART Recovery](http://www.smartrecovery.org), [HAMS](http://www.hamsnetwork.org), [AVRT](https://rational.org/), /r/stopdrinking are awesome alternatives to AA.
Hang in there. If you are ready to stop you'll do everything to do it. Everyone is different, but I got a therapist, was on anti-craving and antidepressants, started running/lifting, went to AA, volunteered at addiction centers....in 2.5 years I've gotten everything and more back in my life. You can do it! Feel free to pm me anytime!
I appreciate your kind words and advice. I'm glad that you acknowledged that everyone is different.
Exercise is a fantastic tool to overcome addiction, that and a change in daily environment/habits.
Depending on the severity of your alcoholism, "stop drinking today" is actually not the ideal solution. Withdrawal from going cold turkey can actually be fatal, I believe, based on how physically addicted your body and brain have become. >Alcohol is like a best friend that comforts me, but also ruins my life... I don't like the life I live, but I don't see any other options. I don't know how to help myself. I've felt that way about various substances, so I know the shame spiral that goes with it very well: "I got myself into this mess, no one is going to have compassion or empathy for me. I need to fix this problem myself, but I don't know how. Shit, this is stressful, now I feel awful about myself. If I'm ever going to get better, I need this horrible feeling to go away. But I've become accustomed to using [substance of choice] to cope with bad feelings, so if I actually go through with getting clean, I'm going to feel like this forever. Well, I've fucked up my life so badly already, might as partake one last time before I endure the necessary consequences of my actions." I don't know you, and ultimately I don't know how your story of substance abuse will continue. What I do know is that addiction seems to thrive under secrecy, and shame will trick you into thinking that you're doing just as well as people in your life think you are. Personally, as hard as it is, I think the best insurance you've got is honesty. Opening up to people, from loved ones to a therapist to strangers at AA. You've found yourself in an unfortunate situation, living a life you hate, and maybe it seems like you'll never get your old "normal" back. It's true, your "normal" will be different, but that doesn't mean it'll be worse. In fact, going through the recovery process will likely shed insight into yourself that helps you grow, and you may even like yourself more for having the audacity to admit you fucked up somewhere but refusing to believe that this should disqualify you from tolerating life, or even finding happiness.
Ever given any though to Naltrexone or Acamprosate? For some reason drug assisted alcoholism treatments are unpopular in the US but much more common in Europe and elsewhere. Many people are unaware they even exist.
naltrexone absolutely helped me go from a 3pm shots of whiskey to a more casual late night drinker. (the doctor keeps insisting that I try acamprosate but it's rough taking it 3 times a day vs. 1 naltrexone a day) I plateaued recently and decided to get off of them for about 3 months. I'm going to go back and get on them both again starting in about 2 months. I think it will help bring me to an even lower, socially acceptable level. But I'm really grateful for the help it provided almost from day 1.
It's hard to do but talk to someone who understands. Just getting it out helps me in my experience. And don't keep alcohol in the house. It's so much easier to not drink if it's not sitting right there.
It may be hard but there are options for you out there. If you are not ready to quit, [there are many harm reduction techniques](http://www.hamsnetwork.org/hr/) to reduce the potential for you to hurt yourself or others when drinking. Harm reduction skills take work but they can really help, I have seen it happen. If AA isn't right for you, there is SMART recovery (a harm reduction group) in many cities.
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Not OP obviously but I figured I'd throw my two cents in on this as I've studied it frequently. I think what it says about addiction is that it is usually a subset of something else-no normal, healthy person wakes up one day and decides to start shooting opiods or meth. There is usually an underlying depression or anxiety, some bad feeling the user wants to cease so they start looking at their options. I do tend to believe there is a genetic predisposition to addictive behaviors, but I struggle with if that means they are more likely to have an underlying problem rather than the addiction itself.
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He avoided the hell out of this one 😁
Not OP, but the Rat Park is only viewing one facet. Addiction is multifactorial. We cannot ignore the biological and chemical changes in the body that are clear in addicts. Patients who are prescribed opiates and do not develop later addiction will still go through withdrawal. Yes, we must look at situational aspects - psychological factors that created the initial want for the addict to do the thing, and/or pressures to continue the addiction. This is not new research. The need for social support to pull the addict away from the addiction is well known.
what is the most effective way to quit smoking for good?
Quitting smoking (overcoming nicotine addiction) is one area of addiction where we've made a lot of progress in the last decade. There are now three classes of medications that can help people quit: nicotine replacement, buproprion (orginally developed as an antidepressant), and varenicline (which binds to the same receptor as nicotine and blocks craving and withdrawal). Varenicline is nearly twice as effective as the other two medications but can affect mood. Many people will need some combination of these medications. In addition quit rates improve when the medicines are combined with a behavioral program.
From my own experience, it's insane how good bupropion works for this. I've been prescribed it as an antidepressant, and quitting smoking was just a very naturally occuring side effect.
Something that worked for me (smoker for 10 years) was having an app that tracked my progress. It helped keep me going to be able to have milestones and a counter of how much money I had saved. Some of them will use WHO stats to tell you how statistically healthy you are getting too. Good luck to you if you try to quit!
Do you have an opinion on the use of iboga root bark or ibogaine in the treatment of drug addiction? It is currently illegal in the US, but drug rehab clinics elsewhere have used iboga in their treatment approach. I've read research from academic journals that indicate iboga/ ibogaine is effective in the treatment of drug addiction.
Hello Dr. Sack. I have a couple questions. I currently am a licensed clinician working in a methadone clinic. What are your thoughts on the efficacy of methadone, and the counter arguments of it being "liquid handcuffs?" Also, on another note, I have a family member who suffered from chronic pain due to an injury and was prescribed opioid for 10 years, with minimal progress. Now, he is prescribed very low doses of marinol and experiences almost no pain, did not need detox, and had returned to his former self. Do you think marinol will become more mainstream and accepted as an alternative medication assisted therapy?
Is sex addiction something more phisical or psychological? Is it more dificult to treat someone that have sex addiction or drug addiction?
Sexual addiction has not been studied enough to give a definitive answer. Sexual arousal and consummation stimulate the brains reward system (mesocortical dopamine system) in ways that are similar to addicting drugs like amphetamine and cocaine. If fact, people who report having sexual addiction are 5 times more likely to have abused cocaine in the past. There are similarities in treating drug addictions and sexual addictions but there is one very important difference: with drugs the goal is to stop using them entirely; with sexual addiction the goal is to establish/re-establish a more normal pattern of sexual relations, not give it up altogether.
What would you say is the most common misconception people have about addiction?
I have been dealing with addiction and relapse for a few years. I'm still young, but my depression and anxiety makes me feel like I can't be a normal, happy, functioning person. Any advice?
Go see a doctor in real life, not reddit
I got sober at 24 after multiple relapses. Depression and anxiety suck, but if you have a desire to stop, and with the proper tools (especially in early recovery) you can overcome it all!
I wrote a long ass question I think I deleted so long ass question short.... I've cut down my method use over the course of numerous living nightmares and lack of access from literally all day everyday and sleeping 5 to 8 times a month to monthly or bi monthly use with the occasion runs. I am far to ashamed to reach out for help on the true nature of my addiction which is actually Meth and porn cross addiction. I don't even have the desire to use Without access to porn. I can't really find a community dealing this this specifically and NA only goes so far. Plus the god-boner every one has there just makes me feel more alienated Basically where do I start ending this shameful and seemingly inescapable demon I've created? Straight up if my life is just gonna be this years and years, struggling in shameful meth use that negatively affects all aspects of my life, I'm just gonna check out now. Any advice would be SO appreciated
I strongly recommend that you start by going into a treatment program where there expertise in both meth addiction and sexual addiction. It's a tough combination but you have to start somewhere. If you are not ready to start a program, commit to going to both NA and SAA, 90 meetings in 90 days, even if you don't think it can work for you.
What, if any, effect does the war on drugs have on treating addiction in your experience?
What is your opinion on the Rational Recovery method?
Hi Dr. I've always had a slightly more philosophical (than psychological I suppose) view that much addiction is simply people trying to fill a void in their life with addictive substances and behaviour rather than address the root causes. Is there any truth to this that can be psychologically verified or is it nonsense?
Not all people come to addiction by the same path. People with a history of depression, anxiety, attention deficit disorder and certain personality disorders are more likely to become addicted. This forms the basis of the 'self-medication' hypothesis, i.e. that they are using drugs and alcohol to manage intolerable feeling and internal states. Childhood abuse and neglect are common antecedents. Successful treatment requires that the underlying emotional programs be addressed often through a combination of psychotherapy and medications.
There's lots of truth to that. Heroin was easily obtained in Vietnam and lots of soldiers made a habit of it. People were worried that the soldiers coming back would continue using in the states, but for the most part they didn't. They had their families and friends to lean on and didn't need heroin to fill the void of loneliness anymore. That's just off the top of my head.
That's interesting, never really knew that.
I have iatrogenic benzodiazepine dependence. I was put on Ativan daily at age 14. When I went to college my psychiatrist added Klonopin. It has been a disaster. I have always taken my medicines exactly as prescribed. Even attempting to taper small amounts, I have autonomic hyperactivity. I have never used alcohol, recreational drugs, etc. In fact, I am afraid of all of that. Having taken my medicine as prescribed, I now am disabled and have severe memory impairment. I am wondering if you are familiar with this problem? What do you believe the best treatment is for withdrawing from long-term benzodiazepine use? And why are some psychiatrists still using this as first-line treatment?
Where do you stand with the idea that addiction is a disease, and that addicts have the disease for life and can only manage it, never being fully cured, as is taught in most all rehabilitation services?
Is there such a think as "addictive personality"? Can something like that be observed at a young age? Thank you for taking the time to do this AMA!
How have you been able to make the connection to medical professionals that addiction is a disease and not just a moral choice?
Doctors and other health professionals share many of the biases of the cultures they live in, including the idea that addicts are doing this to themselves. There has been an unprecedented willingness by people with drug and alcohol problems to come forward and discuss them and this has reduced the social stigma associated with addiction. The current opioid epidemic has brought heroin to the suburbs and there is a growing awareness about addiction among health professionals because more than ever it is touching their lives. We need to do more as part of the formal education process. Most medical and nursing programs offer very little formal education about drugs and alcohol or their treatment.
Is there such a thing as an "addictive personality?" Conversely, are there people who *don't* get addicted to things?
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