As a recovering addict myself (opiates due to Army-related back injury...and a lot of other things that I was keeping bottled up for decades), I can't really disagree with anything you said. That fear of relapse is why when I go in to a doctor, one of the first things I'll tell them is to never give me opiates.

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Addiction permanently changes the brain. So literally once you are an addict you are always an addict. It might take you a year to become addicted to something. If you recover and are doing well, it takes only days to get back to that point. Those brain pathways are always there.

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If we can permanently change the brain one way, what's preventing us from permanently changing another? Are these pathways "destructive", for lack of better term.

Maybe in other words, can we not leverage the "addictive effects on the brain" for good?

diehard03 said:

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Addiction permanently changes the brain. So literally once you are an addict you are always an addict. It might take you a year to become addicted to something. If you recover and are doing well, it takes only days to get back to that point. Those brain pathways are always there.

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If we can permanently change the brain one way, what's preventing us from permanently changing another? Are these pathways "destructive", for lack of better term.

Maybe in other words, can we not leverage the "addictive effects on the brain" for good?

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It's more the other way around to my understanding. Our brain is designed to make strong connections. We do this with language, walking, swimming, riding a bike. That's why we can go years without doing these things and pick them back up again very quickly. Addiction uses these same processes in a maladaptive way

Neuroplasticity is a real thing. The same entrenchment that wires addiction into our cognition can be re-wired. This is how PTSD and other mental health disorders are treated.

The etiology if addiction seems to me to be primarily spiritual. St. Augustine said it well in the 4th century: " you made us for yourself oh God and our hearts are restless until they rest in you.

What kind of model do you advocate for addiction? Are you a fan of the RDoC criteria? Do you see if as challenging for any models of addiction?

It seems to be a growing problem for some reason over the past 10 years. Across the spectrum from wealthy/celebrities to the very poor. I note it sort of correlates with a decline in church attendance, perhaps the two are not unrelated, but at the same time the problem doesn't seem as extreme in Europe.

I dunno.

I think the modern climate puts more pressure into being great. I see my peers and others around me and see all the great things they do and I feel like I need to do that as well.

Then you get on Facebook, LinkedIn, or even Texags and it seems like everyone is rich, successful, and has it figured out.

Meanwhile I don't feel like I have it figured out so I get depressed which leaves the door open for many things.

FTACo88-FDT24dad said:

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Neuroplasticity is a real thing. The same entrenchment that wires addiction into our cognition can be re-wired. This is how PTSD and other mental health disorders are treated.

The etiology if addiction seems to me to be primarily spiritual. St. Augustine said it well in the 4th century: " you made us for yourself oh God and our hearts are restless until they rest in you.

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Neuroplasticity is real but becomes less versatile with age. Language is a good guide here. A 3 year old can permanently forget their first language and pick up a new one without an accent. A 30 year cannot do either of those things. Babies and toddlers can have addictions, then grow up problem-free. Teens and older end up laying down permanent connections that are very easy to reactivate even after decades.

I agree on the spiritual aspect. Happy, healthy, content people don't become addicts. The first steps to addiction are always trying to use whatever to treat or ignore some deep misery

americathegreat1492 said:

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What kind of model do you advocate for addiction? Are you a fan of the RDoC criteria? Do you see if as challenging for any models of addiction?

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Definitely the disease model. It seamlessly integrates into what we do already, and the research is really good.

I'd never even heard of the RDoC criteria. It hasn't percolated down to us yet, I guess. It makes sense, but I don't think the biochemistry and lab capabilities are there yet. I do like the emphasis on psych problems as biological problems.

And no, I am in no way an innovator in this field. Very much a follower

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Neuroplasticity is real but becomes less versatile with age.

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My wife has to remind me that this is likely the reason that my parents continue to struggle with misgendering me, whereas kids have absolutely zero issue with getting it right.

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I think the modern climate puts more pressure into being great. I see my peers and others around me and see all the great things they do and I feel like I need to do that as well.

Then you get on Facebook, LinkedIn, or even Texags and it seems like everyone is rich, successful, and has it figured out.

Meanwhile I don't feel like I have it figured out so I get depressed which leaves the door open for many things.

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Social media has been a net negative on society, imo due to this.

diehard03 said:

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I figured at some point someone would bring in transgender to this thread that is about addiction.

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Or, as you can see, both are part of her story and they tend to intersect.

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And my comment was simply about neuroplasticity. I think he just wanted to use his standard laugh/cry emoji again.

nortex97 said:

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PacifistAg said:

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Neuroplasticity is real but becomes less versatile with age.

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My wife has to remind me that this is likely the reason that my parents continue to struggle with misgendering me, whereas kids have absolutely zero issue with getting it right.

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I dunno if you intended that as a joke but I laughed. I figured at some point someone would bring in transgender to this thread that is about addiction.

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No, I used a personal example to respond to ramblin's point about neuroplasticity.

Nevermind, I'm stupid.

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Nevermind, I'm stupid.

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No problem. So am I.

What???

From Luke 11:

24 "When an impure spirit comes out of a person, it goes through arid places seeking rest and does not find it. Then it says, 'I will return to the house I left.' 25 When it arrives, it finds the house swept clean and put in order. 26 Then it goes and takes seven other spirits more wicked than itself, and they go in and live there. And the final condition of that person is worse than the first."

I think this describes the spiritual side of addiction well. Particularly the effects and risks of relapse.

nortex97 said:

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PacifistAg said:

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nortex97 said:

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PacifistAg said:

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Neuroplasticity is real but becomes less versatile with age.

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My wife has to remind me that this is likely the reason that my parents continue to struggle with misgendering me, whereas kids have absolutely zero issue with getting it right.

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I dunno if you intended that as a joke but I laughed. I figured at some point someone would bring in transgender to this thread that is about addiction.

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No, I used a personal example to respond to ramblin's point about neuroplasticity.

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Maybe you are the one who has a neuroplasticity issue with regard to talking about your gender? I don't think we should agree to jump on your parents about it with you.

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We must be careful here. The argument specifically is that while neuroplasticity exists, there's no study showing it leads to gender dysphoria, ergo it's something to disregard despite all we know about it. People who change how they dress, think, and act couldn't possibly rewire their brains in the process, especially in a society that affirms such things (or even subcultures that have existed outside the mainstream where they're embraced and shown affection they weren't given elsewhere). Thus brain scan studies where subjects self select for the study must show a static brain and remain unchallenged or something…it's all quite hazy really. If it's supports the cause embrace it, if it doesn't discard it (until it supports the cause again!).

There has also been a lot of research into what is driving drug overdose deaths. An interesting and surprising finding is that stricter drug laws correlate with higher overdose deaths. On the other hand, decriminalization and addiction management programs, whether public or private, seem to decrease overdose deaths. Of course medicine and social science are complicated, so it's not easy to tease out. But those trends are pretty clear.

Just in the past 10-15 years it continually becomes more difficult for doctors to prescribe narcotics. First they would categorize you as a pain doctor is a certain percentage of patients were on narcotics. That requires a special license, training and supervision, and you get in big trouble if you don't comply. Then they moved all the narcotics to more restrictive classes of controlled substances which require special permits to prescribe. Recently, they've limited opiate prescriptions to 7 days unless you jump through a lot of hoops. Certain large chain pharmacies will also refuse to fill narcotics over a certain amount using some arcane calculations. On the one hand, this has been effective. Doctors are prescribing less narcotics than ever. About one doc per year in a 50 mile radius of me gets in trouble with the state for missing something regarding narcotics.

Good news right? Wrong. While we're prescribing less and less, more and more people are dying of overdoses. How does that make sense? Well, there is a thriving black market for these things. Addicts don't just stop being addicts when they can't get narcotics from their doctor. They go find it somewhere else. When you're addicted to something, it literally becomes the most important thing in your life. People are going to expend all their effort and resources to obtain their addiction regardless of the consequences. So these people end up borrowing or stealing from family members or buying these off the streets. Suddenly a controlled situation guided by a doctor is in the hands of the addict themselves, shady drug dealers, or untrained family members.

Portugal has been an amazing success story for the opposite reason. They completely legalized all drugs and the public health system has awesome programs that can either help with abstinence or help with regular maintenance and control of addiction. Their overdose rate is far lower than ours and their rate of drug use in general is lower as well. And it's been that way for 20 years. During that time, we've gotten more strict and more people are dying. They've gotten less strict and less people are dying. It will be interesting to look at Oregon, as they just pushed through a big decriminalization program. I haven't been able to find any reports on their overdoses since they made the change, though. Everything is still lagging a few years

Your Portugal point is off. I'll have to go find the article but they're swinging back the other way. Will take time.

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I also never buy Oreos because the whole box will be gone in 1-2 days.

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Sweet Lord - this.

I think it's also worth figuring out why people get addicted or use in the first place. I can relate to the HS QB with a shoulder injury and prescribed Oxy and is now a heroin addict, as a reason I wouldn't ever take opiates for pain relief. But I think there's a clear line drawn to income inequality, lack of meaningful work through neoliberalism, the decline in church membership (loss of community) etc that can make addiction as much an economic and sociology phenomena as it is a biological issue as well.

I am not at all an advocate of a biomedical disease model of mental disorders in general. Why is a really complex discussion. I suppose this would be a minority opinion in psychiatry, but it's a widespread enough opinion in psychology. Short story is flawed arguments and questionable empirical support. What data mean are not obvious. Here is somewhat of a primer on addiction models that discusses the different ways in which neuroscience research can be interpreted to support either a disease model or a developmental-learning model. The author argues for the latter.

https://pubmed.ncbi.nlm.nih.gov/30332573/

diehard03 said:

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We must be careful here. The argument specifically is that while neuroplasticity exists, there's no study showing it leads to gender dysphoria, ergo it's something to disregard despite all we know about it. People who change how they dress, think, and act couldn't possibly rewire their brains in the process, especially in a society that affirms such things (or even subcultures that have existed outside the mainstream where they're embraced and shown affection they weren't given elsewhere). Thus brain scan studies where subjects self select for the study must show a static brain and remain unchallenged or something…it's all quite hazy really. If it's supports the cause embrace it, if it doesn't discard it (until it supports the cause again!).

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just FYI, linking neuroplasticity and transgenderism isn't the point whatsoever. Pacifist was talking about her parents failing to call her by the right context while her younger child was able to pick it much quicker.

Just because someone vaguely mentions transgender doesn't mean we have to relitigate the entire concept.

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That's, like, your opinion man.

Malibu2 said:

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I think it's also worth figuring out why people get addicted or use in the first place. I can relate to the HS QB with a shoulder injury and prescribed Oxy and is now a heroin addict, as a reason I wouldn't ever take opiates for pain relief. But I think there's a clear line drawn to income inequality, lack of meaningful work through neoliberalism, the decline in church membership (loss of community) etc that can make addiction as much an economic and sociology phenomena as it is a biological issue as well.

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Preach brother! I've mentioned it before but Chris Arnaude's book Dignity is a good and quick read.

diehard03 said:

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We must be careful here. The argument specifically is that while neuroplasticity exists, there's no study showing it leads to gender dysphoria, ergo it's something to disregard despite all we know about it. People who change how they dress, think, and act couldn't possibly rewire their brains in the process, especially in a society that affirms such things (or even subcultures that have existed outside the mainstream where they're embraced and shown affection they weren't given elsewhere). Thus brain scan studies where subjects self select for the study must show a static brain and remain unchallenged or something…it's all quite hazy really. If it's supports the cause embrace it, if it doesn't discard it (until it supports the cause again!).

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just FYI, linking neuroplasticity and transgenderism isn't the point whatsoever. Pacifist was talking about her parents failing to call her by the right context while her younger child was able to pick it much quicker.

Just because someone vaguely mentions transgender doesn't mean we have to relitigate the entire concept.

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I swear, it's always the same posters who make this place so tiresome.

Malibu2 said:

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I no longer drink alcohol (going on 4 years now) as it has caused problems and I've just concluded that some things in life aren't for me. I also never buy Oreos because the whole box will be gone in 1-2 days. In high school I wisely concluded that owning a video game console was going to hold back my academic potential and haven't owned one since Nintendo 64. I also like gambling, psychedelic drugs, long distance running (those sweet sweet endorphins), and posting on TexAgs. In short, I have an addictive personality and have had to engineer my life and choices around my natural predispositions.

More interestingly, my father was adopted and through ancestry.com I was able to figure who his birth parents were. I also read some newspaper articles about my biological paternal grandfather's frequent stints in jail with DWI, and his ultimate death from drinking related liver problems. That made me feel somewhat better that my natural isms may be more biological than moral failings.

AMA.

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Gave up video games for marriage, Oreos for the same reason. Not addicted to alcohol but I've come close and had to stop daily consumption for awhile when it was my go to for stress.

Copenhagen. Sweet sweet Copenhagen.