The Opioid Epidemic - A.K.A The Crisis of Addiction

Discussion in 'Politics & Current Events' started by superdave, Mar 30, 2017.

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  1. Dr. Wankler

    Dr. Wankler Member+

    May 2, 2001
    The Electric City
    Club:
    Chicago Fire
    https://www.vox.com/policy-and-poli...ddiction-treatment-sean-blake-opioid-epidemic

    Vox is looking into an under-explored aspect of the problem: Rehab is not only less effective than it should be, and it is often pretty close toa scam.


    In story after story, the same experience was repeated over and over: of patients and families getting sucked into an American rehab industry that is largely unregulated, shockingly ineffective, and ruinously expensive.

    Vox is launching an investigation into the notoriously opaque addiction rehab industry, called The Rehab Racket. We’re crowdsourcing the experiences of patients and families, with an emphasis on cost and quality of care. . . .
    ...
    Addiction treatment is difficult work, but it can succeed, and evidence-based care does exist. For opioid addiction in particular, studies show medications like methadone and buprenorphine cut the death rate among patients by half or more.

    But the parents I spoke to have learned — as thousands of Americans discover each year — that much of the US rehab industry does not provide evidence-based, effective care.

    American rehab is dominated by a 12-step approach, modeled after Alcoholics Anonymous, that only works for some patients and doesn’t have strong evidence of effectiveness outside of alcohol addiction treatment.

    hat’s often coupled with approaches that have even less evidence behind them. There’s wilderness therapy, focused largely on outdoor activities. There’s equine therapy, in which people are supposed to connect with horses. There’s a confrontational approach, which is built around punishments and “tough love.” The research for all these is weak at best, and with the confrontational approach, the evidence suggests it can even make things worse.

    “It is a scam,” Carol Beyer, founder of Families for Sensible Drug Policy and a mom in New Jersey, told me. She estimates she spent well over $100,000 on treatment — including 12-step and “tough love” programs — and still lost her two sons to drug overdoses.​

     
  2. dapip

    dapip Member+

    Sep 5, 2003
    South Florida
    Club:
    Millonarios Bogota
    Nat'l Team:
    Colombia
    1. I remember reading somewhere that drug rehab is basically that, a scam, and that there are companies specialized in skimming insurance companies, and that they lure addicts with perks, then clean them up a little and then entice them back. I think this was the article:

    https://www.usatoday.com/story/opin...t-they-deserve-editorials-debates/1671792002/

    Or maybe it was from mj?

    https://www.motherjones.com/crime-justice/2019/02/opioid-epidemic-rehab-recruiters/

    2. So, faith based therapies don't work? I'm shocked!!!
     
  3. Q*bert Jones III

    Q*bert Jones III The People's Poet

    Feb 12, 2005
    Woodstock, NY
    Club:
    DC United
    One thing I've never understood is how humans could have evolved a genetic predisposition to get addicted to stuff, like alcohol, that has only existed in any great measure of consumption for a blip of relative time, like 15,000 years at the very most.
     
  4. song219

    song219 BigSoccer Supporter

    Apr 5, 2004
    La Norte
    Club:
    DC United
    Nat'l Team:
    Vanuatu
    You don't "cure" anyone of an addiction and you certainly don't do it in 28 days. If it was that easy to cure you wouldn't need a rehab-a detox would be enough.
    What is amazing is that anyone stays clean for any significant amount of time.
     
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  5. Dr. Wankler

    Dr. Wankler Member+

    May 2, 2001
    The Electric City
    Club:
    Chicago Fire
    This is one of the things that the super-moralists don't understand. "Why don't they just stop after two or three drinks like me?" Because you can stop at two or three drinks, but an actual addict can't. That's something I've learned. I drink more than I should, but the result is weighing more than I need to, not full-blown alcoholism. And it's luck of the draw that keeps me from being an alcoholic, and not moral superiority as evidenced by my self restraint when I cut myself off every night I drink well before reaching the shitfaced stage.
     
  6. soccernutter

    soccernutter Moderator
    Staff Member

    Aug 22, 2001
    Don't drink beer but like cheese
    Club:
    Tottenham Hotspur FC
    Nat'l Team:
    United States
    Somebody else did something about a year or so ago as well. Like On the Media or RadioLab...maybe Fresh Air, I don't remember. But basically said the same thing - rehab programs like The Betty Ford clinic are highly unregulated and there is little evidence they are successful...what ever successful means.
     
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  7. Q*bert Jones III

    Q*bert Jones III The People's Poet

    Feb 12, 2005
    Woodstock, NY
    Club:
    DC United
    You might be thinking of Reply All’s jawdropping expose of the rehab racket.
     
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  8. sitruc

    sitruc Member+

    Jul 25, 2006
    Virginia
    I've heard reporting in several places. It's definitely not an original topic.
     
  9. russ

    russ Member+

    Feb 26, 1999
    Canton,NY
    Club:
    Liverpool FC
    Nat'l Team:
    United States
    Particularly given the stigma given to mental health issues,which is what many substance abusers are unknowingly trying to self-treat.
     
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  10. dapip

    dapip Member+

    Sep 5, 2003
    South Florida
    Club:
    Millonarios Bogota
    Nat'l Team:
    Colombia

    IIRC, we share that trait with at the very least, other primates, so it might be related with our brain processing certain substances, plus the actual high coming from your own brain, not the alcohol or drugs.

    https://allthatsinteresting.com/drunk-monkeys-st-kitts

    A controversial research project that involves giving alcohol to 1,000 green vervet monkeys has found that the animals divide into four main categories: binge drinker, steady drinker, social drinker, and teetotaller.

    The vast majority are social drinkers who indulge in moderation and only when they are with other monkeys – but never before lunch – and prefer their alcohol to be diluted with fruit juice.

    Fifteen percent drink regularly and heavily and prefer their alcohol neat or diluted with water. The same proportion drink little or no alcohol.

    Five percent are classed as “seriously abusive binge drinkers”. They get drunk, start fights and consume as much as they can until passing out. As with humans, most heavy drinkers are young males, but monkeys of both sexes and all ages like a drink.

    Now that I think, cats get high on catnip, and I think some wild animals binge on 'rooms or rotten fruit.

    https://www.alternet.org/2014/12/animals-addiction/

    However, there are many examples of animals in their natural habitats that deliberately seek out substances for inebriation. And in almost every case, they are the same substances mankind has used for centuries.

    The case of fermented fruit is the best known one. Video footage shows a variety of African animals putting their rivalries aside to enjoy the Marula fruit when it’s fermented. Drunken elephants pal around with tipsy monkeys; even an ostrich stumbles away with the promise of a serious hangover. But this being nature, there are much stranger methods employed by animals to get high.

    Australians wallabies, so cute and fuzzy, seek out poppy plants to indulge in the opiates within. Dogs who live by cane fields learn to harass certain toads that inhabit them until they release their glandular bufotenin, a form of the hallucinogen, DMT. This is the same psychoactive substance enjoyed by humans who lick toads and drink ayahuasca.

    Sh!t... Toadies!!!
     
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  11. Dr. Wankler

    Dr. Wankler Member+

    May 2, 2001
    The Electric City
    Club:
    Chicago Fire
    Catnip? Not for this guy.



    Video of a jaguar eating and tripping on ayahuasca
     
  12. soccernutter

    soccernutter Moderator
    Staff Member

    Aug 22, 2001
    Don't drink beer but like cheese
    Club:
    Tottenham Hotspur FC
    Nat'l Team:
    United States
    I came across some research a year or two back which suggested that we have always had this trait. In the past, it was beneficial in terms of hunting or gathering or other things along those lines, but since the discovery and advent of inebriating substances, this trait is now a negative. I've been trying to find that research for a while with no luck.
     
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  13. soccernutter

    soccernutter Moderator
    Staff Member

    Aug 22, 2001
    Don't drink beer but like cheese
    Club:
    Tottenham Hotspur FC
    Nat'l Team:
    United States
    Nope, don't listen to that one...but taking a quick look, might have to add it.
     
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  14. Q*bert Jones III

    Q*bert Jones III The People's Poet

    Feb 12, 2005
    Woodstock, NY
    Club:
    DC United
    I can't recommend it highly enough.
     
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  15. Dyvel

    Dyvel Member+

    Jul 24, 1999
    The dog end of a day gone by
    Club:
    Leeds United AFC
    Nat'l Team:
    Ireland Republic
    At some point in my late 40’s I went to the fridge for what I thought was my fourth of the night but turned out to be my sixth. That’s when I began a “no more than four” rule at home. I come from a long line of alcoholics and addiction problems run deep in my family. I’ve been to too many funerals already. The hard part now is the funerals of the children of my friends. The opiate problem has decimated the young adult population.
     
  16. bostonsoccermdl

    bostonsoccermdl Moderator
    Staff Member

    Apr 3, 2002
    Denver, CO
    This is the most frustuating part. A study from from Harvard awhile back estimate only 5-10% of the addicted community sticks with the program. It has a terrible success rate, yet is the go to model for rehabs.
    (If you were to walk into a board meeting and touted a 5-10% success rate, you would laughed of the room.)
    They also have a nifty habit of cliches where they turn it around on the patient to instill guilt and make it there fault when questioned.
    We need to be better as a society and at least challenge the 12 step model because it simply isn't effective.
     
  17. luftmensch

    luftmensch Member+

    May 4, 2006
    Petaluma
    Club:
    Los Angeles Galaxy
    Nat'l Team:
    United States
    We evolve all kinds of annoying shit, like allergies of various kinds, and it doesn't necessarily have to take a long time.

    I actually read an interesting book not too long ago pointing out the flaws of the paleo diet argument, and one of them was that physical evolution isn't always as slow a process as we're led to believe. Her biggest example was a positive one, the evolution of lactose tolerance in certain populations, but it applies to the evolution of things like addiction predispositions as well.
     
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  18. Dr. Wankler

    Dr. Wankler Member+

    May 2, 2001
    The Electric City
    Club:
    Chicago Fire
    What book is that? P.M. if it is the sort of "bro science" I read all the time but never post in the "What Are You Reading" threads in the Books forum.

    I think it's funny that Paleos and Vegans use the same argument against dairy. "It's not natural."

    Neither are clothes.
     
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  19. Dr. Wankler

    Dr. Wankler Member+

    May 2, 2001
    The Electric City
    Club:
    Chicago Fire
    It has a higher success rate in certain limited contexts. But its success rate is within the margin of error of zero when it's part of a court-mandated treatment.

    The church nextdoor to me hosts meetings three nights a week. Sunday night is court-ordered treatment night. I've found needles in my flowerbed on three occasions, and I suspect they landed there on Sundays.
     
  20. soccernutter

    soccernutter Moderator
    Staff Member

    Aug 22, 2001
    Don't drink beer but like cheese
    Club:
    Tottenham Hotspur FC
    Nat'l Team:
    United States
    While I do understand this, and do agree, I am coming from the perspective of having accepted that addiction is a medical condition, not a psychological one, and not a choice.
    But there are a couple of aspects to which "success" is not clearly defined. For example, oncologists will say cancer is beaten when somebody goes 5 years in remission. But no such definition is present for addiction. Is success 30 days? 90 days? 12 months? 5 years?
    But also regarding "success," does that mean never indulging in that behavior? If an alcoholic has a drink single drink, does that mean they have relapsed? Is the only definition of success total abstinence?
    But going even further, what does addiction mean? What defines an alcoholic? Regarding alcoholism, the common definition usually involves getting drunk (usually daily, or multiple times a week). But 12 steppers will tell you alcoholism is something with drives the decision making. So one person who can get drunk every Saturday can be fine while the next person who gets drunk every weekend can be an alcoholic.

    MInd, I have been through some of the research, and both the definitions of "addiction" and "success" are not consistent.

    With all that said, I have a serious issue with many of the recovery programs which use the 12 step program. The issue with them is that they tout what they us, but those in AA or NA or GA or what ever A have a desire to get clean which is self-driven. The recovery programs are not in those recovery-for-money programs, they are present to take money, and I will never promote them. But I will promote a smaller, self-funded 12 step program as it is driven by the self-motivation to get clean.

    Yet, one thing which I found very interesting is that there is a difference in how people manage addiction as compared to brain development. It seems that those who start their addictive behavior before their brain is fully developed, they have a more difficult time getting sober. Those who start after full development have an easier time getting sober.
     
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  21. luftmensch

    luftmensch Member+

    May 4, 2006
    Petaluma
    Club:
    Los Angeles Galaxy
    Nat'l Team:
    United States
    Couldn't remember so it took a bit of creative searching to find, but it's this one:

    [​IMG]

    I won't say it was a great book but it was an interesting read.
     
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  22. bostonsoccermdl

    bostonsoccermdl Moderator
    Staff Member

    Apr 3, 2002
    Denver, CO
    I agree with all of this, no disagreement on my part. To your point, success is hard to define. Regarding what I said earlier, you have to wonder how many wanted to be there (12 step meetings) to begin with, who were serious about being sober, and how many gave it a legitimate chance before ditching it. I know of people who did the "program" for a period of time and still suffered.

    One of the issues I have with AA is that someone can be sober and a local leader in the recovery community for years, and they relapse. Due to the structure and attitude of the program, all the progress gets tossed out the window and they are supposed to come back, announce it to the meeting, and essentially humble themselves for a 24-hour chip, and start over from day 1. Many are too ashamed to do so, and never come back, and stop seeking help.

    I agree that it is a medical condition, and it should be treated as one. 12 step programs don't do that. Or more precisely they claim it is one, but try to wear both hats, and treat it is a series of character defects. They need to get called out on their ambiguity.
     
  23. soccernutter

    soccernutter Moderator
    Staff Member

    Aug 22, 2001
    Don't drink beer but like cheese
    Club:
    Tottenham Hotspur FC
    Nat'l Team:
    United States
    Yup. That is my issues with recovery programs like that. Even self-enrolled don't necessarily want to get sober.

    Do you have data/research on this? From my experiences, which are talking to various people who have been in programs like AA, or knew people who were, and I've even read The Big Book, that seems to be a bit more about the support structure of the group, to me. Beyond that, though, it gets to what success means. There is the "how many days sober" but there also is how many days since recovery has helped define that person's station in life. I have an uncle who sees it that way, that the point is working on recovery, not just being sober. To me, this seems to be the breakdown in how people view the Anonymous programs, definitely externally and probably internally. To me, that is the drawback to those programs.

    To counter that, I worked in prison many years ago (a "Go Home") prison which mandated all inmates who tested positive or were caught with drugs take the recovery program. They were based on the 12 steps, but were run by licensed social workers/counselors, some of whom were in recovery themselves. These programs were able to get the inmates to look at addiction differently and gave them tools to use, which I don't think are provided to most Anonymous groups. This, to me, provides a safety net to any "relapse."

    Agreed, but constructively, because it is a place where a lot of people go to get support/help.
     
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  24. bostonsoccermdl

    bostonsoccermdl Moderator
    Staff Member

    Apr 3, 2002
    Denver, CO
    I don't have data/research on it, but I have heard this theme repeatedly from various people. Data/research isn't necessary when you have spoken with "boots on the ground" so to speak which describe the atmosphere.

    I also want to be clear. There are positives to 12 step programs, and I know I come across as coming down hard on them. The steps themselves are basically a guide and a structure to solid living, and are similar to many of the buddhist principles to healthy living. My issue is the message gets lost in a lot of the hyperbole (Big Book included) and I hear that from people who have been in the program for years.

    The program needs to be modernized and revamped to get the positive messages across in my opinion.
     
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  25. soccernutter

    soccernutter Moderator
    Staff Member

    Aug 22, 2001
    Don't drink beer but like cheese
    Club:
    Tottenham Hotspur FC
    Nat'l Team:
    United States
    Yup. Agreed with all.
     
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