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

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.​

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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!!!

 

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.

 

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.

 

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.

 

You might be thinking of Reply All’s jawdropping expose of the rehab racket.

 

I've heard reporting in several places. It's definitely not an original topic.

 

Particularly given the stigma given to mental health issues,which is what many substance abusers are unknowingly trying to self-treat.

 

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.

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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!!!

 

Catnip? Not for this guy.



Video of a jaguar eating and tripping on ayahuasca

 

I can't recommend it highly enough.

 

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.

 

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.

 

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.

 

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.

 

Couldn't remember so it took a bit of creative searching to find, but it's this one:



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