Research on drug addiction points to socioeconomic and cultural factors predicting addiction, not consuming the drug.
See the work of Johann Hari. People become addicts because they’re unhappy with their lives and their environment, not because opioids are inherently addictive. Which shouldn’t be surprising to anyone who has experienced addiction.
> People become addicts because they’re unhappy with their lives and their environment,
You know what's one thing that makes people very unhappy with their lives? Severe chronic pain. Aside from the pain, it also removes a great deal of agency and self-efficacy from their lives. They can't control the pain, the medical system is basically out of their control, and now there's a societal hysteria about opiates.
Beyond that, what you're describing it the difference between addiction and dependency. Any flesh and blood human will become dependent on opiates after a few weeks. It's why doctors have you taper off opiates and other meds that cause dependency.
Although even that distinction seems to be going by the wayside in the current hysteria.
> You know what's one thing that makes people very unhappy with their lives? Severe chronic pain.
That's my point. Having taken an opiate actually has little to do with whether they form an addiction. So we shouldn't be focused on restricting supply to treat and prevent addiction.
> Any flesh and blood human will become dependent on opiates after a few weeks.
Yes, if by dependency you're referring to withdrawal symptoms or tolerance. Opioid addiction however varies wildly depending on the demographic, despite all having consumed opioids. It's not the act of taking opioids that predicts whether someone becomes addicted. Research points to addiction not being caused by the drugs themselves. This isn't surprising when you consider that humans get addicted to such a wide variety of totally unrelated chemical combinations. When you think about it, isn't it a little suspicious that almost any chemical that can be consumed is potentially addictive? That strongly suggests that addiction is not about the drugs really, and research is finally corroborating this.
Having said that, now think about the fact that all food is drugs (chemicals that affect and manipulate your biology) and it becomes apparent that addiction is a much much bigger issue than one might assume when only thinking about things like Oxy and booze as drugs. If one qualifies harmful diet as drug addiction it turns out the majority of our society is suffering from addiction. But there's very little research going on in this area, despite diet probably being the most prevalent and harmful form of drug addiction. You can't unsee it. The similarity between someone talking about their struggles with poor diet ("but that cheeseburger/cheetos/soda/etc. is all I have, can't I have just one thing to look forward to?") and someone talking about alcoholism or smoking is almost indistinguishable.
I don’t think hysteria is an accurate term here as the danger and massive negative impact of opiates is very real. It is not imagined.
I like the word hysteria but am careful in its use because historically it has been used to discount and ignore very real problems with large chunks of the population [0].
I think to help patients and to help people suffering from addition and at risk for addiction it’s important to understand the problem. If people dismiss the problem as imaginary or happening to “them” and not “us” it is much more difficult to not have tons of people die.
I'm sure that's a factor, but it seems unlikely to me it's the only one. All else being equal, going through a repetitive cycle of pain/craving and relief throughout recovery seems likely to encourage addiction as well. Which of course isn't to say that everyone who experiences that will become addicted, or that those who do won't skew toward those who are facing other difficulties in life, but from what I've read it does have an effect. And it fits my common sense, not that one should rely on that in absence of real evidence.
My point is limiting access to opioids isn't effective at treating addiction. Yet that's how our society has chosen to respond to drug addiction across the board, from opioids to alcohol.
The war on drugs doesn't work. And we've had 50 years now to see that. It's sad that the extent of our national conversation about the opioid epidemic is a soap opera about the Sackler family. There will be no front page articles on HN about actually treating addiction.
Well, yes for opiates I believe that's largely true. But I will say that as somebody going through chronic pain and anxiety for the first time, I can definitely see how my meds for those respective conditions could lead to a dependency despite an otherwise good social/support network and job.
This is very true. One needs to consider both physical addiction and psychological addiction.
If you give 100 people high doses of Oxycotin for a month, all 100 will exhibit withdrawal symptoms when the drug is stopped. However, 80 of those will probably suffer through it and not crave the drug after that, 17 will willingly continue to use the drug to avoid the withdrawal symptoms and 3 will (if possible) escalate the dose to the point they care about nothing else.
That's the psychological part of it.
And yes, I made those numbers up, but you get the point.
See the work of Johann Hari. People become addicts because they’re unhappy with their lives and their environment, not because opioids are inherently addictive. Which shouldn’t be surprising to anyone who has experienced addiction.