Can I please just get this out - drug addiction is NOT A DISEASE!

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You can't win an argument just by being right!
It starts out as "harmless" fun, but, when it turns into an addiction, it's something you can't control. Addiction affects the mind into "needing" the drug, and it makes your time all-consumed with getting it.

So, I'd say it's a sign of a broken mind, but I don't really want to say if it's a "disease" or not.
Yeh I'm pretty sure someone doesnt wake up one day and say Right. Today I think I'll become an addict.



You can't win an argument just by being right!
I suppose it could happen, but I'm with you - it probably doesn't.
I have a friend who was a heroin addict. Pretty sure she thought it would be a once off. Didnt like the first time so tried again. Before she knew it the 'ritual' had a hold of her.

Interestingly enough when she decided enough was enough because she was pregnant her rehab counsellor told her that most of his clients were c section babies, which she was. That's not to scare anyone who might have or might need to experience c section. He said the babies first experience is with a very powerful drug. Not all babies born by c section will end up addicts, ofcourse, but I found this interesting. So who is to say who chooses to be an addict or not.



right, but we kinda do. like, let's say someone got lung cancer and went into remission; if they were a smoker, even after they went into remission, i think most people would find that as irresponsible as an alcoholic sippin a martini
Right, but that is kind of an isolated incident where a disease can be directly linked to a behavior - it's almost a situation where a "disease" is the result of an addiction.

But I've pointed out many times that in millions of cases, disease cannot be linked to any specific behavior - lots of people get lung cancer who've never touched a cigarette (and there are that segment of chronic smokers who beat the odds and never get lung cancer.)

Just because drug addictions may ultimately lead to disease symptoms (due to unnatural toxins and stresses on organs) does not mean that an addiction is the same as one day waking up to discover you have Muscular Dystrophy (or any other actual disease.)

An addiction is a mental & physical state that begins as a behavior - and can only begin with the ingestion of an addictive substance, but disease may find any victim with or without any behaviors or substances.



Yeh I'm pretty sure someone doesnt wake up one day and say Right. Today I think I'll become an addict.
At the same time, no one just wakes up an addict - they have to take something and become addicted to it first (again, "Crack-baby" or kidnapping someone, strapping them to a table and injecting them with heroin for 3 weeks like some mad scientist scenarios aside).

Conversely, people do (and you have) just woken up to discover they have a disease through no choice, action, taking of a substance, imbibing liquor to drown their sorrows, experimenting with chemicals to join a crowd, inhaling nicotine to calm their nerves, drinking 8 cups of coffee to wake up, escaping from reality by taking an opioid or any other behavior.

Addiction is a state of mental & physical dependency on a chemical - it is not a "disease" and fits none of the medical definitions for disease.



You can't win an argument just by being right!
Conversely, people do (and you have) just woken up to discover they have a disease through no choice, action, taking of a substance, imbibing liquor to drown their sorrows, experimenting with chemicals to join a crowd, inhaling nicotine to calm their nerves, drinking 8 cups of coffee to wake up, escaping from reality by taking an opioid or any other behavior.

Addiction is a state of mental & physical dependency on a chemical - it is not a "disease" and fits none of the medical definitions for disease.
How do you know I just woke up to it? I might have walked straight into it by choice. Please stop making assumptions on my behalf, Cap.
My mother died of melanoma. She chose to fry herself for a tan. Was she less deserving of treatment because it was her choice?
A friend of mine was a competitive body builder and chose to take roids. Almost lost his leg from a staf infection. Should he have just been left in the corner because he chose to take drugs?

That's how this opinion people who choose something dont deserve treatment comes across. You choose to go and stir up a bee hive not realising you have an allergy and you almost die from anaphylactic shock. Your choice so you know, is it ok to shove you to the bottom of the queue?



Yeh I'm pretty sure someone doesnt wake up one day and say Right. Today I think I'll become an addict.
Here in America, not so sure about that.



I think addiction is a fine word by itself, since it establishes that their behavior is now biological/compulsive, but doesn't group it alongside afflictions that people have far less control over. Disease, even if technically accurate, carries a lot of connotations with it.
If I understand the gist of what you mean, I think disease is still a preferable way of framing the issue.

Two levels of calling addiction a disease come to mind. The first is a technical level, where I essentially defer to my understanding the general medical consensus (though by no means universal). I do believe there are more people that would disagree on this level than you think, but it sounds like we basically agree here. The second is on which is a more effective semantic weapon, which one actually frames the issue better for treatment.

I think, generally, the basic disagreements are going to be over two sets of qualities: size of two pools of people and how far along a spectrum of understanding addiction as a "disease" society [generally] is.

The two pools (very broadly defined):

A) Those that would benefit from a tougher stand against their addiction, other's sympathy might actually enable their habits. This group may benefit from an understanding of addiction as a matter of primarily personal willpower. Such as understanding it less as a "medical" problem (which can feel like it's distant and skewed toward expertise) and finding that they have all the tools they need to control the addiction themselves. Those that find that the better, longer term solution is from an individual place.

B) Those that would benefit from from a more empathetic approach, a more rehabilitative approach perhaps. This group may benefit from an understanding addiction as a "medical" issue as this approach gives more incentive to seeking out advice and expertise. Those that find the better, longer term solution is from a social place.

I'm sure you can guess that I think B is less served than A.

First, I believe neither A or B contain an insubstantial number of people. So I also believe that both approaches have their place contextually.

I think the A is the natural position for most people. I mean, I even often attempt to tough out the non-controversially medical issues more than I should. But it seems to me people are often a tiny bit embarrassed to seek out help when they could use it. And more than a tiny bit when there's an understanding of an issue where it's a personal failing rather than a medical one.

Understanding it less as a personal failing also serves as a preventative measure, in my opinion. Personally, I'd be more likely to heed the effects of addiction if it was considered a physical failing rather than if it was considered a mental failing. I (wrongly) think that I am impervious to tests of will.

Basically, I think addicts are more encouraged to seek assistance if they understand addiction as a disease, and I think more people would benefit from seeking that assistance than not.

To be totally honest, my interest in this area is less about this area and more about the somewhat morally adjacent area of how to treat prisoners.



And c'mon, a heroin addicted baby is not part of this conversation as it was clearly not it's fault.
You said darwinism, that's how darwinism works.

No. The baby did not make the choice to become addicted. Therefore it is free from the "darwin reaper".

also, I said a "little darwinism"



No one said let them die....please don't have a holier than thou attitude. Believe me when I say I've reversed death in countless people who have overdosed on drugs.
So out of curiosity, how do you make the choice? Someone addicted to booze or painkillers stumbles across the road and gets hit by a bus, ends up with half his leg ripped off and is exsanguinating. You make the decision someone else is more deserving of treatment because they're not an addict?
This is a genuine question. People on or reading here might be addicted to something. How do you think they might feel with some of the comments addicts dont deserve treatment in this thread.
Who said i make a choice? We save them all.



You can't win an argument just by being right!
You said you have to let Darwinism play out. That indicates you do decide who deserves treatment and who doesn't.



No one said let them die
Blix did, and you responded with "Haha." Which is exactly what ash described:

"...it's another to laugh/find joy in imagining someone just letting someone who is OD'ing die."

I assume none of this was serious, but then, she didn't accuse anyone of being serious. She said it was gross to laugh at even imagining it, which is certainly what happened. You can agree or not, but she hasn't exaggerated or misrepresented anything.

Some of it is serious. I'm serious when I say that we save everyone in the united states. i'm also serious when I say of all the diseases out there, drug addiction is one that I would be the LEAST concerned about. I don't really get a lot of pleasure out of seeing people who don't understand how the system works talk about being ethical and what not. The reality is that these scumbags who overdose are usually repeat offenders and they cost the system so much money that could have gone to more deserving folks. Case in point: I spent over 560,000$ in treatments and tests on an IV heroin abuser who was coming back for the 4th time with infective endocarditis (heart infection). He also has had 2 liver transplants from repeat alcohol use. This guy has cost the healthcare system 1.5 million dollars alone.

Also the same day, a young girl born with leukemia dies because her parents could not afford stem cell transplanation....Now...we can all wish to live in a universe where we can save everyone but if i had to choose between the drug addict and this young girl I know what I would have liked to do.

So yeah, drug addiction is no laughing matter but quite frankly they do it to themselves and I have no sympathy.



You said you have to let Darwinism play out. That indicates you do decide who deserves treatment and who doesn't.
That is not what I said. Go re-read. What I believe and what we actually do in real life are different things.



You can't win an argument just by being right!
You said you have to let Darwinism play out. That indicates you do decide who deserves treatment and who doesn't.
That is not what I said. Go re-read. What I believe and what we actually do in real life are different things.
You do. You decide in your own mind who is more deserving of treatment and you keep confirming it. That's playing God.



Back to the discussion, and a sorta response to what Slappy said earlier: I think most of the people who object to the term "disease" aren't objecting to the literal definition or disputing the science of addiction. They're probably just disputing the implication (real or perceived) that addiction being a disease absolves the addict of responsibility for it, since in most cases getting sick is a thing that just happens to you; we don't normally place blame on people for getting sick, unless their sickness is the result of overt recklessness.
right, but we kinda do. like, let's say someone got lung cancer and went into remission; if they were a smoker, even after they went into remission, i think most people would find that as irresponsible as an alcoholic sippin a martini


you don't know the half of it. Working in a hospital gives you a different perspective. If you're a smoker and you're trying to cut down but you sneak in a cigarette or two...honestly I don't care. When I say drug addicts I really mean those individuals who I see REGULARLY in the hopsitals for drug/addiction related diseases. People with severe COPD on oxygen at home with all kinds of meds who come to the hospital with opneumonia and I go to see them and I can't find them..."Hey nurse, where is Mr. X?" Nurse: "He went to go smoke" And i kid you not these people drag their IV lines and oxygen tanks with them outside while they smoke. Addiction is real harmful but all of those who jumped on me earlier in the thread missed my point....I was postulating theoretically what would happen if we stopped saving those who are prone to self-harm. would we stop producing generations who have addiction structured neuropathways?

Theoretically speaking...yes.



You said you have to let Darwinism play out. That indicates you do decide who deserves treatment and who doesn't.
That is not what I said. Go re-read. What I believe and what we actually do in real life are different things.
You do. You decide in your own mind who is more deserving of treatment and you keep confirming it. That's playing God.
I'm insulted at what you're insinuating. Everyone one of my patients whether the king or the homeless have gotten the same care from me. Shame on you.

I might add...>90% of my patients do not reimburse me, so please do not make any suppositions on me. You do not know me.



you don't know the half of it. Working in a hospital gives you a different perspective. If you're a smoker and you're trying to cut down but you sneak in a cigarette or two...honestly I don't care. When I say drug addicts I really mean those individuals who I see REGULARLY in the hopsitals for drug/addiction related diseases. People with severe COPD on oxygen at home with all kinds of meds who come to the hospital with opneumonia and I go to see them and I can't find them..."Hey nurse, where is Mr. X?" Nurse: "He went to go smoke" And i kid you not these people drag their IV lines and oxygen tanks with them outside while they smoke. Addiction is real harmful but all of those who jumped on me earlier in the thread missed my point....I was postulating theoretically what would happen if we stopped saving those who are prone to self-harm. would we stop producing generations who have addiction structured neuropathways?

Theoretically speaking...yes.
A woman I know was kvetching about her building management. She said they do not keep the hallways free of dust as they have been ordered to do because she has severe asthma. This is a woman whom I see almost daily in my neighborhood smoking cigarettes.



you don't know the half of it. Working in a hospital gives you a different perspective. If you're a smoker and you're trying to cut down but you sneak in a cigarette or two...honestly I don't care. When I say drug addicts I really mean those individuals who I see REGULARLY in the hopsitals for drug/addiction related diseases. People with severe COPD on oxygen at home with all kinds of meds who come to the hospital with opneumonia and I go to see them and I can't find them..."Hey nurse, where is Mr. X?" Nurse: "He went to go smoke" And i kid you not these people drag their IV lines and oxygen tanks with them outside while they smoke. Addiction is real harmful but all of those who jumped on me earlier in the thread missed my point....I was postulating theoretically what would happen if we stopped saving those who are prone to self-harm. would we stop producing generations who have addiction structured neuropathways?

Theoretically speaking...yes.
A woman I know was kvetching about her building management. She said they do not keep the hallways free of dust as they have been ordered to do because she has severe asthma. This is a woman whom I see almost daily in my neighborhood smoking cigarettes.
That is so sad. We have made it ok to be entitled but not ok to tell someone that they need to help themselves.



You can't win an argument just by being right!
I'm insulted at what you're insinuating. Everyone one of my patients whether the king or the homeless have gotten the same care from me. Shame on you.

I might add...>90% of my patients do not reimburse me, so please do not make any suppositions on me. You do not know me.

Shame on me? Because I think everyone ill deserves not to be judged and called a scumbag by a 'doctor' who thinks they get to judge sick person? How does that work? I must have hit nerve.



I'm insulted at what you're insinuating. Everyone one of my patients whether the king or the homeless have gotten the same care from me. Shame on you.

I might add...>90% of my patients do not reimburse me, so please do not make any suppositions on me. You do not know me.

Shame on me? Because I think everyone ill deserves not to be judged and called a scumbag by a 'doctor' who thinks they get to judge sick person? How does that work? I must have hit nerve.

When you do heroin and you come in for ur 4th time and eat up all the hospitals money that could have gone to a life saving heart transpplant to a kid with cyanotic heart disease...yeah i judge you and you are a scumbag to me.

That does not mean I don't save you, spend all that money on you, provide you with counseling, spend an hour on the phone with a rehab facility to let you in for free, discharge you with free medications and still see you back in the hospital the next month. Thank you for putting doctor in quotes. 14 years of schooling earned me that i suppose.