Most people with addiction simply grow out of it (2014)

https://psmag.com/social-justice/people-addiction-simply-grow-widely-denied-91605

by jseliger • 2 years ago

133 108 2 years ago

anonzzzies• 2 years ago

You can be addicted to mostly anything; ‘healthy’ (veg, sports etc) and unhealthy. I have seen many people ‘grow out of it’ which meant they replaced one addiction by another (or more than one), but the new ones are acceptable in society so now you are not an addict anymore (…). For instance, I know more than a few ex harddrug addicts who are now addicted to gaming, work, sports, alcohol (also a hard drug but somehow accepted and cheap), sex etc.

ghuroo1• 2 years ago

I would say almost everything is acceptable once you understand the balance and how it impacts you if you do/over do it.

I agree there are a lot of normalised addictions, including the modern trend of counting every step, heart rate beat, times you go in the bathroom and even sleep analysis so you can compare to your friends.

lkdfjlkdfjlg2• 2 years ago

Can you show us a single example of someone who destroyed their life because they couldn't stop counting their steps?

No? So maybe don't call it an "addiction" if you want words to have any meaning.

lebean• 2 years ago

It's true, when I started counting my steps, I just couldn't stop. Then I had to have data about my sleep and bowel movements, so that I could have data-driven insights about my body. My friends and family got annoyed at my compulsion to gather data about mundane activities. It got so bad, I started doing sexual favors to feed my habit, and I am ashamed to admit I was gathering data while I did it to improve my performance. Folks, be careful when you count steps! It's easy to get hooked and you may end up like me!

BobaFloutist• 2 years ago

Not every form of disordered behavior is best understood as an addiction.

jdietrich4• 2 years ago

This is why harm reduction is absolutely crucial. A lot of people will recover on their own given time, but you can't recover if you're dead. A moralistic model based primarily or solely on abstinence-based recovery fails addicts, their families and society.

vivekd4• 2 years ago

Without the moralism, harm reduction is a vague term. Here in Canada the government has been pushing safe supply as a part of harm reduction. We still get the same number of overdoses but our cities are now filled with tent encampments and people with addiction issues. It doesn't seem to have helped with anything it's just made things worse

I don't deny that there are some forms of harm reduction which are proven to be effective. But I also think it's a vague weasel word for just give them drugs or just make it all legal. Which is not a good policy as we have seen here.

Ironically just using vague terms like harm reduction without putting forward a specific strategy is a sort of moralizing of its own

klyrs• 2 years ago

No, some local governments have been doing safe injection sites. Safe supply is a political football that's scapegoated despite not being implemented anywhere in Canada. And neither is a solution to the homelessness, addictions, and mental health crises.

Every time I hear a politician talking about safe supply, they say it's not a silver bullet. Which is weird because nobody claims it's a silver bullet. Know what else isn't a silver bullet? Criminalization. Or, everything else that's ever been tried. It's a hard problem, there isn't a silver bullet solution, get over it.

What's harm reduction good for? Reducing harm. It isn't harm prevention, it isn't free housing, it isn't free addiction counseling, it doesn't fart roses.

Safe injection sites keep users close to medical professionals so we can keep people from dying alone. Safe supply would ensure that users aren't going to accidentally OD on kerfentanyl thinking it's ordinary fentanyl. Needle exchanges keep users supplied with sterile equipment to reduce risk of injections such as HIV and hepatitis C. Each policy is an example of harm reduction. The general philosophy is to not let perfect be the enemy of good.

jdietrich4• 2 years ago

Drug use and addiction are complex biopsychosocial phenomena with many causal factors and associated harms. It is to be expected that any effective response would likewise be complex and multifactorial. People living with drug addictions are usually living with a multitude of other problems, many of which would still remain if a magic wand were to cure their addiction instantly. A homeless schizophrenic heroin addict would still be in a dire situation if heroin didn't exist.

Drug policy in North America seems to be ideologically fixated both on addiction as a singular problem, and on singular solutions to that problem. Addiction is an important and very hazardous part of someone's life, but it's only one part. Lots of people who live in tents or behave erratically in public aren't addicted to drugs; lots of people who are addicted to drugs don't live in tents or behave erratically in public.

Giving someone an adequate and reliable supply of pharmaceutical opioids is quite likely to reduce their risk of overdose if it gets them away from a highly variable supply of very potent synthetic opioids, but thinking that it'll solve all of their problems is pure fantasy. Keeping people alive is a prerequisite to fixing the rest of their life, but nothing more than that.

tayo42• 2 years ago

Does harm reduction include safe access to drugs? Basically this is why all substances need to be legal. So it's regulated. So many needless deaths becasue of overdoses that didn't need to happen. People just need to be supported through their low points so they come out the other side.

To many ignorant people have an opinion on this though, as you can see in some of these comments. If you never used drugs, don't know people that died needlessly, you don't get to have an opinion.

jdietrich4• 2 years ago

Does harm reduction include safe access to drugs?

Only if it's part of an evidence-based and empirically validated strategy. We know that safe access to drugs can work as part of a harm reduction strategy, but there's also good reason to believe that thoughtless moves towards decriminalisation or legalisation can exacerbate harms. The Swiss model has worked incredibly well after a lot of difficult trial-and-error, but the Portuguese model is increasingly looking like a mistake. Even with the relatively lower-risk example of cannabis legalisation, we're seeing a very mixed picture in terms of outcomes. The devil is in the details.

lazide2• 2 years ago

Alternatively, for some - most really - the real possibility of death and real consequences is what was necessary to pull out of it. To break through the delusional behavior. But even then, it may not be enough.

The Issue, imo, is when death is not a certainty, but a surprise consequence (or sudden) due to bad or inconsistent supply, etc.

I recently met someone who it took 6 NARCAN to revive last time he overdid it. Frankly, I’m surprised his body was able to handle it - apparently it was an extremely unpleasant experience.

And, frankly, he might not come back next time.

He seemed to take it seriously. We’ll see.

Not letting your kid touch the hot stove at all is as bad as letting them pull a pot of boiling water down on their head.

tanseydavid2• 2 years ago

> for some - most really - the real possibility of death and real consequences is what was necessary to pull out of it

This is not true at all for some significant part of this demographic.

And I feel compelled to mention that I am well-aware that this is totally counter-intuitive.

Remnant44• 2 years ago

I don't have a lot of personal experience dealing with addiction in either myself or others, but TFA lays out to me a pretty compelling claim that addiction is a developmental disorder. The current mainstream belief of addiction as disease has always seemed to me like it had a great number of holes; it's main purpose was to make people stop stigmatizing addicts for moral failing.

The comparison to ADHD made in the article is an interesting one: although for sure many ADHD kids do age out of the diagnosis, I know many ADHD adults who still have it significantly impact their lives. What do we do with addiction if you've made it past your brain developmental point and you're still addicted?

hn72774• 2 years ago

I've heard the first-time heroin experience described as feeling like "being wrapped in a warm, wet blanket." What else feels like that?

A lot of addiction is trying to get back to the comfort of the womb to escape from early childhood traumas and abuses.

You get a taste of that with the use but never get close to it again after.

curtisblaine• 2 years ago

What else feels like that?

Probably being wrapped in an actual warm, wet blanket.

notso411• 2 years ago

A lot of addiction is trying to get back to the comfort of the womb to escape from early childhood traumas and abuses.

Says who

_z7iw7• 2 years ago

never get close to it again after.

The problem isn't whether they can get close to it again, the problem is that for some people, addiction is connected with using an external means of dissociation to obtain instant control over feelings without relating to them on their own terms. there are ways certainly to return to peace but it's a long and narrow road through your own self's karma. karma is not outside. it s a power sticking to your consciousness which exists by propagating itself and being reinput back into your consciousness through your behavior by modifying your vision to see what was rather than what is. actually opening eyes to reality and accepting it is said to be curative and the thing which can suppress and eventually stop karma. it seems to simply die out when it cannot act. at that time it's explained that your consciousness becomes able to experience nirvana (peace) in connection with the world of origin. some of key things arent well understood by most students of Buddhism anymore. even though someone experiences peace once they have still yet to find out what condition can cause the true rest, which Buddha explained near the end of his life reluctantly.

karma can be made, for example by telling lies, by grudge, and "attachment" in the sense of idealism

Viliam1234• 2 years ago

Even if after a few years you grow out of an addiction, it can destroy your health in the meanwhile. Or maybe you won't survive those years. How many do successfully grow out of the "crocodile" addiction?

Perhaps the actual lesson should be that addition is not a yes-or-no thing, but rather a scale. For each addictive thing, it would be nice to know (1) the half-time of growing out of it, and (2) the distribution of health impacts during that half-time.

dang• 2 years ago

Most People with Addiction Simply Grow Out of It. Why Is This Widely Denied? - https://news.ycombinator.com/item?id=34167068 - Dec 2022 (7 comments)

Most People With Addiction Grow Out of It (2014) - https://news.ycombinator.com/item?id=19013480 - Jan 2019 (125 comments)

Most People with Addiction Simply Grow Out of It - https://news.ycombinator.com/item?id=8396375 - Oct 2014 (156 comments)

iammjm• 2 years ago

I wonder about where habits end and addictions begin. I think once a ball is rolling it’s not easy to stop it, as it kinda does it on itself

baxtr• 2 years ago

The best definition I’ve read somewhere was along the lines: addiction is something you do repeatedly even though you know it’s harmful for you.

dylan604• 2 years ago

This makes it sound like you trying to say addiction is a mental thing. When your body is physically addicted so that you are sick and in pain because you didn't dose, that's not mental. At that point, it could be more harmful to not fix regardless if you know it or not.

Omin• 2 years ago

There are so many behaviors that fit that description that few would count as addiction. For example eating sweets or junk food, procrastinating, not drinking enough.

c22• 2 years ago

So like driving a car?

rysertio2• 2 years ago

This article confuses drug use with addiction. Addiction is a state where a patient wants to quit a drug, but can't. And that is when you want to intervene as a psychiatrist.

frereubu• 2 years ago

Can you say where the article does this? It seems pretty explicit to me, with the key word being diagnosable: "I quit at around the age when, according to large epidemiological studies, most people who have diagnosable addiction problems do so — without treatment."

alpaca1284• 2 years ago

Afaik addiction isn't defined based on what the person wants, but if their life is negatively affected by it.

Sometimes I don't get why that's a necessary condition, but for addiction it makes sense.

cmaggiulli• 2 years ago

There is nothing in the definition of addiction that requires the desire to quit

rPlayer6554• 2 years ago

No addiction as I understand it is _even if they want to_ they cannot. Not all addicts want to quit.

LAC-Tech6• 2 years ago

Alternately, you just execute people for drug trafficking. A total win in terms of net human suffering.

rpmisms3• 2 years ago

El Salvador seems to be quite happy these days...

LAC-Tech6• 2 years ago

The murder rate of the USA is now almost 3 times higher than that of El Salvadors.

New Zealand now has more murder than El Salvador.

nurumaik• 2 years ago

In terms of net human suffering we can execute everyone. No people -- no suffering

LAC-Tech6• 2 years ago

That would increase total suffering, as people condemned to be executed will under go a great deal of suffering.

lupusreal2• 2 years ago

E.g. the Singapore method. It works better than the western methods but people don't want to take it seriously and would rather suppress the suggestion.

https://en.wikipedia.org/wiki/List_of_countries_by_prevalenc...

afarviral3• 2 years ago

The "by any means necessary" method...? I think a society based around the normalization of this level of punishment is distopian. Achieving the lowest opiate addiction rate possible may not be worth it given the probability of wrongful incarceration/death, its optimising the wrong thing. I think humanity should just accept the multi-facetedness of the universe and work on systems which work without compromising our humanity. We are hooked on mental shortcuts and quick fixes.

331c8c71• 2 years ago

Also ban the chewing gum while at it (as they do there).

alpaca1284• 2 years ago

And then you'd only have to deal with every addiction that's not related to illegal drugs. What are you going to do about alcoholism, or gaming addiction? Execute brewers and game developers?

xetplan• 2 years ago

You must not leave the house much.

fons• 2 years ago

ONLY A QUARTER OF PEOPLE WHO RECOVER HAVE EVER SOUGHT ASSISTANCE IN DOING SO (INCLUDING VIA 12-STEP PROGRAMS). THIS ACTUALLY MAKES ADDICTIONS THE PSYCHIATRIC DISORDER WITH THE HIGHEST ODDS OF RECOVERY.

Confirmation bias at its best.

marifjeren• 2 years ago

this is a lot more hopeful messaging than I'm used to hearing about addiction but I also think it's worth noting this limitation from the study:

""" institutionalized individuals or those who experienced fatal or severe consequences due to their SUD may have not been sampled """

And also.. the average remission times for these addictions are still very long, e.g. roughly 15 years for heroin or alcohol

AtlasBarfed• 2 years ago

What was the followup to the "Vietnam vets addicted to heroin that stopped when they came back"? That was a hot internet topic about, what 5-10 years ago that was basically alleging addiction was strongly tied to surroundings/social graph?

thebigspacefuck2• 2 years ago

Johann Hari has carried that torch a bit, has some very interesting ideas

matrix87• 2 years ago

that's cool, do the harm reduction shit, just keep it confined to SF and Oakland so the rest of us don't need to deal with the aftermath

binary132• 2 years ago

Every time this topic comes up on hackernews it gets brigaded.

friend_and_foe• 2 years ago

Now do cigarettes.

jasfi2• 2 years ago

I believe that stress is one of the cornerstones of addiction. When people can't handle stress they turn to substances. When people "grow out" of addiction, they're really either finding another addiction, or learning to manage their stress and let go of substances used to cope.

I'd love to see trials of what Ashwagandha can do for addiction, because it lowers cortisol nearly immediately and is a relatively safe herb.

afarviral3• 2 years ago

Studies typically show reductions in cortisol levels after several weeks or months of regular ashwagandha supplementation

jasfi2• 2 years ago

Those were likely long-term studies only. I can tell you I always feel a drop in stress within minutes. But I only take it when I feel stressed, and not daily. I think the effects could be too strong if taken daily.

fdsfdsafdsafds• 2 years ago

I was very curious about this statement by the article's author:

Moreover, if addiction were truly a progressive disease, the data should show that the odds of quitting get worse over time. In fact, they remain the same on an annual basis, which means that as people get older, a higher and higher percentage wind up in recovery.

The first reference I clicked on was https://pubmed.ncbi.nlm.nih.gov/22985744/, which states:

Remission from PDUD was greater for younger individuals.

It seems this article is based too heavily on the personal experience and opinions of the author.

FWIW, I think that societal solutions can work as well as medical ones. However, that has the implicit assumption that drug addiction, and the use of certain drugs, is bad. This is an opinion I have recently returned to, and also that reducing drug use and addiction to certain substances should begin with societal norms and limiting supply.

celdon25• 2 years ago

Those so-called societal solutions should be expanded in scope to include making society a less hostile place in general. Most people tolerate it (with effort), some think it is fine. But then there’s the poor souls who can’t cope with it.

They may make futile attempts to grow a support network that ultimately ends up mocking them instead of supporting. Nobody wants to have their “vibes” ruined by witnessing someone going through a mental health crisis of any severity, though some may see it as an opportunity to win internet points. Understand that most places aren’t reasonably civil like HN or your local tech meetup group (maybe it is because they are addicts themselves in some capacity). In such a situation one might even make things worse for themselves by going through a phase of daring to fight back.

They may expand their search radius with a Google search but find nothing but SEO ghost towns and dejected, sterile walled gardens; instead of the thriving, curious, decentralized communities they remembered from their youths. Until nostalgia gives way to nihilism and then there’s no turning back. That’s assuming they’ve even lasted this long, crutching on that dev experience or what have you. A lot of hazards (not just drugs) can end a person if they lack a viable support network.

These are objective faults with society that should be addressed, because that’s where the disease actually is spreading from. I realize that’s an unrealistic goal, but we have been doing so poorly at it that any competent effort at scale would sow more optimism, and optimism is what they need most.

ilaksh• 2 years ago

I'm not sure I have seen this idea before. Interesting idea.

I think you need to differentiate between different levels and types of addiction and different substances. It's not all quite the same thing.

Also, not mentioned is the role of advertising and culture in alcohol addiction.

Or poverty and circumstances like homelessness.

Or the availability and social acceptance of substances in a group.

footlose_3815• 2 years ago

Took me until my later 30s to fall out of love with pot. It just takes me away from a clearer state of mind. When I’m on it, a few hours pass numbly. When I’m away from it, suddenly stuff matters much more.

sfc322• 2 years ago

They don't call it Dope because it makes you smarter

Most people with addiction simply grow out of it (2014)

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