Addiction is a disease

[chris epic]

So SCIENCE is saying that addiction is a disease, thanks to phychologists. Frankly this is absolute rubbish. First of all, I have been an "addict" and although I have overcome alcoholism and drug abuse, I still demonstrate an "addictive personality."

I even used to buy in to the whole "disease" thing, especially with time spent in AA.

When the idea started to really get me thinking is when I heard pseudo-celebreties and others on television who were caught in a scandal involving drug or alcohol abuse saying "Wow, yeah, you know, its a disease..."

But the insinuation is very easy to see "I just can't help it, I have no control over it"

This is undoubtably a psych trick used to manipulate an audience into sympathy, justify personal choices that were unpleasing to others, or bluntly prohibiting people from taking personal responsibility for their actions.

The bottom line: in most cases, no one forced you to take that first sip or use that first dose when you were completely sober, regardless of your emotional state.

This could very easily get into a free will/determinism argument. I will be the first to admit that my genes and my environment may very well make me more likely than others to abuse substances, but that doesn't keep me out of the clear for being accountable for my mistakes- my police record and the bridges I have burned in the past attest to this.

Also, identifying addiction with disease makes it easier for the loved ones of those who use and abuse to cope with the crisis.

But what is the bottom line? Is it a disease? I dont think so.

[skeptigirl]

Addiction is a complex problem. While no one "forces" people, one doesn't typically become an addict after using a substance once. When a threshold is crossed, that's when addiction starts. That threshold differs for people and for the substance one becomes addicted to. There also seems to be significant differences in recovery based on the substance and obviously based on the person.

Society doesn't do well with deciding what to do with addicts. Arrest them or put them in detox, we simply don't address the problem as the science suggests we should because there is this element of freedom in there. I'd love to see people sent to drug treatment with longer mandatory commitments with each relapse but it will never happen. Too many social issues get in the way.

[Dancing David]

I agree , addiction is a set of behaviors. However some people do seem to have a higher biological vulnerability and the effects of substances are physical and do have an impact on a physical body.

I think the main point to the disease model is to remove the 'moral' element of addiction, in that addicts are not morally inferior, they do not lack will power. They suffer from a behavioral disorder that can be very biologicaly driven.

(Including the wierder forms of non-biological addiction, like gambling. There is usualy a biological cycle in there. It is called a human body.)

[Dancing David]

This is undoubtably a psych trick used to manipulate an audience into sympathy, justify personal choices that were unpleasing to others, or bluntly prohibiting people from taking personal responsibility for their actions.

.

I would say that the big trick, and I will grant you there is one, is that it is to get the addicts to admit they can't control the behavior.

If an addict views it as a lack of spiritual connection then they will fail, bacause that's not the problem.(Even though AA mislead people there, religion is a coping skill not the path.)

If the addict views it as a will pwoer issue they will fail. The problem for most addicts is that they compare themselves to other people and they make value judgements like "They can use and it doesn't get out of control" and they end up trying to control thier use. The problem there is they can't control thier use, the minute they base thier recovery on use they are lost. (Although the course will vary after they dry out and have a long period of abstinenece).

Jack Trimpey and AA agree on one thing, if you are an addict you must not use, no matter what. The disease model is mainly a trick to get people to accept that. If they view it as a moral or will power issue then they will continue down the wrong path and they will keep drowning themselves in the shallow water.

[Dustin Kesselberg]

The idea that "addiction is a disease" buys into that whole philosophy that no one is responsible for their actions due to their genetic circumstances. The same argument is sometimes made for pedophiles, that they are genetically predisposed to sexual attraction to children and can somehow be "cured" of it. I believe it's all nonsense. Whether someone is predisposed to specific emotions or actions is another question, but whether they can or can't control their actions is what is important.

People who are addicted to alcohol or other drugs like to make up the excuse that they suffer from a "disease". Addiction is as much of a disease as is being selfish or being an *******. Addiction is people giving into their desires even though they know they should not be. I sometimes have the desire to punch people in the face when they get on my nerves, but I don't do it. Other people do punch others when they get annoyed. Those people are the same kinds of people who lack self control in other aspects of their life as well.

Are we now living in an age where there is no such thing as self-responsibility anymore? No such thing as any responsibility? I for one am sick and tired of the insanity plea and the "but it's a disease!" excuse.

[lionking]

I would say that the big trick, and I will grant you there is one, is that it is to get the addicts to admit they can't control the behavior.

If an addict views it as a lack of spiritual connection then they will fail, bacause that's not the problem.(Even though AA mislead people there, religion is a coping skill not the path.)

If the addict views it as a will pwoer issue they will fail. The problem for most addicts is that they compare themselves to other people and they make value judgements like "They can use and it doesn't get out of control" and they end up trying to control thier use. The problem there is they can't control thier use, the minute they base thier recovery on use they are lost. (Although the course will vary after they dry out and have a long period of abstinenece).

Jack Trimpey and AA agree on one thing, if you are an addict you must not use, no matter what. The disease model is mainly a trick to get people to accept that. If they view it as a moral or will power issue then they will continue down the wrong path and they will keep drowning themselves in the shallow water.
I believe that "addiction is a disease" is a cop out. I speak as someone with an alcohol problem currently under control. I have heard researchers say that abstinence from alcohol for a period of more than 12 months can lead to control of the addiction, but I haven't been dry for 12 months yet so cannot say.

Gambling is an equally serious addiction, but what could be the biological basis for this? If something is a disease, surely there must be some biological basis. Or am I wrong on this???

[Soapy Sam]

I feel the word is used too widely and comprises several rather different problems.

I'm an oxygen addict. Can't live without the stuff. Tried. Couldn't go two minutes.

Is this a disease? It's unquestionably biological. Extreme discomfort is experienced by removal of the substance. Prolonged withdrawal results in death.
Sounds disease-ish to me.

Alcoholism may have an element of this, because some folk do lack the enzymes to safely metabolise the stuff. In their case, there seems to be a parallel.

But there are also, obviously, differences.

It's clear alcoholics recover only when they take responsibility for their own behaviour. That doesn't sound like disease to me. It sounds like exerting the will.

If viewing a behaviour as an illness makes it easy to treat / cure / alleviate, well, call it an illness by all means.
But if that's not the case, I'd prefer to call it behaviour and tackle it from that angle.
Words are tools, not straitjackets.

[lionking]

I feel the word is used too widely and comprises several rather different problems.

I'm an oxygen addict. Can't live without the stuff. Tried. Couldn't go two minutes.

Is this a disease? It's unquestionably biological. Extreme discomfort is experienced by removal of the substance. Prolonged withdrawal results in death.
Sounds disease-ish to me.

Alcoholism may have an element of this, because some folk do lack the enzymes to safely metabolise the stuff. In their case, there seems to be a parallel.

But there are also, obviously, differences.

It's clear alcoholics recover only when they take responsibility for their own behaviour. That doesn't sound like disease to me. It sounds like exerting the will.

If viewing a behaviour as an illness makes it easy to treat / cure / alleviate, well, call it an illness by all means.
But if that's not the case, I'd prefer to call it behaviour and tackle it from that angle.
Words are tools, not straitjackets.

Well said Soapy. A clear view on a complex subject.

[ponderingturtle]

The first thing is that disease is not a very well defined word in common use. What of these are diseases and what are not

Influenza
Cancer
Allergies
ADD
Addiction
Schizophrenia

Also there is the point that people feel compulsions at different intensities, so what is a minor act of will for one person is much harder for someone else, so the first might view the second as weak, but they are not resisting the same urge.

It is sort of like is obesity a disease or a personal failing? Well it can be either one. Some people are physically incapable of being a normal weight, others are psychologically addicted to food(and for the alcoholics here, imagine if you had to drink just a little every day), others just don't care.

So until we get a well defined definition of disease, we can not address addictions relationship to disease.

[Solus]

It's called disease because the person is more prone to that undesirable behavior. It makes them vulnerable to abuse of the action be it gambling or alcohol. It requires some special steps to address the problem. I agree just saying I have disease, I can't get better and this is the way I am is no good. Leave it to the media to distort everything.

It's a disease the sense that it's heredity also.

[ponderingturtle]

It's called disease because the person is more prone to that undesirable behavior. It makes them vulnerable to abuse of the action be it gambling or alcohol. It requires some special steps to address the problem. I agree just saying I have disease, I can't get better and this is the way I am is no good. Leave it to the media to distort everything.

It's a disease the sense that it's heredity also.

So everything on my list is a disease then.

[Solus]

So everything on my list is a disease then.

Sorry, not feeling well enough right now to look into my old books check what psychology defines as a disease. Doesn't matter what you think it should be called if that's what it's called. Someone in a more feisty mood might come on though, and address this with a good source. I'll just use a really junk source: http://en.wikipedia.org/wiki/Disease

There you go. ;)

This was decided long before I was born and probably before you were.

[Dymanic]

So SCIENCE is saying that addiction is a disease, thanks to phychologists.


Wait... psychology is a SCIENCE?

[ponderingturtle]

Sorry, not feeling well enough right now to look into my old books check what psychology defines as a disease. Doesn't matter what you think it should be called if that's what it's called. Someone in a more feisty mood might come on though, and address this with a good source. I'll just use a really junk source: http://en.wikipedia.org/wiki/Disease

There you go. ;)

This was decided long before I was born and probably before you were.

So oddly enough I think from the way you are defining disease a car accident counts.

[Twilek]

I had this argument with someone a while ago. He went so far in the defense of the "it's a disease" statement that he suggested that, because some people are pre-disposed genetically to have alcoholism, they could therefore be said to be alcoholics even if they never have a drink. Needless to say, I found that a bit absurd.

[yersinia29]

Psychology is mostly quackery and non-scientific, but psychiatry is not that much better.

The problem is that the brain is incredibly hard to study, much different than a heart or a lung. We know nohting about how the brain works, so as a result we stumble in defining disease vs behavior for all these psychological issues.

And I'm so freaking sick of people using MRIs and CT scans to "prove" that something is a disease. Yes, your brain lights up differently when you drink alcohol vs when you are sober. So what. Your brain also lights up differently when you eat chocolate vs eating bread, does that mean eating chocoloate is a pathological process? Of course not.

Your brain lights up differently for every single thing you do. When you are doing laundry, your brain lights up very differently than when you are sleeping. So lets please drop the sensationalistic crap with brain imaging "proving" anything at all.

[Pup]

Of course people jump on the bandwagon of "it's a disease so it's not my fault" or "it's a lack of willpower so it's all your fault," to further whatever agenda they want.

But I think there are a lot of conditions which, like addiction, are a mixture of disease and voluntary behavior. We just don't usually think of them in those terms.

To take a really basic example, say a person has a disease in a joint that makes normal movement painful but possible. There's no doubt they have something physically different than other people, that causes restricted movement in everyday life. But there's also no doubt that in theory, if offered say $1000 to move the joint through its full range of motion without showing any outward signs of pain, they could do so, through sheer willpower.

So I watch a video of them winning the $1000, not realizing what I'm seeing, and conclude I'm watching a person free from disease, who can move like anyone else. What I'm not aware of is the amount of willpower it's taking them to do it.

When I find out the truth, I think, if they can move normally, why don't they just do it all the time? The symptoms of their disease would disappear if they just had more willpower.

And that's literally true.

But it's also true that to move normally would require them to expend way more effort than the average person. If they can't muster up that willpower, then what? Should they do it anyway, because life isn't fair, sucks to be them, but there's no excuse to be a weakling? Or is it okay for them to fail, because the disease makes it so hard?

No simple answer.

[UserGoogol]

And I'm so freaking sick of people using MRIs and CT scans to "prove" that something is a disease. Yes, your brain lights up differently when you drink alcohol vs when you are sober. So what. Your brain also lights up differently when you eat chocolate vs eating bread, does that mean eating chocoloate is a pathological process? Of course not.

Eating chocolate is a biological process. The way I see it, a disease is simply a bad biological process. The act of eating chocolate is merely not very harmful, so it's not a disease. The mind is biological, so whatever the mind does that is bad is a disease. If you're a jerk, (and coincidentally, there is sometimes a link between alcoholism and jerk-like behavior) then that's a sort of mild mental illness you have.

I think the problem is that people put free will on a pedestal that it really doesn't deserve to be on. People don't really like to admit that willpower is simply another part of the brain, so when people find out that something is caused by some sort of problem with the brain, they feel that free will is simply out of the picture. This really isn't the case.

There are two ways to solve a brain problem, from the inside through will power, or from the outside through medical treatment. It so happens that alcoholism is a problem where dealing with the problem from the inside is extremely necessary. But it still seems valid to call it a disease.

[skeptigirl]

The idea that "addiction is a disease" buys into that whole philosophy that no one is responsible for their actions due to their genetic circumstances.Not necessarily. I can have the disease of diabetes and choose to take care of myself or not. Having the disease is not an excuse to ignore its consequences.

The same argument is sometimes made for pedophiles, that they are genetically predisposed to sexual attraction to children and can somehow be "cured" of it. I believe it's all nonsense. Whether someone is predisposed to specific emotions or actions is another question, but whether they can or can't control their actions is what is important.

People who are addicted to alcohol or other drugs like to make up the excuse that they suffer from a "disease". Addiction is as much of a disease as is being selfish or being an *******. Addiction is people giving into their desires even though they know they should not be. I sometimes have the desire to punch people in the face when they get on my nerves, but I don't do it. Other people do punch others when they get annoyed. Those people are the same kinds of people who lack self control in other aspects of their life as well.This reflects a very naive understanding of genetically determined behavior. That includes genetically predisposed behaviors which then may or may not be triggered or need to be triggered in order to be acted out.

We know that male identical twins raised apart have higher correlation of alcoholism than fraternal twins raised apart. And for some reason this does not appear in female twins raised apart.

I have an un-neutered male and female dog. The female is in heat. There is no way you can watch that male dog whine night and day and literally stop eating for a couple of the worst days and not recognize this is biologically determined behavior. They also have some pretty strong hunting behaviors no one taught them such as sniffing out underground moles and digging like crazy, sometimes successfully catching them.

Pigs have addictive behaviors when you offer them the choice of certain drugs or food. Some animals will starve to death choosing drugs over food.

You can find a wealth of Addiction Research at Brookhaven (http://www.bnl.gov/CTN/addiction.asp) including the following studies:

Gene Therapy Reduces Drinking in Rats with Genetic Predisposition to “Alcoholism”
Finding confirms earlier result using better model for human alcohol abuse (http://www.bnl.gov/bnlweb/pubaf/pr/PR_display.asp?prID=04-47)

Methamphetamine Delivers ‘One-Two’ Punch to the Brain Mechanism may knock out brain’s ability to “just say no.” (http://www.bnl.gov/bnlweb/pubaf/pr/2001/bnlpr120101a.htm)

Researchers Document Brain Damage, Reduction in Motor and Cognitive Function from Methamphetamine Abuse; "Speed" Shows More Neurotoxic Effects Than Heroin, Cocaine, or Alcohol (http://www.bnl.gov/bnlweb/pubaf/pr/2001/bnlpr030101.htm)

MAPPING THE ROOT OF COCAINE CRAVING: SURPRISING FINDINGS ON DRUG'S EFFECT IN BRAIN REGIONS (http://www.bnl.gov/bnlweb/pubaf/pr/1999/bnlpr010199.html)

Here are some more studies just to give you an idea, you can use the scientific process to reach a better understanding of the complexity of addiction rather than a judgmental moralistic knee jerk reaction.

Mouse Models for Addictions (http://learn.genetics.utah.edu/units/addiction/genetics/neurobiol.cfm)Decades ago, researchers first tested laboratory strains of rats and mice for specific addiction traits, such as high preference for certain drugs or alcohol. Since individuals within a laboratory strain are virtually identical, they all have the same addiction profile. But researchers discovered that individuals from different strains had vastly different addiction profiles. This was one of the earliest clues that addiction has a genetic component.

Addiction research in a simple animal model: the nematode Caenorhabditis elegans. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15464131&dopt=Abstract)

The Neurobiology of Addiction Research Center (NARC) (http://neurosciences.musc.edu/research/narc/narc.html)

Genetic determinants of alcohol addiction. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1096556&dopt=Abstract)

Substance Abuse Among Women: Familial Factors and Comorbidity (pdf file) (http://www.nida.nih.gov/PDF/DARHW/245-270_Merikangas.pdf)

Are we now living in an age where there is no such thing as self-responsibility anymore? No such thing as any responsibility? I for one am sick and tired of the insanity plea and the "but it's a disease!" excuse.See previous comments and perhaps consider dismounting from your moral high horse.

[skeptigirl]

I believe that "addiction is a disease" is a cop out....It's only a cop out if you consider having a disease is an excuse to ignore it. Declaring addiction a moral failure provides nothing in the way of prevention or treatment. Labeling addiction a disease does not mean as a disease the person is exempt from responsibility for their behavior. Would you exempt an epileptic from responsibility who chose to drive despite not having their seizures under control?

Wasting time on matters of blame and disgust merely detract from where we should be spending time, that is conducting research for cures and treatment, as well as educating young people about triggers and thresholds instead of telling them stupid things like marijuana is a gateway drug. Drug abuse education should be evaluated for its effectiveness and we need to be willing to let go of the methods which fail. Preventing addiction is easier than treating it.

What we could do better is define the aspects of addiction which are disease and those which are the results of behavior the disease affects but for which we still hold the addict responsible. For example, drunk drivers should IMO be given jail sentences, even for first offenses. Second offenses should result in mandatory treatment for alcoholism because we know from research people with 2 DUIs are almost all alcoholics. There can be some exceptions but even then, you are probably looking at an addict that just hasn't crossed the threshold yet, triggering the disease.

If you only look at the personal responsibility, you get a person who is in all likelihood, going to re-offend when released from jail. If you only look at the illness, you get a person who's addiction does indeed result in harm to others and you don't hold the person accountable. Both aspects of addiction need to be addressed. Unfortunately we tend to only address the behavior and fail to require mandatory treatment. Yet we know from research, the addiction affects judgment. It's an unscientific approach.

[skeptigirl]

I had this argument with someone a while ago. He went so far in the defense of the "it's a disease" statement that he suggested that, because some people are pre-disposed genetically to have alcoholism, they could therefore be said to be alcoholics even if they never have a drink. Needless to say, I found that a bit absurd.I think it has been established that a person predisposed to addiction must still experience disease triggers. Just as being predisposed to cancer may not mean you will get it. There are many things which reflect a combination of nature and nurture.

[skeptigirl]

Psychology is mostly quackery and non-scientific, but psychiatry is not that much better.

The problem is that the brain is incredibly hard to study, much different than a heart or a lung. We know nohting about how the brain works, so as a result we stumble in defining disease vs behavior for all these psychological issues.

And I'm so freaking sick of people using MRIs and CT scans to "prove" that something is a disease. Yes, your brain lights up differently when you drink alcohol vs when you are sober. So what. Your brain also lights up differently when you eat chocolate vs eating bread, does that mean eating chocoloate is a pathological process? Of course not.

Your brain lights up differently for every single thing you do. When you are doing laundry, your brain lights up very differently than when you are sleeping. So lets please drop the sensationalistic crap with brain imaging "proving" anything at all.
This is a poor understanding of what MRIs and PET scans look at. You don't compare drunk and sober, you compare a drunk alcoholic to a drunk non-alcoholic.

[skeptigirl]

Of course people jump on the bandwagon of "it's a disease so it's not my fault" or "it's a lack of willpower so it's all your fault," to further whatever agenda they want.....Unfortunately, it is lawyers who came up with the idea of using disease models of behavior as a mainstay of criminal defense. However, society typically distinguishes between not knowing what you were doing and knowing it was wrong but doing it because of your predisposing factors be they abuse as a child or genetic. We don't let pedophiles off the hook for behavior, but we recognize they are highly likely to re-offend.

Disease does not equate to "therefore no responsibility". If you cannot stop yourself, you are responsible to seek treatment. And I think that is the terminology we could use to discuss "diseases" which result in behavior that harms other people.

[skeptigirl]

....

I think the problem is that people put free will on a pedestal that it really doesn't deserve to be on. People don't really like to admit that willpower is simply another part of the brain, so when people find out that something is caused by some sort of problem with the brain, they feel that free will is simply out of the picture. This really isn't the case.

There are two ways to solve a brain problem, from the inside through will power, or from the outside through medical treatment. It so happens that alcoholism is a problem where dealing with the problem from the inside is extremely necessary. But it still seems valid to call it a disease.
You raise a good point. We also have this approach to free will that says if you don't volunteer for treatment, we won't force you. Yet addiction is a disease which seriously affects "will power". It creates a dilemma with no easy answers. But in an effort to protect free will, we may be going too far when we allow addicts who harm other people to make their own decisions.

I'm not advocating screening people for addiction then locking up people in treatment facilities. But I do think we need more mandatory treatment for addicts who repeatedly break the law. And it could be based on how dangerous the behavior is. Drunk drivers kill about 15,000 people a year (http://www-nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/RNotes/2005/809904.pdf) in this country. Think about it, 15,000 people is five 911s every year. Sentencing laws need reform.

Yet we view selling drugs as as serious crime and our jails are filled with users and dealers alike.

We need a few less addicts in jail and a few more in mandatory treatment in my opinion.

[yersinia29]

This is a poor understanding of what MRIs and PET scans look at. You don't compare drunk and sober, you compare a drunk alcoholic to a drunk non-alcoholic.


So what that comparison is still bogus.

Suppose I'm a chocolate connoisseur and eat chocolate all day long. I'm subject A.

Subject B is a person that never eats chocolate.

Now you get a fMRI or PET of both of us while eating chocolate. My brain scan will be different than his, because over all the years of chocolate eating I've formed a lot more synaptic connections than subject B has related to chocolate.

So the results of that scan are meaningless. However, I've repeatedly heard so-called scientists and their lawyer cronies claim that this imaging difference proves that its a "disease process" and therefore the person cant control their own actions or behavior.

[skeptigirl]

So what that comparison is still bogus.

Suppose I'm a chocolate connoisseur and eat chocolate all day long. I'm subject A.

Subject B is a person that never eats chocolate.

Now you get a fMRI or PET of both of us while eating chocolate. My brain scan will be different than his, because over all the years of chocolate eating I've formed a lot more synaptic connections than subject B has related to chocolate.

So the results of that scan are meaningless. However, I've repeatedly heard so-called scientists and their lawyer cronies claim that this imaging difference proves that its a "disease process" and therefore the person cant control their own actions or behavior.I don't usually say this sort of thing but, you are talking out of your ass.

If you have a specific issue you think brain research claims an answer to and you have contradictory evidence, that might be worth discussing. But here you have made an absurd blanket statement that brain scans have not been successful in studying the brain. All it shows is your incredible lack of knowledge of neuroscience research.

Have you considered actually reading a little bit about the diagnostic tools you so oddly dismiss out of hand? Have you read what the tools can reveal, what they are being used for that might not yet be solid science and what they are not useful for? Because your claim is evidence you don't know a lot about the science or the scans.

[Solus]

So oddly enough I think from the way you are defining disease a car accident counts.

I quoted wikipedia not myself.

I looked at my psychology textbooks I've kept over the years. It's not defined as a disease after all. If someone really wants me to, I'll take pictures of the pages; there is some good information within the book.

Way too much for me to type out however.

[Solus]

There is of course plenty of BS in psychology but do note that's it's a newer science only about 200 years old. Consider how long other sciences have had to develop.

Coffin therapy (http://www.reviewjournal.com/lvrj_home/2001/Sep-30-Sun-2001/news/17108257.html)
Weird psycholpgist (http://worldlegionofpower.com/drnerenberg/release1.htm)

I personally know this guy, he is a character indeed. I would not allow him to practice psychology, I think he is so full of it. I've dealt with him not as patient but an observer. I wish I had the videos he showed. He was on Montel Willams (I think) and he actually showed the video of that to patients in the waiting room. :boggled:



I wish could get new information maybe he gave up that idea. Amusing.

[Simone]

[QUOTE=skeptigirl;2447411]

For example, drunk drivers should IMO be given jail sentences, even for first offenses.

:(
Now you know that that would be almost impossible for all drunk drivers to be given jail sentences, while its just considered a misdemeanor, 364 days in jail, most offenders pay a fine and go on their way. If they do a weekend in jail, they continue to drink, it doesn't change their ways.

[Dustin Kesselberg]

Not necessarily. I can have the disease of diabetes and choose to take care of myself or not. Having the disease is not an excuse to ignore its consequences.

Diabetes is a result of lifestyle in some cases and not the lifestyle itself. "Alcoholism" is simply drinking too much alcohol. If someone gets cirrhosis of the liver, pancreatitis, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies or sexual dysfunction from drinking too much alcohol then those things can be considered diseases. But "alcoholism" itself can't. Moreover, Addiction can simply be ended by not drinking anymore.


I have an un-neutered male and female dog. The female is in heat. There is no way you can watch that male dog whine night and day and literally stop eating for a couple of the worst days and not recognize this is biologically determined behavior. They also have some pretty strong hunting behaviors no one taught them such as sniffing out underground moles and digging like crazy, sometimes successfully catching them.

So?

Pigs have addictive behaviors when you offer them the choice of certain drugs or food. Some animals will starve to death choosing drugs over food.

So?

You can find a wealth of Addiction Research at Brookhaven (http://www.bnl.gov/CTN/addiction.asp) including the following studies:

Gene Therapy Reduces Drinking in Rats with Genetic Predisposition to “Alcoholism”
Finding confirms earlier result using better model for human alcohol abuse (http://www.bnl.gov/bnlweb/pubaf/pr/PR_display.asp?prID=04-47)

Methamphetamine Delivers ‘One-Two’ Punch to the Brain Mechanism may knock out brain’s ability to “just say no.” (http://www.bnl.gov/bnlweb/pubaf/pr/2001/bnlpr120101a.htm)

Researchers Document Brain Damage, Reduction in Motor and Cognitive Function from Methamphetamine Abuse; "Speed" Shows More Neurotoxic Effects Than Heroin, Cocaine, or Alcohol (http://www.bnl.gov/bnlweb/pubaf/pr/2001/bnlpr030101.htm)

MAPPING THE ROOT OF COCAINE CRAVING: SURPRISING FINDINGS ON DRUG'S EFFECT IN BRAIN REGIONS (http://www.bnl.gov/bnlweb/pubaf/pr/1999/bnlpr010199.html)

Here are some more studies just to give you an idea, you can use the scientific process to reach a better understanding of the complexity of addiction rather than a judgmental moralistic knee jerk reaction.

Mouse Models for Addictions (http://learn.genetics.utah.edu/units/addiction/genetics/neurobiol.cfm)

Addiction research in a simple animal model: the nematode Caenorhabditis elegans. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15464131&dopt=Abstract)

The Neurobiology of Addiction Research Center (NARC) (http://neurosciences.musc.edu/research/narc/narc.html)

Genetic determinants of alcohol addiction. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1096556&dopt=Abstract)

Substance Abuse Among Women: Familial Factors and Comorbidity (pdf file) (http://www.nida.nih.gov/PDF/DARHW/245-270_Merikangas.pdf)

See previous comments and perhaps consider dismounting from your moral high horse.

All of your studies do nothing but argue that addiction can be genetically predisposed to specific individuals. This doesn't mean it's a disease. CRIME and VIOLENCE can be genetically predisposed to specific individuals. Is crime a disease now? If it's a disease why punish violent criminals? After all they just suffer from a disease!

[Dustin Kesselberg]

So what that comparison is still bogus.

Suppose I'm a chocolate connoisseur and eat chocolate all day long. I'm subject A.

Subject B is a person that never eats chocolate.

Now you get a fMRI or PET of both of us while eating chocolate. My brain scan will be different than his, because over all the years of chocolate eating I've formed a lot more synaptic connections than subject B has related to chocolate.

So the results of that scan are meaningless. However, I've repeatedly heard so-called scientists and their lawyer cronies claim that this imaging difference proves that its a "disease process" and therefore the person cant control their own actions or behavior.

I guess Subject A has "acute coco syndrome":rolleyes:

[chris epic]

Exactly, the "cure". You can't "cure" pedophelia, or homosexuality, or addiction. I do believe there is part genetic drive/part environmental/and part what ever further intricacies weave together our behavior.

I was never "cured" from my addictive behavior- I am thankful for it when it manifests itself through positive things in my life: like music, school, my fiancee, art-

My father was a crack addict and an alcoholic he's been sober for 15 years- is he still an addict? Absolutely- he smokes, drinks a lot of coffee, runs a company full time, does international ministry full time, and is still raising children.

I guess the "cure" is the positive things you can channel that "predisposition" into- like service, or whatever. But even the compulsivity an addict displaces into positive activities can be unhealthy

[Dustin Kesselberg]

I don't usually say this sort of thing but, you are talking out of your ass.

If you have a specific issue you think brain research claims an answer to and you have contradictory evidence, that might be worth discussing. But here you have made an absurd blanket statement that brain scans have not been successful in studying the brain. All it shows is your incredible lack of knowledge of neuroscience research.

Have you considered actually reading a little bit about the diagnostic tools you so oddly dismiss out of hand? Have you read what the tools can reveal, what they are being used for that might not yet be solid science and what they are not useful for? Because your claim is evidence you don't know a lot about the science or the scans.

He didn't argue that brain scans can't effectively study the brain. He argued that they are irrelevant to the discussion of whether addiction is a disease or not. Brain scans can show that people who are more violent tend to have differently working brains than non-violent people. Do you now argue that violence is a disease? If it's a disease then why should we punish violent criminals?

[chris epic]

The way I see it (coming from a predisposed addict), is by asking the biological question: how does this genetic disposition benefit someone? If there are benefits, how can it be a disease? After all, which ever way an "addict" chooses to channel their behavior is only a symptom or side effect.

Tenacity! Human beings need to be tenacious to "get things done." I excel, with compulsivity, at anything I personally enjoy (whether those values are natural or nurtured). The same is with a junkie: they may not have a job, and could care less about their family or themselves, but when it comes to their addiction, they WILL find a way to get, they WILL have all the proper tools to execute the activity, and they WILL be an expert on what ever it is they are putting in their body.

I see this trate being merely a human behavioral necessity that just happens to be more concentrated in some than others.

[Dustin Kesselberg]

The way I see it (coming from a predisposed addict), is by asking the biological question: how does this genetic disposition benefit someone? If there are benefits, how can it be a disease? After all, which ever way an "addict" chooses to channel their behavior is only a symptom or side effect.

Tenacity! Human beings need to be tenacious to "get things done." I excel, with compulsivity, at anything I personally enjoy (whether those values are natural or nurtured). The same is with a junkie: they may not have a job, and could care less about their family or themselves, but when it comes to their addiction, they WILL find a way to get, they WILL have all the proper tools to execute the activity, and they WILL be an expert on what ever it is they are putting in their body.

I see this trate being merely a human behavioral necessity that just happens to be more concentrated in some than others.

I really doubt that meth addicts can simply "channel" their addiction into something positive. They use meth to get high and only to get high. They don't want to channel it elsewhere. They want to get doped up and become oblivious to the world. That's why they do it. They don't do it simply for "something to do".

[chris epic]

If it's a disease then why should we punish violent criminals?After all, they can't help the fact that they were born with an abnormally small hypothalamus

[chris epic]

[QUOTE=Dustin;2447986]I really doubt that meth addicts can simply "channel" their addiction into something positive. They use meth to get high and only to get high. They don't want to channel it elsewhere. They want to get doped up and become oblivious to the world. That's why they do it. They don't do it simply for "something to do".

Aye, ya missed me point. I did- I was a meth addict- I still had hopes and dreams, I just put them on hold while I used. You think I was oblivious to the fact that I was destroying my life? Don't be so presumptuous. Because when I got clean, I didn't want to use meth, but I was still the same person I was before- so I replaced my compulsion to use deadly substances with education, community service, goals, love... etc.

[Solus]

I don't usually say this sort of thing but, you are talking out of your ass.

If you have a specific issue you think brain research claims an answer to and you have contradictory evidence, that might be worth discussing. But here you have made an absurd blanket statement that brain scans have not been successful in studying the brain. All it shows is your incredible lack of knowledge of neuroscience research.

Have you considered actually reading a little bit about the diagnostic tools you so oddly dismiss out of hand? Have you read what the tools can reveal, what they are being used for that might not yet be solid science and what they are not useful for? Because your claim is evidence you don't know a lot about the science or the scans.

I'll help you out later, I've seen Dustin's posts before and he mustn't be allowed to win on shoddy opinions. Lets give some respect to the science section now.

Opinions are worthless and must be backed by research. Since I have access to that, this should be fun. When I feel like I'll get some pictures of that book I mentioned. I think I can post pictures of a book? :confused: I'm giving credit to the authors and it's not the whole book just about 10 pages.

[athon]

I've seen more definitions for the word 'disease' then you can poke a stick at. But for the most part, they all have a central point;

A disease is an impeding deviation in the normal functioning of an organism.

'Normal functioning' is always the sticking point; all organisms vary, and the extent to which this variation impedes their wellbeing or way of life can be rather open to debate. Yet diseases are always an alteration of the normal functioning, which is a good place to start with exploring whether something is a disease or not.

The question is; could your functioning be said to be affected which results in an addiction? The straight forward answer is 'yes'. Now, are all addictions perversions of normal functioning? I would argue again 'yes', only on the grounds that the mind and our behaviour have no non-material part, therefore can only result from neural functioning. If this fails, even if from lack of will power, determination or desire, I would define that as a failure in function.

The problem arises because we associate pity with disease, as if we can seperate functioning from desire. If somebody is sick, it's not their fault. I can't make that association with the term 'disease' by any stretch of the definition. Therefore, whether they have control or not, it remains a disease if their functioning is impeded in some manner.

My two cents.

Athon

[Dustin Kesselberg]

Aye, ya missed me point. I did- I was a meth addict- I still had hopes and dreams, I just put them on hold while I used. You think I was oblivious to the fact that I was destroying my life? Don't be so presumptuous. Because when I got clean, I didn't want to use meth, but I was still the same person I was before- so I replaced my compulsion to use deadly substances with education, community service, goals, love... etc.

You simply stopped using and overcame your addiction and then decided to do something constructive. You didn't "replace" your addiction for meth with an addiction for education.:rolleyes:

[Dustin Kesselberg]

I've seen more definitions for the word 'disease' then you can poke a stick at. But for the most part, they all have a central point;

A disease is an impeding deviation in the normal functioning of an organism.



Do violent criminals function normally? No. Therefore they are suffering from a disease?:rolleyes:

[athon]

Do violent criminals function normally? No. Therefore they are suffering from a disease?:rolleyes:

Is this an argument? A refutation and a :rolleyes:? Seriously?

I'll pretend you had something valid to say and respond anyway. Yes, according to text book definitions of disease, psychoses that lead to criminal activity (which is an impediment of function) are diseases. An action that leads to a crime, though, is not always a disease, as the organism's function is unimpeded. Their action may simply have contravened an established rule.

The problem is not in the definition of disease, but rather the connotations of the term, which are readily related to a physical malformation or complete cessation of function. People find it difficult to see slight deviations in brain wiring or neurochemistry as impediments, especially if willpower can influence the effects.

So, I'll pretend you defined criminal and run with that. Next time you have something to say, in the very least articulate your point clearly, give some rationalisation and try not to come across so ignorant.

Athon

[Solus]

You simply stopped using and overcame your addiction and then decided to do something constructive. You didn't "replace" your addiction for meth with an addiction for education.:rolleyes:

Some people have addictions to stupidity that's nearly incurable I'm afraid...

Really now be nice and compliment the man, no need to more bitter than I am.
Did you die in world of warcraft today or something, I morn for your loss.:rolleyes:

[athon]

Side-note; my father spent years blaming his alcoholism on being a disease. In one essence he was correct. The problem was his understanding of disease to include aspects he had no personal control of, as if the effects absolved him of responsibility. 'It's a disease, I can't help it' is irresponsible.

Everybody has the responsibility of their own differences in society. Therein lies the difference.

Athon

[Dustin Kesselberg]

Is this an argument? A refutation and a :rolleyes:? Seriously?

I'll pretend you had something valid to say and respond anyway. Yes, according to text book definitions of disease, psychoses that lead to criminal activity (which is an impediment of function) are diseases. An action that leads to a crime, though, is not always a disease, as the organism's function is unimpeded. Their action may simply have contravened an established rule.

The problem is not in the definition of disease, but rather the connotations of the term, which are readily related to a physical malformation or complete cessation of function. People find it difficult to see slight deviations in brain wiring or neurochemistry as impediments, especially if willpower can influence the effects.

So, I'll pretend you defined criminal and run with that. Next time you have something to say, in the very least articulate your point clearly, give some rationalisation and try not to come across so ignorant.

Athon

Let's assume someone doesn't have psychosis but is simply a pathological criminal. Do all pathological criminals have diseases?

[Dustin Kesselberg]

Some people have addictions to stupidity that's nearly incurable I'm afraid...

Really now be nice and compliment the man, no need to more bitter than I am.
Did you die in world of warcraft today or something, I morn for your loss.:rolleyes:

Addictions to stupidity, huh?

[athon]

Let's assume someone doesn't have psychosis but is simply a pathological criminal. Do all pathological criminals have diseases?

Are they at the whim of their compulsions? Is there a deviation in their mental functioning? Then yes.

How is this definition difficult to comprehend? There are aspects of it which are tricky to apply (such as stating precisely when something becomes an impediment, a status which is always related to the environment), but all in all the concept is quite clear.

Athon

[Dustin Kesselberg]

Are they at the whim of their compulsions? Is there a deviation in their mental functioning? Then yes.

So are all pathological criminals diseased? Should we then punish them?

[athon]

So are all pathological criminals diseased? Should we then punish them?

The question of punishment in relation to pathological illnesses is a massive can of worms with no simple answer and is a somewhat different topic, related more to the rationalisation of a penal system than to do with the definitions of disease.

Do you question whether schizophrenia is a disease as well? If somebody kills under the influence of their schizophrenic condition, should they go to jail? If somebody has any neurological condition which influences their behaviour, should they be released into society? These are not simple questions.

I don't think you've really read these posts at all, or are skimming them and refusing to really think about them, satisfied with your preexisting assumptions. If you had have read my above post about alcoholics believing that 'disease' is the equivalent of release from responsibility, then you'd already know my opinion.

Seriously, where are you going with these questions? If you have a point, state it. Games such as these make you look feeble.

Athon

[skeptigirl]

Side-note; my father spent years blaming his alcoholism on being a disease. In one essence he was correct. The problem was his understanding of disease to include aspects he had no personal control of, as if the effects absolved him of responsibility. 'It's a disease, I can't help it' is irresponsible.

Everybody has the responsibility of their own differences in society. Therein lies the difference.

AthonIf he went on to commit suicide for that alcoholism, would that be from the disease, depression? Or would the depression just be an excuse like the alcoholism?

There is no reason NOT TO separate out disease from responsibility. Who says having a disease releases you from responsibility? That simply is added on but it doesn't have to follow.

Here's a gross example that will stick in your head since it seems my example of a person with epilepsy still having the responsibility not to get behind the wheel of a car if they don't have their seizures under control just went past people.

Suppose you had a person with a colostomy. It's a disease. Does that mean if they never bothered to put on a bag and let sh!+ pour out anywhere they went they are excused because they have a disease?

Disease and responsibility are two different things. An addict is responsible to get treatment. If they kill someone or beat their wife, they are responsible. It doesn't change the nature of addiction.

[skeptigirl]

So are all pathological criminals diseased? Should we then punish them?

Yes and yes.

Thieves may not fit the definition of having a pathology but a serial murderer like Jeffry Dahmer certainly did.

[skeptigirl]

The question of punishment in relation to pathological illnesses is a massive can of worms with no simple answer and is a somewhat different topic, related more to the rationalisation of a penal system than to do with the definitions of disease.

Do you question whether schizophrenia is a disease as well? If somebody kills under the influence of their schizophrenic condition, should they go to jail? If somebody has any neurological condition which influences their behaviour, should they be released into society? These are not simple questions.

I don't think you've really read these posts at all, or are skimming them and refusing to really think about them, satisfied with your preexisting assumptions. If you had have read my above post about alcoholics believing that 'disease' is the equivalent of release from responsibility, then you'd already know my opinion.

...You are correct about the complexity and I didn't mean to lessen it in my last post. I simplified it for those having a harder time understanding 'disease' does not equate to 'excused'.

[athon]

If he went on to commit suicide for that alcoholism, would that be from the disease, depression? Or would the depression just be an excuse like the alcoholism?

I don't think alcoholism is an excuse, per se. But it doesn't absolve anybody of the responsibility one has to seek some form of treatment.

There is no reason NOT TO separate out disease from responsibility. Who says having a disease releases you from responsibility? That simply is added on but it doesn't have to follow.

Here's a gross example that will stick in your head since it seems my example of a person with epilepsy still having the responsibility not to get behind the wheel of a car if they don't have their seizures under control just went past people.

Suppose you had a person with a colostomy. It's a disease. Does that mean if they never bothered to put on a bag and let sh!+ pour out anywhere they went they are excused because they have a disease?

Disease and responsibility are two different things. An addict is responsible to get treatment. If they kill someone or beat their wife, they are responsible. It doesn't change the nature of addiction.

Ummm... I agree. That was kind of the point of my post; that my father remained responsible for his actions in spite of it being a 'disease' as such.

Athon

[Dustin Kesselberg]

Do you question whether schizophrenia is a disease as well? If somebody kills under the influence of their schizophrenic condition, should they go to jail? If somebody has any neurological condition which influences their behaviour, should they be released into society? These are not simple questions.


They're simple questions. Is schizophrenia a disease? Yes.
Should people with schizophrenia be punished like other criminals? No.
Should people who have neurological conditions which influence their behavior be free to live in society? Only if the conditions influence on their behavior doesn't make them violent.




Seriously, where are you going with these questions? If you have a point, state it.

Alcoholism isn't a disease.

[Dustin Kesselberg]

Yes and yes.

Thieves may not fit the definition of having a pathology but a serial murderer like Jeffry Dahmer certainly did.

Why punish them if they can't control their actions? If they have a disease then they aren't responsible for their actions. How can you punish them?

[ponderingturtle]

There is of course plenty of BS in psychology but do note that's it's a newer science only about 200 years old. Consider how long other sciences have had to develop.


This is irrelevant. There are plenty of sciences much newer, genetics for example. Or if you connect it to previous ideas like chemistry and biology then you can tie psychology to previous ideas of human behavior.

[ponderingturtle]

Do violent criminals function normally? No. Therefore they are suffering from a disease?:rolleyes:

Mabey, does it matter? Should an alcoholic who is a drunk driver be treated differently from someone else who drives drunk?

[CACTUSJACKmankin]

For the not-addiction crowd: what evidence would convince you that addiction is infact a disease?
For the addiction proponents: what evidence would convince you that addiction is NOT infact a disease?
Would brain scan evidence settle the issue? Why and Why not?
Is there any extent to the prevelance of willfull behavior that would settle the issue? why and why not?

BTW, there is a word for people who say psychology and psychiatry are non-scientific... scientologists.

[Dancing David]

I believe that "addiction is a disease" is a cop out. I speak as someone with an alcohol problem currently under control. I have heard researchers say that abstinence from alcohol for a period of more than 12 months can lead to control of the addiction, but I haven't been dry for 12 months yet so cannot say.

Gambling is an equally serious addiction, but what could be the biological basis for this? If something is a disease, surely there must be some biological basis. Or am I wrong on this???


I didn't say there was a disease, I said there is a biological basis for human behavior. Simply we have bodies. Most addictions are based upon the same set of behaviors as paraphilias. Not all addiction will work the same way but you have the adrenaline involved, or an obsessive compulsive disorder or other mental illness(in some cases). Then there is the compulsive cycle, which is involved in the anxiety release cycle, tension about the cognitive object and then the release of that tension. Most of what keeps the addiction going is the cognition supporting it and the training of the habits.

Then there are those who have biological vulnerabilities to addiction whatever the route may be. But anyone who has heard me speak about addiction or mental illness knows that i am a firm believer in personal responsibility.

[Dancing David]

I had this argument with someone a while ago. He went so far in the defense of the "it's a disease" statement that he suggested that, because some people are pre-disposed genetically to have alcoholism, they could therefore be said to be alcoholics even if they never have a drink. Needless to say, I found that a bit absurd.


Yeah, that sure is. Biological vulnerability does not translate to disease, even in cancer.
Now the issue of self medication , especialy in bipolar disorder, is another issue. But the alcoholism is not the disease

[Dancing David]

Psychology is mostly quackery and non-scientific, but psychiatry is not that much better.

The problem is that the brain is incredibly hard to study, much different than a heart or a lung. We know nohting about how the brain works, so as a result we stumble in defining disease vs behavior for all these psychological issues.

And I'm so freaking sick of people using MRIs and CT scans to "prove" that something is a disease. Yes, your brain lights up differently when you drink alcohol vs when you are sober. So what. Your brain also lights up differently when you eat chocolate vs eating bread, does that mean eating chocoloate is a pathological process? Of course not.

Your brain lights up differently for every single thing you do. When you are doing laundry, your brain lights up very differently than when you are sleeping. So lets please drop the sensationalistic crap with brain imaging "proving" anything at all.


Psychology can be a science, but that does not mean everything called psychology is science. Any more than alternative medicine is science.

Paging Mercutio, paging Mercutio.

[nails3jesus0]

I have heard AA people say its a disease, but not psychologists ????

I tried to find something on the american psychological association website about it, but they refer to it as 'substance abuse disorders" repeatedly.

[Dancing David]

It's only a cop out if you consider having a disease is an excuse to ignore it. Declaring addiction a moral failure provides nothing in the way of prevention or treatment. Labeling addiction a disease does not mean as a disease the person is exempt from responsibility for their behavior. Would you exempt an epileptic from responsibility who chose to drive despite not having their seizures under control?

Wasting time on matters of blame and disgust merely detract from where we should be spending time, that is conducting research for cures and treatment, as well as educating young people about triggers and thresholds instead of telling them stupid things like marijuana is a gateway drug. Drug abuse education should be evaluated for its effectiveness and we need to be willing to let go of the methods which fail. Preventing addiction is easier than treating it.

What we could do better is define the aspects of addiction which are disease and those which are the results of behavior the disease affects but for which we still hold the addict responsible. For example, drunk drivers should IMO be given jail sentences, even for first offenses. Second offenses should result in mandatory treatment for alcoholism because we know from research people with 2 DUIs are almost all alcoholics. There can be some exceptions but even then, you are probably looking at an addict that just hasn't crossed the threshold yet, triggering the disease.

If you only look at the personal responsibility, you get a person who is in all likelihood, going to re-offend when released from jail. If you only look at the illness, you get a person who's addiction does indeed result in harm to others and you don't hold the person accountable. Both aspects of addiction need to be addressed. Unfortunately we tend to only address the behavior and fail to require mandatory treatment. Yet we know from research, the addiction affects judgment. It's an unscientific approach.

Thank you, the standard of care applies wether you have a disease like schizophrenia or a biologicaly/behavioraly intermix of behaviors like addiction.

Personal responsibility rocks!

[Dancing David]

So what that comparison is still bogus.

Suppose I'm a chocolate connoisseur and eat chocolate all day long. I'm subject A.

Subject B is a person that never eats chocolate.

Now you get a fMRI or PET of both of us while eating chocolate. My brain scan will be different than his, because over all the years of chocolate eating I've formed a lot more synaptic connections than subject B has related to chocolate.

So the results of that scan are meaningless. However, I've repeatedly heard so-called scientists and their lawyer cronies claim that this imaging difference proves that its a "disease process" and therefore the person cant control their own actions or behavior.

That is the nature of expert testimony, which is not related to the biological basis of human behavior. There are many alcoholics who are not 'type two' alcoholics. There are those who have less of a biological vulnerability to alcoholism.

The fact that some people in a court use something does not invalidate what the rest of the people in the world are doing.

PS The only behavior an addict has a hard time controling is thier use. They can choose to avoid use, that is what relapse prevention is all about.

[Dancing David]

[QUOTE=skeptigirl;2447411]

For example, drunk drivers should IMO be given jail sentences, even for first offenses.

:(
Now you know that that would be almost impossible for all drunk drivers to be given jail sentences, while its just considered a misdemeanor, 364 days in jail, most offenders pay a fine and go on their way. If they do a weekend in jail, they continue to drink, it doesn't change their ways.

The fact that our court system chooses to treat it that way does not excuse the behavior. They should loose thier license for the second offense, period. No excuses, if they own the car it should be impounded.


unrelated rant

Alcohol is a real problem when people drive. Assault should not be a misdemeanor either. But hell we will continue to act as though cocaine is the real problem and put millions of people in prison for that and the alcohol manufacturing and distribution system will continue to support the most lethal substance of abuse.

[Dancing David]

Diabetes is a result of lifestyle in some cases and not the lifestyle itself. "Alcoholism" is simply drinking too much alcohol. If someone gets cirrhosis of the liver, pancreatitis, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies or sexual dysfunction from drinking too much alcohol then those things can be considered diseases. But "alcoholism" itself can't. Moreover, Addiction can simply be ended by not drinking anymore.


That is why i said that the disease model is a trick, the point is you have to not drink or use. It isn't simple at first but it becomes so.

All of your studies do nothing but argue that addiction can be genetically predisposed to specific individuals. This doesn't mean it's a disease. CRIME and VIOLENCE can be genetically predisposed to specific individuals. Is crime a disease now? If it's a disease why punish violent criminals? After all they just suffer from a disease!

Predisposition is a dangerous word, i prefer vulnerability..

I belive in incarceration for those with mental illness as well.

[Dancing David]

So are all pathological criminals diseased? Should we then punish them?


No they are not, some have learning disorders, some have mental illness, some have ADHD and other mental illnesses, most have screwed up lives and unhealthy patterns of behavior.

And yes we should punish them.

[Dancing David]

Do you question whether schizophrenia is a disease as well?

No.

If somebody kills under the influence of their schizophrenic condition, should they go to jail?

Yes. Most people who murder due to psychopsis know about treatment and are avoiding it.

If somebody has any neurological condition which influences their behaviour, should they be released into society?

Judicial choice.

These are not simple questions.

The standard of care applies in most cases.



[/QUOTE]

[Dancing David]

They're simple questions. Is schizophrenia a disease? Yes.
Should people with schizophrenia be punished like other criminals? No.

I disagree, maybe they should be in a forensic psych unit but they should be treated just like everybody else.

Should people who have neurological conditions which influence their behavior be free to live in society? Only if the conditions influence on their behavior doesn't make them violent.

Unless they are brain damaged that is highly unlikely, and even then siezure medication will usualy control it.
The only people I know who are legaly excused from their behavior, and they can still go to jail, are those with severe autism and developmental disability. I suppose dementia as well.

[Dustin Kesselberg]

Mabey, does it matter? Should an alcoholic who is a drunk driver be treated differently from someone else who drives drunk?

No. Alcoholism isn't a disease.

[ponderingturtle]

No. Alcoholism isn't a disease.

So a predisposition towards violence should be a mitigating factor, but a predispoistion towards abuseing alcohol should not be a mitigating factor?

Why?

[Dustin Kesselberg]

So a predisposition towards violence should be a mitigating factor, but a predispoistion towards abuseing alcohol should not be a mitigating factor?

Why?

I never said a predisposition towards violence should be a mitigating factor.

[Earthborn]

Do all pathological criminals have diseases?Yes, by definition. "Pathology" means "disease".

[Dustin Kesselberg]

Yes, by definition. "Pathology" means "disease".

The word I meant to use is 'persistent'.

[Earthborn]

The way I see it (coming from a predisposed addict), is by asking the biological question: how does this genetic disposition benefit someone? If there are benefits, how can it be a disease?That's not a useful way of looking at it, because many things you have no trouble recognising as diseases also have benefits. Whether some genetic predisposition becomes a disease or a benefit depends on the circumstances.

An example: dark skinned people have the benefit of being better protected against sunlight. If they move to a place with less sunlight, they run the risk of serious vitamin D deficiency. Vitamin D deficiency is a disease, even though the genetic predisposition to a high risk to it benefits millions of people worldwide.

[Twilek]

I looked at my psychology textbooks I've kept over the years. It's not defined as a disease after all. If someone really wants me to, I'll take pictures of the pages; there is some good information within the book.

Way too much for me to type out however.

That reminded me, I believe I've encountered that as well. I have a friend who is a psychiatrist and when I read about this in his books it said basically that you should treat the patient as if it is a disease. Meaning, if you tell someone they are sick and lay out a treatment plan for them, they will respond to the advice more positively than telling them the only way to stop being addicted is to just start saying "no". Obviously I'm paraphrasing, but the way it was worded in the book made a lot of sense.

[TellyKNeasuss]

We know that male identical twins raised apart have higher correlation of alcoholism than fraternal twins raised apart. And for some reason this does not appear in female twins raised apart.


About 15 years ago, I was one of the "guinea pigs" for a prototype alcohol abuse prevention program at a university that I was a grad student at. Their finding was that the percentage of cases in which only 1 of a pair of identical was an alcoholic was statistically equal to the percentage of cases in which only 1 of a pair of fraternal twins was an alcoholic.

[chris epic]

That's not a useful way of looking at it, because many things you have no trouble recognising as diseases also have benefits. Whether some genetic predisposition becomes a disease or a benefit depends on the circumstances.

An example: dark skinned people have the benefit of being better protected against sunlight. If they move to a place with less sunlight, they run the risk of serious vitamin D deficiency. Vitamin D deficiency is a disease, even though the genetic predisposition to a high risk to it benefits millions of people worldwide.
Thats a good point, but I don't see how that justifies addiction as a disease. And it's rather screwey logic when using it with the addiction problem.

[chris epic]

You simply stopped using and overcame your addiction and then decided to do something constructive. You didn't "replace" your addiction for meth with an addiction for education.:rolleyes:
Dustin, you dont have a clue buddy :rolleyes: :rolleyes: :rolleyes: I said compulsion, not addiction- it was my compuslive behavior that contributed to my addictions, it is my compulsive behavior that threw me into a thousand constuctive, non-substance replacements. If you honestly think you can draw any conclusions on my life by reading a few of my posts, you're sadly mistaken

[skeptigirl]

Why punish them if they can't control their actions? If they have a disease then they aren't responsible for their actions. How can you punish them?How does having a disease = being unable to control it?

This is the crux of the matter. When the medical community views a problem such as addiction using a disease modal, an incorrect assumption is made by many people that disease means "can't stop yourself". That isn't what the disease model means. If I have a disease, there are many things about it I can control and some I cannot.

The point of using the disease model is it results in avenues of investigation that lead to solutions. Using the premise addiction is a personal failure generally results in a cycle of perpetuating the problem.

At the same time, if research into addiction and other sociopathic behaviors does uncover evidence the behavior is not controllable, then isn't it better to know that than to just keep letting people out of jail after a crime, using the false premise they have the ability to control their behavior?

Some sociopathic disease exists which still leaves the person with a brain defect but they do have control over their behavior. Just as someone with rheumatoid arthritis must live with the unpleasant consequences of their disease, a person with a sociopathic disease may suffer severe emotional consequences controlling their disease. It might mean a pedophile must restrict his movements and cannot be around children ever. But without recognition of the disease factors in that pathological condition, we simply expect that person to control themselves or go to jail. I expect them to control themselves or go to jail as well but medical research may give that person better tools with which to control the behavior. And where research discovers how to detect the dangerous pedophile from the responsible one, we will also have the tools to mandate incarceration in a treatment facility.

Same with determining through research rather than through social stigma who can and who cannot control their addiction. If meth addicts suffer brain damage which disables their ability to recover, then they need long term inpatient treatment. Alcoholics very often need antidepressant medication.

The point is, medical research can sort out fact from moral judgment and with that provide better tools to stop sociopathic behavior before crimes are committed rather than merely providing the revolving prison door and a lot of harmed bystanders.

[UserGoogol]

So are all pathological criminals diseased? Should we then punish them?

Punishment has two purposes. The first is to prevent a person from doing it again, and the second is to deter other people from doing it. Neither of those purposes are really contradictory with the idea that criminality is a disease. If it works, it works. As it currently stands, we do not have an effective medical treatment for "excessive willingness to commit crime," so punishment is the best option available.

ETA: And of course, there's a difference between having a diseased mind and being legally insane.

[chris epic]

Punishment has two purposes. The first is to prevent a person from doing it again, and the second is to deter other people from doing it.

I think it is safe to say that time has proven that the presence of punishment, at least in America, hasn't done much to prevent crimes- people still commit murder knowing they could face life in prison or the death penalty. The same goes for preventing a person from doing it again. A person that goes to prison for drugs can find drugs easier in prison. A person that commits murder; imprisonment doesn't prevent them from committing murder again.

Ultimately, punishment has one purpose: justice- vindication for the state or the victim or the victim's family.

Imprisonment has two purposes: vindication and seperation from society.

[ponderingturtle]

I never said a predisposition towards violence should be a mitigating factor.

But that can pretty easily fit into the catagory of disease.

[skeptigirl]

Mabey, does it matter? Should an alcoholic who is a drunk driver be treated differently from someone else who drives drunk?
The more appropriate questions here are, "what percentage of drunk drivers have some degree of alcoholic disease"? Because my reading suggests most if not all.

And the second question is, "what is the best way to prevent drunk drivers from driving drunk the next time"? Punishment is also supposed to deter the crime. If you assume a person has the ability to quit driving drunk without treatment, then how many will do it again after you 'punish them'? I'd say 15,000 deaths a year suggests mere criminal prosecution isn't a very effect deterrent. I think if the courts recognized how many alcoholics they were slapping on the wrist they might be inclined to take a different approach.

There is a panel of blood tests, for example, that can give you a definitive diagnosis of alcoholism. Abnormalities on a CBC and a liver panel consistently correlate with daily drinking (more than a couple drinks) and/or severe binge drinking. It should be a standard test ordered on all DUIs. The results should be used to order inpatient treatment. Set the treatment up in the jail if you like. The costs you save in preventing disease consequences would pay for the programs.

The person so detained could have work release as soon as they were stable and if employers viewed the addiction as a disease, sick leave would be more acceptable. It would save the employer money if the person could be successfully treated.

But as long as we just sentence the crime and ignore the disease aspects, we let 15,000 more people die every year.

[skeptigirl]

For the not-addiction crowd: what evidence would convince you that addiction is infact a disease?
For the addiction proponents: what evidence would convince you that addiction is NOT infact a disease?
Would brain scan evidence settle the issue? Why and Why not?
Is there any extent to the prevelance of willfull behavior that would settle the issue? why and why not?

BTW, there is a word for people who say psychology and psychiatry are non-scientific... scientologists.There already exists overwhelming evidence of the disease components of addiction.

What you aren't asking here is what evidence suggests we should or shouldn't hold a person responsible for the consequences of their disease?

And what evidence suggests the best approach to take with a pathology that results in harm to bystanders?


And I love that last comment. Evidence based medicine is only a little older than the evidence based premise the brain is an organ just like the liver and pancreas are organs. For a bit longer than the rest of the science of medicine, humans operated under the premise there was a mind body separation. So research into the aspects of behavior and emotion lag a bit behind, but we are at least now aware of the fact brain research is not any more unique than research into other aspects of the human body. There is a structure and an electrochemical physiology and low and behold, no mysterious 'soul' to worry about.

[ponderingturtle]

The more appropriate questions here are, "what percentage of drunk drivers have some degree of alcoholic disease"? Because my reading suggests most if not all.

Then we get back to a semantic arguement about what is an alcoholic and what is a disease. Hmm we have not argued over the proper definition of what an alcoholic is yet in this thread, this seems like a good starting point for it.

You could pretty easily come up with a definition of alcoholic that covered everyone who ever gets a BAC over .08 the federal limit for drunk driving

And the second question is, "what is the best way to prevent drunk drivers from driving drunk the next time"? Punishment is also supposed to deter the crime. If you assume a person has the ability to quit driving drunk without treatment, then how many will do it again after you 'punish them'? I'd say 15,000 deaths a year suggests mere criminal prosecution isn't a very effect deterrent. I think if the courts recognized how many alcoholics they were slapping on the wrist they might be inclined to take a different approach.

THe criminal prosecution is often pretty weak. I know someone who was killed by a drunk driver and the driver was not in prison for more than a year.

So saying punishment does not work, well at the current level it doesn't.

There is a panel of blood tests, for example, that can give you a definitive diagnosis of alcoholism. Abnormalities on a CBC and a liver panel consistently correlate with daily drinking (more than a couple drinks) and/or severe binge drinking. It should be a standard test ordered on all DUIs. The results should be used to order inpatient treatment. Set the treatment up in the jail if you like. The costs you save in preventing disease consequences would pay for the programs.

But how does the relate to how alcoholics are universaly defined?

[skeptigirl]

I didn't say there was a disease, I said there is a biological basis for human behavior. Simply we have bodies. Most addictions are based upon the same set of behaviors as paraphilias. Not all addiction will work the same way but you have the adrenaline involved, or an obsessive compulsive disorder or other mental illness(in some cases). Then there is the compulsive cycle, which is involved in the anxiety release cycle, tension about the cognitive object and then the release of that tension. Most of what keeps the addiction going is the cognition supporting it and the training of the habits.

Then there are those who have biological vulnerabilities to addiction whatever the route may be. But anyone who has heard me speak about addiction or mental illness knows that i am a firm believer in personal responsibility.

Obsessive compulsive disorders offer insight into addictions to things like shopping, hoarding and gambling.

[skeptigirl]

Originally Posted by skeptigirl (italics)

For example, drunk drivers should IMO be given jail sentences, even for first offenses.

[Simone:] The fact that our court system chooses to treat it that way does not excuse the behavior. They should loose thier license for the second offense, period. No excuses, if they own the car it should be impounded.


unrelated rant

Alcohol is a real problem when people drive. Assault should not be a misdemeanor either. But hell we will continue to act as though cocaine is the real problem and put millions of people in prison for that and the alcohol manufacturing and distribution system will continue to support the most lethal substance of abuse.

Note the confused quote attribution, thanks. One of the drawbacks of the edit option time limit. :)


BTW, I share your rant.

[skeptigirl]

For example, drunk drivers should IMO be given jail sentences, even for first offenses.

:(
Now you know that that would be almost impossible for all drunk drivers to be given jail sentences, while its just considered a misdemeanor, 364 days in jail, most offenders pay a fine and go on their way. If they do a weekend in jail, they continue to drink, it doesn't change their ways.Why is this impossible?

The problem is drunk driving laws do not reflect the 15,000 annual deaths from drunk drivers. IMO, drunk driving laws and sentences reflect the fact many judges and legislators as well as much of the public underestimates this fact and underestimates the role addiction to alcohol plays in DUIs.

[skeptigirl]

Diabetes is a result of lifestyle in some cases and not the lifestyle itself. "Alcoholism" is simply drinking too much alcohol. If someone gets cirrhosis of the liver, pancreatitis, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies or sexual dysfunction from drinking too much alcohol then those things can be considered diseases. But "alcoholism" itself can't. Moreover, Addiction can simply be ended by not drinking anymore.



So?



So?



All of your studies do nothing but argue that addiction can be genetically predisposed to specific individuals. This doesn't mean it's a disease. CRIME and VIOLENCE can be genetically predisposed to specific individuals. Is crime a disease now? If it's a disease why punish violent criminals? After all they just suffer from a disease!You need to separate responsibility from disease, the two are not equal. And the way you are defining disease here or the way you are viewing pathology is not the way the medical community views/defines pathology and disease.

[skeptigirl]

He didn't argue that brain scans can't effectively study the brain. He argued that they are irrelevant to the discussion of whether addiction is a disease or not. Brain scans can show that people who are more violent tend to have differently working brains than non-violent people. Do you now argue that violence is a disease? If it's a disease then why should we punish violent criminals?Again, this reflects a poor understanding of brain research.

[skeptigirl]

I've seen more definitions for the word 'disease' then you can poke a stick at. But for the most part, they all have a central point;

A disease is an impeding deviation in the normal functioning of an organism.

'Normal functioning' is always the sticking point; all organisms vary, and the extent to which this variation impedes their wellbeing or way of life can be rather open to debate. Yet diseases are always an alteration of the normal functioning, which is a good place to start with exploring whether something is a disease or not.

The question is; could your functioning be said to be affected which results in an addiction? The straight forward answer is 'yes'. Now, are all addictions perversions of normal functioning? I would argue again 'yes', only on the grounds that the mind and our behaviour have no non-material part, therefore can only result from neural functioning. If this fails, even if from lack of will power, determination or desire, I would define that as a failure in function.

The problem arises because we associate pity with disease, as if we can seperate functioning from desire. If somebody is sick, it's not their fault. I can't make that association with the term 'disease' by any stretch of the definition. Therefore, whether they have control or not, it remains a disease if their functioning is impeded in some manner.

My two cents.

AthonThese are indeed some of the issues which interfere with discussion of addiction as well as some other sociopathic behaviors.

Obesity draws the same problems. We blame people for their overeating. But the science suggests that with only about 5% of obese people trying to diet succeeding, it may be akin to telling someone to hold their breath. In other words overriding a biological imperative is not a simple matter of willpower. The fact a very small number of people succeed is not evidence everyone has the same ability. For as yet undetermined reasons, that 5% have been able to reset the mechanisms which regulate their caloric intake drive.

So you have pity, disgust, blame and different definitions of disease and pathology, as well as a long tradition of viewing brain pathology differently from other pathology.

Take this news story, Brain-damaged people give insights into morality (http://news.yahoo.com/s/nm/20070322/hl_nm/brain_morality_dc;_ylt=AssDQ_uH_VKpfR73ghn9xp0Q.3Q A), for example. If a person had a stroke or brain trauma we would view their behavior change as pathology. But the person born with the same lack of 'a conscience' so to speak, from identical damage or insufficiency of the section of the brain in question would be seen as a criminal.

[skeptigirl]

That reminded me, I believe I've encountered that as well. I have a friend who is a psychiatrist and when I read about this in his books it said basically that you should treat the patient as if it is a disease. Meaning, if you tell someone they are sick and lay out a treatment plan for them, they will respond to the advice more positively than telling them the only way to stop being addicted is to just start saying "no". Obviously I'm paraphrasing, but the way it was worded in the book made a lot of sense.
This is a good point but I would clarify it a bit. When we use the disease model it provides better alternatives to treatment than the immoral behavior model. And research has shown that the cycle of drinking for some people is guilt->drinking->guilt-> drinking so if we can interrupt the cycle by interrupting the guilt it does have a positive effect.


Before I get :bricks: , interrupting the guilt cycle doesn't have to include absolving responsibility. There is the simple act of acknowledging the role guilt plays which has an affect.

[skeptigirl]

About 15 years ago, I was one of the "guinea pigs" for a prototype alcohol abuse prevention program at a university that I was a grad student at. Their finding was that the percentage of cases in which only 1 of a pair of identical was an alcoholic was statistically equal to the percentage of cases in which only 1 of a pair of fraternal twins was an alcoholic.The point?

[athon]

They're simple questions. Is schizophrenia a disease? Yes.

Based on what definition?

Should people with schizophrenia be punished like other criminals? No.

Why not? What is your view of the justice system? I assume it's purely retributive from your statement.

Should people who have neurological conditions which influence their behavior be free to live in society? Only if the conditions influence on their behavior doesn't make them violent.

Interesting that you used the word 'influence'. I'm glad you understand that much. So how are addicts not influenced by their physiology?

Alcoholism isn't a disease.

So you keep saying. Repitition doesn't make it true, though. Have something of substance to say or is it a case of fingers in ears, singing 'lalala'?

Give me your definition of disease, if the one pathologists use doesn't suit you.

For the not-addiction crowd: what evidence would convince you that addiction is infact a disease?

See definition for disease. Addicts have a variation in functioning which impedes normal functioning.

The word I meant to use is 'persistent'.

So, you always have a habit of using your own definitions? Pathological behaviours indicate compulsion resulting from a neurological variation.

Again, let's hear your own definition.

This is the crux of the matter. When the medical community views a problem such as addiction using a disease modal, an incorrect assumption is made by many people that disease means "can't stop yourself". That isn't what the disease model means. If I have a disease, there are many things about it I can control and some I cannot.

Well said, skeptigirl. Thanks. But I don't think Dustin will cope with that definition. He'll invent his own, thank you very much. :rolleyes:


Athon

[athon]

So saying punishment does not work, well at the current level it doesn't.

Which comes to the crux of the issue. Having predispositions which influence your behaviour, be it violence, addiction, or merely not having the emotional capacity to work in society, adds a level of difficulty in being able to modify your behaviour. This does not equate being excused from your responsibility, but it does mean we are all products of our physiology.

Punishment makes us feel better for not committing a crime. It's pure retribution; do bad things and you will have bad things happen to you. The question of how it makes society safer has been questioned since the dawn of time.

The other facets of the penal system - rehabilitation and removal - aim to fix the problem by a) changing the behaviour of the individual to work better in society, or b) remove them from the social group altogether. Both have merits, but both have inherent problems as well.

It's no simple problem. But understanding that our behaviours, through all of the extremes, are born in our physical wiring (both congenital and developed), might help us come to some solution which actually works.

Athon

[skeptigirl]

Then we get back to a semantic arguement about what is an alcoholic and what is a disease. Hmm we have not argued over the proper definition of what an alcoholic is yet in this thread, this seems like a good starting point for it.I was replying to:For the not-addiction crowd: what evidence would convince you that addiction is infact a disease?
For the addiction proponents: what evidence would convince you that addiction is NOT infact a disease?
Would brain scan evidence settle the issue? Why and Why not?
Is there any extent to the prevelance of willfull behavior that would settle the issue? why and why not? So the point of your reply loses me. Defining alcoholism is not as difficult an issue as you suggest. It's a matter of sorting out the people who got drunk at a college party and drove drunk from the people who drink on a regular basis and have an addiction, even one not fully developed. There is no sense sending the idiot who didn't realize boilermakers could have such a rapid affect to inpatient treatment for alcoholism.

Give me a medical history and two tubes of blood and I can tell you if you have an alcohol problem and to what degree you have it. And that makes for nice objective criteria to base a diagnosis on.

You could pretty easily come up with a definition of alcoholic that covered everyone who ever gets a BAC over .08 the federal limit for drunk drivingWe have come further in alcoholism research than this.

THe criminal prosecution is often pretty weak. I know someone who was killed by a drunk driver and the driver was not in prison for more than a year.

So saying punishment does not work, well at the current level it doesn't.You won't get an argument from me here. But if we are going to up the sentences (which we should) doesn't it make sense to use the research we have and make that time in jail as productive as possible?

Besides, I can tell you there is also plenty of research that consequences are not on the mind of the relapsing addict.

But how does the relate to how alcoholics are universaly defined?What do you mean, how does it relate? We do manage in medicine to develop universal diagnostic criteria for diseases. How would it not relate?

[skeptigirl]

Here is one example of the research into laboratory tests for level of alcohol use. There are more tests than these, some more sensitive and specific than others. A medical practitioner can make a pretty good call on this disease with current knowledge. Add the history and blood tests to the fact you have a person with a DUI and an accurate diagnosis is well within the capability of modern medicine.

Comparison of the combined marker GGT-CDT and the conventional laboratory markers of alcohol abuse in heavy drinkers, moderate drinkers and abstainers. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=16799164)RESULTS: GGT-CDT (5.35 +/- 1.08) in the heavy drinkers was significantly higher than in the reference individuals (3.30 +/- 0.37). The sensitivity of GGT-CDT (90%) in correctly classifying heavy drinkers exceeded that of CDT (63%), GGT (58%), mean corpuscular volume (MCV) (45%), aspartate aminotransferase (AST) (47%), and alanine aminotransferase (ALT) (50%), being also essentially similar for alcoholics with (93%) or without (88%) liver disease. When comparing the data using either moderate drinkers or abstainers as reference population, the sensitivity of GGT-CDT, CDT, and ALT remained unchanged whereas the sensitivity of GGT, MCV, and AST was found to show variation. CONCLUSIONS: GGT-CDT improves the sensitivity of detecting excessive ethanol consumption as compared with the traditional markers of ethanol consumption. These findings should be considered in the assessment of patients with alcohol use disorders.

[skeptigirl]

...

Well said, skeptigirl. Thanks. But I don't think Dustin will cope with that definition. He'll invent his own, thank you very much. :rolleyes:


AthonThan you and you're welcome. Perhaps we should ask Dustin if he harbors some bitterness about alcoholism or addiction for any particular reason or is he just disgusted with drug users in general?

[chris epic]

The more appropriate questions here are, "what percentage of drunk drivers have some degree of alcoholic disease"? Because my reading suggests most if not all.

I disagree. Getting pulled over for a DUI is literally luck of the draw. I have driven 100s of times drunk and have gotten two DUIs. Most people tha get DUIs were just in the wrong place at the wrong time.

I am in an alcohol class weekly per my DUI sentence. In a room of about 25 of us, about 4 or 5 say they are alcoholics, the rest are college students that just shoudn't have driven that night, but admit they don't believe they have alcoholism. Of coarse they could be lying, in denial, or haven't reaped enough consequences in their life as a result of drinking, but for the most part, they don't seem to fit the profile.

Its one of the first questions I ask them "do you think you have a problem with drinking?" and most of them say no. But it isn't like its hard to be honest with everyone in there.

[Aquila]

Would you call the long term use of prescription drugs like Lipitor an addiction?
The person taking them originally had a choice to start them or change their symptoms through diet and excercise. Those who chose the drugs often cannot come off them without being given serious consequences from their doctors. It's really a dependence, not addiction, but I think the same principles of free choice versus pressure from society apply.

[skeptigirl]

Would you call the long term use of prescription drugs like Lipitor an addiction?
The person taking them originally had a choice to start them or change their symptoms through diet and excercise. Those who chose the drugs often cannot come off them without being given serious consequences from their doctors. It's really a dependence, not addiction, but I think the same principles of free choice versus pressure from society apply.These are simply unrelated concepts. You are ignoring the qualities of addiction that distinguish it from simply using something everyday.

[Simone]

Why is this impossible?

The problem is drunk driving laws do not reflect the 15,000 annual deaths from drunk drivers. IMO, drunk driving laws and sentences reflect the fact many judges and legislators as well as much of the public underestimates this fact and underestimates the role addiction to alcohol plays in DUIs.
Jails are so overcrowded with other crimes. Locking people up because they are caught driving drunk the first time will never happen. I have delt with people that have been arrested 40+ times for various crimes and are still walking the street.
Some murderers are released 3 years or less.

A DUI driver loses his license after the 3rd conviction of DUI. His license is suspended or revoked, for up to 3 years or more. If he is caught driving on a DUI again during this suspension, his car can be impounded and he is charged with felony DUI, spends the night in jail and is brought before the judge for bond hearing.
The laws appear strict, but there always seem to be cracks that people slip through. There needs to be more severe punishments, I agree.
People continue to drive anyway, they continue to drink.
Unless they are involved in a crash that results in death to the other party, they go to jail and don't get to drink anymore!
And he will probably use that excuse to continue to drink when he gets out.
A vicious circle.

[skeptigirl]

Originally Posted by skeptigirl
The more appropriate questions here are, "what percentage of drunk drivers have some degree of alcoholic disease? Because my reading suggests most if not all"?

I disagree. Getting pulled over for a DUI is literally luck of the draw. I have driven 100s of times drunk and have gotten two DUIs. Most people tha get DUIs were just in the wrong place at the wrong time.

I am in an alcohol class weekly per my DUI sentence. In a room of about 25 of us, about 4 or 5 say they are alcoholics, the rest are college students that just shoudn't have driven that night, but admit they don't believe they have alcoholism. Of coarse they could be lying, in denial, or haven't reaped enough consequences in their life as a result of drinking, but for the most part, they don't seem to fit the profile.

Its one of the first questions I ask them "do you think you have a problem with drinking?" and most of them say no. But it isn't like its hard to be honest with everyone in there.Actually, the fact people do drive drunk 100s of times for every 1 time they get caught is one of the reasons people with DUIs typically have addictive behaviors.

It sounds like you recognize you have a problem and you are saying the other guys in the class really did get caught on that one time they drove drunk. I can guarantee you unless your class is an anomaly, they are in denial.

Denial is a prominent feature of alcoholism. Lots of people have an issue with the word, "alcoholic". They picture it is the guy who is, "worse than me, therefore I am not one." And even if you don't focus on the terminology, research shows people underestimate how often they drink and how often they drink and drive. Family members underestimate how much the alcoholic drinks as well. Another feature of alcoholism is constantly offering drinks to others or getting them to engage in drinking such as, "let's go to the pub." The reason is it helps the person in denial feel their level of drinking is "normal". "See, everyone else drinks as much as I do, so I am OK."

[skeptigirl]

Jails are so overcrowded with other crimes. Locking people up because they are caught driving drunk the first time will never happen. I have delt with people that have been arrested 40+ times for various crimes and are still walking the street.
Some murderers are released 3 years or less.

A DUI driver loses his license after the 3rd conviction of DUI. His license is suspended or revoked, for up to 3 years or more. If he is caught driving on a DUI again during this suspension, his car can be impounded and he is charged with felony DUI, spends the night in jail and is brought before the judge for bond hearing.
The laws appear strict, but there always seem to be cracks that people slip through. There needs to be more severe punishments, I agree.
People continue to drive anyway, they continue to drink.
Unless they are involved in a crash that results in death to the other party, they go to jail and don't get to drink anymore!
And he will probably use that excuse to continue to drink when he gets out.
A vicious circle.

You are confusing what does happen with what should happen. I discuss what should happen because it never will if no one talks about it.

Those 15,000 annual deaths are hidden in that not enough people are paying enough attention.

[chris epic]

It's really a dependence, not addiction,In this circumstance, dependency is synonymous with addiction. When people in the medical or psychological field speak of developing chemical dependency, they are just using a less abrasive word for addiction.

[chris epic]

Another feature of alcoholism is constantly offering drinks to others or getting them to engage in drinking such as, "let's go to the pub." The reason is it helps the person in denial feel their level of drinking is "normal". "See, everyone else drinks as much as I do, so I am OK."
Yes, that's called "misery loves company."

I can see that. There are also varying degrees of alcoholism. The general stereotype is a soul-batered man or woman, under weight with a bottle of vodka in arms reach. Not so typical, though- I was never one of "those" alcoholics. I was the type, however, where once I had one drink, it was very very very hard for me to just leave it at that, and if I did stop at just one drink, I felt miserable at the amount of self-restraint I had to exhibit. Another "symptom" was the choiced I made when I was drunk: usually always bad- criminal in fact, or violent. I had to stop period. But it wasn't just the DUI sentence that influenced my decision to quit, because I continued to drink until months after my last DUI- it was a combination of things- and I knew it was important that my choice to quit wasn't because I was court ordered- I had to quit because I wanted to quit. I think the last straw was when I faught with one of my friends, a pretty ugly fight, and then got into an awesome relationship with a woman that inspired me to better myself.

I think we're getting caught up in connotation. I have ADD, but I wouldn't call it a disease although it contributes to "abnormal behavior" (what ever the hell that means). Its a disorder... again, what ever- For all I know, the alcoholism, the substance abuse; it's all rooted in my "ADD"- but I can't seem to consider that a disease either when I feel its contributed to other positive things in my life like excessive thought and introspection, art, and a good sense of humor.

[chris epic]

As far as jail for DUI offenders- I was put in work-release. In the city I live in, the jails are over crowded, so they leave non-violent offenders out of jail first, makes sense to me.

[HawkeyeMD]

In this circumstance, dependency is synonymous with addiction. When people in the medical or psychological field speak of developing chemical dependency, they are just using a less abrasive word for addiction.

Not exactly. :cool:

The problem with the word 'addiction' isn't the abrasiveness, it's the difficulty in defining the term, just like you're seeing here. It's easier to define 'abuse' and 'dependence', and both people who are abusing or are dependent can be addicts.

Roughly, abuse is abnormal use of the substance even though it interferes with social, occupational or physical functioning. Dependence is that plus tolerance, withdrawal symptoms or a pattern of compulsive use.

[nails3jesus0]

ok I guess I got ignored. I tried to find evidence of psychologists deeming addiction a disease, rather than a disorder, and found none. I think the whole AA mantra of addiction being a disease is silly and untrue, but I think psychology is getti