Timely for me. I'm currently reading The Urge: Our History of Addiction by Carl Erik Fisher, which has been very interesting so far.
posted by Well I never at 1:44 AM on September 19 [1 favorite]

an interesting article, but why in the actual fuck are they referring to a woman with a PhD as a "dropout"
posted by 5_13_23_42_69_666 at 2:26 AM on September 19 [5 favorites]

Fascinating article. I¡¯m in recovery myself - a 12 step program is working for me. I think I¡¯ll need to read this a few times to understand it.

Keep coming back.
posted by awfurby at 2:34 AM on September 19 [3 favorites]

why in the actual fuck are they referring to a woman with a PhD as a "dropout"

geds qualify for high school equivalency in the united states with which the guardian, as a british paper, may be unfamiliar [wiki²]

see e.g. table [jama] in study with phd as lead author
posted by HearHere at 3:27 AM on September 19 [1 favorite]

people with substance-use disorders are actively discouraged from vocalising what they want from the recovery process. ¡°If they try, they are told that they are selfish; that their character defects and thinking were what got them into trouble; and that thinking for themselves is dangerous.

This is the problem I found with AA. It was very demoralizing to be told my addiction was my fault and moral failing. There were things I did like about AA, especially the aphorisms, but I found that there were too many know it alls and judgmental people trying to take over the meetings. I went to rehab last year and was disgusted by how demoralizing the staff were to the patients. The last thing an addict needs to hear is that they aren¡¯t capable of making choices for themselves, all the while many of the staff are vaping during meetings.

I have a PhD and did medical research for 35 years, although not in addiction research. I did think about switching over but never did. I wish I had because the field is extremely interesting, to say the least.
posted by waving at 3:36 AM on September 19 [11 favorites]

an interesting article, but why in the actual fuck are they referring to a woman with a PhD as a "dropout"


Because she dropped out of high school but ended up becoming a scholar with a PhD? It's kind of the narrative arc of the article.
posted by hankmajor at 3:37 AM on September 19 [5 favorites]

That¡¯s not my experience of AA. My experience of it is that just like many many other people I experience feelings about myself that I don¡¯t know how to deal with, and alcohol was the solution to that. The problem comes when if you take alcohol away what replaces it in dealing with those feelings? The 12 steps aren¡¯t about feeling like an immoral loser but about learning to deal with the parts that make me ¡°restless, irritable and discontented¡±.

Acceptance, fellowship and service are the replacements for alcohol.
posted by awfurby at 4:02 AM on September 19 [2 favorites]

These people need professional help, but none is forthcoming.
posted by es_de_bah at 5:15 AM on September 19 [2 favorites]

A lot of this debate about the role of agency in addiction is being made obsolete in real time by the incredible impact of GLP-1s on compulsive overeating and its cardiac, respiratory and metabolic comorbidities. They are already powerfully effective to reduce drug and alcohol consumption for many patients prescribed for obesity or obesity-caused diabetes, and what they are teaching about brain pathways for pleasure-seeking may lead to drugs that are expressly designed to counter opioids, cocaine and amphetamines.
posted by MattD at 6:17 AM on September 19 [7 favorites]

Smith always maintained that her drug taking was a choice

Then she has nothing to complain about, does she? Or could it be that addiction damages the user's ability to make a choice? Like a compulsion? Or a disease?

As a recovering addict myself, I found nothing at all useful in what Smith offers. She simply seems to bristle at the idea that she isn't fully in control of her actions, or that her addictive behavior is something she'll have to guard against for the rest of her life. It is often difficult to accept hard truths.
posted by SPrintF at 8:20 AM on September 19 [5 favorites]

I really went into this wanting to believe Smith, as she so clearly feels it is important to be believed, about her understanding of her own mind and motivations. But whew, she comes off as a pretty unreliable narrator in this article. I haven't read her scholarly work so maybe it's the Guardian that is doing her dirty, dunno.
posted by We put our faith in Blast Hardcheese at 2:19 PM on September 19 [3 favorites]

Yeah, the question at the beginning of addiction isn't "did you decide to shoot up that first time by yourself?", but "what made being a junkie look so romantic to you in the first place?"

I think most of us addicts start off thinking we are just looking for some fun when we're really looking for emotional distance from something painful in our lives. And the shit of it is, it works! For a while, anyhow.

I'm not going to make any definitive statements about the inner life of this woman - I wish her peace. But poverty and abuse aren't the only kinds of pain that can foster an addiction.

What worries me about her framing is that it's a throwback - blaming a person for that very first decision to use, and all the sequelae. I mean, let's remember that even the disease model just got really accepted in the US after white kids from nice families got addicted to oxy, and suddenly you couldn't just blame "those kind of people".

I mean, for alcoholics, there had been wider acceptance, but for users of any other kind of drug, no chance before oxy hit the suburbs.

So in THIS political environment, how do we think this line of thought will be used?
posted by Vigilant at 11:59 AM on September 20 [4 favorites]

They are already powerfully effective to reduce drug and alcohol consumption for many patients prescribed for obesity or obesity-caused diabetes, and what they are teaching about brain pathways for pleasure-seeking may lead to drugs that are expressly designed to counter opioids, cocaine and amphetamines.

This is a narrow way to view a situation. Solving addiction with a silver bullet, sounds pretty futile
posted by Didymus at 7:34 AM on September 21 [1 favorite]

MattD: "A lot of this debate about the role of agency in addiction is being made obsolete in real time by the incredible impact of GLP-1s on compulsive overeating and its cardiac, respiratory and metabolic comorbidities. They are already powerfully effective to reduce drug and alcohol consumption for many patients prescribed for obesity or obesity-caused diabetes, and what they are teaching about brain pathways for pleasure-seeking may lead to drugs that are expressly designed to counter opioids, cocaine and amphetamines."

I have tried to get GLP-1 prescribed to me for alcohol addiction to no avail. For some reason my provider will not write a prescription. I have been to rehab. I¡¯ve taken naltrexone and these have just not completely helped me yet. So this morning, I went to an online pharmacy and ordered some and I¡¯m paying out-of-pocket for it. I got a psych consult with a nurse practitioner, which was a huge waste of time. She wouldn¡¯t even prescribe Acamprosate. The only thing she would prescribe to me were SSRI, which I have been told. I absolutely cannot take because I have bipolar disorder. It seems to get decent care. You really just have to pay out-of-pocket.
posted by waving at 7:41 AM on September 22

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