Alcoholics are frequently people who don't realize they have anxiety disorders, and think they need alcohol to be calm. People who drink cup after cup of coffee/soda because it helps them to "focus" and "be productive" might do well with being tested for ADD. People with undiagnosed clinical depression get hooked on cigarettes way more often than other groups. Etc.

The famous Rat Park experiment showed that addiction is not nearly as common a thing, for neurotypical individuals living in an adaptive environment, as we assumed when we built our models of addiction epidemiology. Most addicts (sparing a few drugs like cocaine and heroin that create strong chemical dependence) are either not neurotypical, or in a mal-adaptive environment, or both. Fix the problem with the neurology or the environment, and the addiction becomes easy to break.

A lot of recreational drugs are fine if approached in a medical context. Amphetamines, nicotine, MDMA, whatever—given appropriately-controlled dosing and a desire to achieve a therapeutic effect rather than a "high", one can consume these substances in a long-term fashion without addiction, and remain "healthy" or even "healthier".

It's the undiagnosed who are the problem. Since they don't think they have a problem (except perhaps a problem common to all human experience, or a problem with their environment—anything but an uncommon neuroendocrine ailment) they don't even realize that there's any other point than the "high" to begin with. They pursue these drugs because they seem really, really good: they get the recreational effects and they help with their problems! And then they get addicted, because they associate a recreational dosing schedule (rather than a therapeutic one) with their life getting better.

Are you sure? Prescription drug abuse is rampant. And in my experience, most of these people do legitimately need the drugs they're abusing - but they also see them as "fun recreational substances." I've noticed this seems to be especially true for anti-anxiety medications and painkillers. People take them to treat their conditions and to enjoy the way the abuse of it makes them feel. I think the fact it's a legitimate prescription makes it "okay" since in their minds they need it and there's no harm in taking extra because of that.

Of course, then they run out of their prescription before they can refill it and then there's some miserable days (or shady transactions) ahead.

I'm speaking from extensive experience in Mississippi. Maybe it's different in wealthier places. I do get the sense those are are better off tend to adhere more to the correct dosing schedule, but I have no idea how to begin untangling cause-and-effect there.

The benzodiazepine class of drugs also has a chemical dependence problem, and serves as a good example of the medical establishment's reaction to prescription drug abuse. When prescribing a benzo-class drug nowadays, your doctor will work with you to create a dosing schedule that includes its own "taper-off" period (and perhaps secondary therapies to counter withdrawal effects) to avoid addictive potential. They will also try to find a drug which not only fits the effect profile they want, but which you can safely afford out-of-pocket, or they will attempt to get you on a manufacturer's discount plan, and so forth, to ensure you never encounter the "I can't get my dose this month, but I'm at the height of treatment and addicted so I have to do something else" problem.

In the modern day, just prescribing the drug instead of the treatment program as a whole is medically irresponsible.

In that case, there are a lot of medically irresponsible doctors. I have never seen nor heard of a doctor that does that. And the problem is truly rampant from what I see here. Maybe people are doctor-shopping, I don't know. I do know that most of my non-professional acquaintances have prescriptions for something and nearly all of them abuse it. And to clarify, I don't mean "oh, I'm going to take an extra one because I'm feeling really anxious/in pain today", I mean "I'm gonna take six and get fucked up."

> to ensure you never encounter the "I can't get my dose this month, but I'm at the height of treatment and addicted so I have to do something else" problem.

FWIW, I pretty much never see this. They always find a way to afford their dose that month[1]...the problem is they run through it in 1-2 weeks. Then they either suffer, ask their friends for help, or more rarely find something more extreme.

[1] Fortunately there seems to be cheap generics available for most of them. I know a month's worth of kolonopin runs about $15-20; my ex was on it and she didn't have insurance.

Saturday, while trying to finish a task for my startup, I took LOADS of caffeine, and it didn't work.

I suspected I might be addicted, and tried yesterday to not touch anything with caffeine.

Had horrible withdraw symptoms :(

And still can't work properly (I work in random spurts, usually I work more if it is a new or interesting task)

Any doctor aware that an ADHD pro-drug treatment exists will have no problem diagnosing people with ADHD any more, because it's no longer a risk they're taking of potentially giving some addict their fix, or giving some drug chemist the raw materials for their next batch of speed. It's an awareness problem at this point; most doctors don't know about these drugs, and still think ADHD treatment is a scary place they don't want to go near. Psychiatrists tend to be more up-to-speed (heh), but even then it can depend on the country.

Do you know if Vyvanse has different outcomes that typical adderall/ritalin? I know Strattera gives much different side effects for myself, but i have never tried vyvanse

I found Vyvanse recently became legal in Brazil, but it has two problems: First, still requires a prescription, and medics are not free, I cannot randomly visit doctors until one that knows about it (seemly it is still obscure here) heard of it and agrees to try to diagnose me. The other, it is ABSURDLY EXPENSIVE (28 pills is about half of a monthly mininum wage)

As for Strattera, Brazil officially ignore it, like if it don't existed, so you can import it without much consequences. Still expensive though :( (less than Vyvanse, but expensive)

EDIT: I feel sad that as a 27 year old that hates meds I will end taking meds like a 70 year old take (I already have to chronically use 2 meds... this will add another one)

Another commenter mentioned vyvanse which i haven't tried but have heard good things about - though i do believe that is still an amphetamine and likely controlled.

For example I don't buy sugar, at all.

All my sugar intake comes from stuff that has sugar in it, like the occasional sweet chocolate...

As for exercises... I try, I can even do some months, but after a time they start make me feel extremely bored and I cannot even pay attention to them while doing them, so I stop.

After a while I start again.

The exception was Kung Fu, but I have right now no accessible decent academy.

What we need to do is realize that addiction is not a bad thing intrinsically. Sure, it has the downside of needing a supply of the addictive thing, but that might be a minor and perfectly reasonable price to pay. Just like popular medications that have a small chance of making all your skin die and fall off, or over time, frying your nerves and making you jerk around. Never, in my personal experience, have any medical personnel made a big deal about those side effects of "good" drugs like anti-psychotics, stabilizers, or anti-depressants. But mention "bad" drugs and they go nuts about similarly small tradeoffs.

(It's worth noting that this doesn't necessarily apply to just drugs. WoW-addiction falls into this definition too.)

ADHD might not be a problem if you're living in a wild environment and roaming the woods as a primary activity. Schizophrenia might not be an issue of you live in a society where you're considered a 'seer/prophet' and taken care of by the community for your 'valuable' service. Heroin might not be an issue if you're filthy rich and happy with your lifestyle.

Practically speaking, of course society might value labeling any use of heroin as 'addiction' because it might be too rare for people to be able to live well while using. Similarly, I believe making alcohol a bit more of a 'drug' (as it is commonly seen) is not a bad thing because so many people, relatively, become unhealthily dependent on it.

I've become more and more convinced that it would benefit us all if we 1) let go of our somewhat arbitrary current definitions of 'illegal drugs' and 'addiction' (at least in 'common' conversation), and 2) keep in mind that the goal of criminalizing a substance or labeling someone as 'mentally ill' is to help people function in whatever society their in, and not an attempt to objectively define any of these things.

I have a lot of friends who by many definitions suffer from various 'mental problems'. Many of them function well because they chose a lifestyle, career, and social environment that suits them, rather than taking the path of medication. While this is not an option for everyone, I wish the mental health industry would spend more energy on this rather than simply 're-socializing' people through medication or therapy.

To be clear, I realize this is not a simple issue, and that for many people medication is a lifesaver. I also realize that the impact of incorrectly advising people on these matters can ruin lives. I'm not an expert!)

In 2015, I'm not so sure about that. The roots of America's cannabis prohibition are firmly rooted in bald-faced racism, for instance, with a side order of not wanting to annoy textile manufacturers.

I sincerely think that more harm is caused by any attempt to bring the justice system to bear on what people choose to put into their own body. Any objective analysis would come to the same conclusion - the fact that it hasn't suggests ulterior motives.

Alcohol is a weird drug that affects so many parts of the brain; I don't think it's just coincidence that it's the drug of choice for so many people who have mental disorders?

I know for myself, when I had my breakdown in my late twenties--alcohol is the only drug that really seemed to make me feel normal(a least for awhile). I went to various Psychiatrists and was prescribed the usual regime of tri, and hetrocyclic antidepressants--none worked in the slightest in my case. I finally found Klonopin. Yea, it worked at first, but was not better than alcohol. I know Klonopin has a long half life, but in my experience the effects wore off pretty quick?

My point is I feel a lot of people abuse alcohol because the other drugs just don't work very well. I remember a Psychiatrist telling me I wish I could prescribe more Klonopin, so you didn't need to drink a six pack a day, but I can't. I'm afraid of the load on you liver. He was right, and I'm glad he didn't increase the dosage of Klonopin--I think? I really didn't have a say in the matter.

But the anxiety went on for years and honestly effected my life and career. I went on to become an Alcoholic.

I got to the point where I gave up, but didn't want to blow out my liver(I had a medical backround, and saw just how horrid alcohol was to the liver.) I saw someone die from liver failure, and it was Hell. It was beyond the worse misery I have ever seen, and it went on for days.

I knew I was a alcoholic, and Psychotropic medications were not helping me so I just decided to keep my drinking down to only the times I truly needed it(that meant no partying, no drinks at dinner, etc.) I was a drug I used to treat my symptoms. I stayed away from hard liquor. Just medicated with beer and wine.

Well years later--my career is toast, but I'am still alive. Most days were a pain in the ass, but I got through it, and had some good days. If anyone reads this who is suffering from an anxiety related disorder; I can honestly state that the my level of anxiety did get better with the natural aging process. If you are controlling panic attacks with alcohol--only drink enough to stop the paints attack. In my case 2-3 drinks would stop a panic attack if I timed it right.

My worse years were the 90's up through around 2005. Back in the ninties I could get away with a little bit of alcohol on my breath. I couldn't imagine self medicating today--where alcohol is so demonized in many circles, and Cops don't take any sympathy. "Just lock him up even if even though he blew under .08 percent. He probally has something else in his blood stream, and through synergy, and our narrative, we can get a conviction?"

The Psychiatriactic profession has failed us. Very few drug companies are working on new Psychiatric drugs. No wonder people self medicate? What I find ironic is right now it is harder than ever to get SSDI for a Phychiatric disorder.

No I am not on SSDI, but would be homeless if I didn't get very lucky a few investments early on.(absolute blind luck on that money). I got lucky. I really should be homeless.

Regarding 'self medicating', I'd say that it's more like palliative care. That is, it makes people feel better to some degree, but does not treat (and may actually worsen) underlying conditions.

While I can certainly understand the attraction of palliative care, I wish there was more that we could do for the underlying issues.

Plus, I could grow it myself for almost no cost.

Anything that upsets the economic and industrial consumption status quo is going to meet fierce and powerful resistance from those currently selling consumption every minute of their lives.

Except "addict" is a loaded term, which implies... well, unequivocally maladaptive behavior.

You seldom hear about people who lie to their loved ones about their hidden coffee stash, or steal from their child's piggybank to sustain their caffeine fix.

In a situation where coffee would be banned, we would in all likeliness see a rise in coffee smuggling, a drop in quality of coffee, and coffee addicts would face problem due to the illegality of the stuff : imagine that one day, your dealer is all out of coffee. That would cause a withdrawal syndrome. So people would keep stash of coffee, and other behavior charateristic of 'drugs addict'

More likely if caffeine were banned. If coffee were banned, those with a dependence (which is most likely on caffeine, not coffee) would substitute other sources. Like tea. Or soda.

(People might smuggle coffee if it were banned, the way they smuggle Cuban cigars into the US, but as a prohibited luxury rather than an item of dependence that there was no legal means to fulfill.)

You do realize that caffeine is more addictive than cannibas right? If there is an illegal drug trade for that pot then I can't imagine people would just give up on coffee when it's harder to kick.

There's no one accepted unidimensional criteria for addictiveness. Among the criteria generally used, some put caffeine more addictive than cannabis, some less (though all put both of them extremely low.)

> If there is an illegal drug trade for that pot then I can't imagine people would just give up on coffee when it's harder to kick.

If it is coffee, but not the addictive component caffeine) that is prohibited, and there are lots of other sources of caffeine, such a trade, I argue, would be more like the trade in likewise-prohibited Cuban cigars -- a luxury. Caffeine addicts would have a ready supply of alternative sources of caffeine and thus not really need the illicit trade, just as nicotine addicts do when Cuban cigars are prohibited.

Withdrawal from physical dependency of high doses of caffeine is decidedly unpleasant (with the potential for week long bouts of diarrhea, night sweats, uncontrollable shaking, fever and massive headaches, for example - from personal experience after going of pre-workout supplements with doses in the 400mg+ range of caffeine)

I also seldom hear of people who lie to their loved ones about their hidden drug/alcohol stash, or steal from their child's piggybank to sustain their drug/alcohol fix. Really, I do often hear the same sad generic story which you refer to, but there are never any specifics nor any thing else that would prove it is actually as common as is purported.

She could either pay the rent or buy alcohol. She purchased alcohol and was evicted form her home.

Living homeless in the park, she and her children didn't eat for two days. When she received money, she decided to continue forgoing food to spend the money on alcohol.

After over a month of homelessness, during an Indiana winter that was below freezing during the day and colder at night, she was offered private housing and food for herself and her children. The only catch was that she'd have to remain sober. She preferred the alcohol. My wife has permanent medical problems from sleeping in those conditions.

She didn't steal from her daughter's piggy bank to buy alcohol. She did use her daughter's social security number to apply for a student loan, then use the loan money to go on a bender.

Alcoholism isn't just a generic scare story told by DARE officers to keep kids from drinking. It's a real issue killing a real woman named Virginia.

This is a cruel joke that gets played on drunks. She didn't prefer the alcohol, she was/is addicted; and our society deals with addiction in probably the worst possible way. They may as well have asked her to jump over the moon. Rational people don't do that to themselves or their families. I didn't say that these things never happen. I said they are more rare than some would have you believe. I have my own horrible story in that vein (my father), but what I don't do is use it to pander to peoples' emotions in an effort to further perpetuate, or perhaps even expand the disaster that is the drug war. Addiction is an ugly unfortunate thing that exists, and as sad and regrettable as your wife's tale, and my father's tale, and the tales of others are; using these tales to support the continuance of, or the heaping of even more hardship (criminal sanctions) upon the susceptible/unfortunate/whatever is and always was the wrong thing to do.

You're absolutely right that the choice she was presented with was no choice at all. She prefered alcohol over housing in the same way that Stephen Hawking prefers sitting over walking. That was the point that I was trying to make - there are people who cannot make rational decisions on these matters.

As for the drug war, my wife has tens of thousands of dollars of medical debt because some bureaucrat decided that it's more important that my mother-in-law be punished for being an alcoholic than that a child might have a warm place to sleep at night. Punishing addicts makes as much sense as punishing cancer patients.

Same here. Best regards.

Thanks, but that's not what I said, you're mistaken on that account.

>This isn't something about which people are simply exaggerating.

The stories don't need exaggeration.

My response, and what I find offensive about these stories' use in pro-drug war propaganda, is that they are being used to pander to peoples' emotions in an effort to support the current dreadful state of affairs.

Actually, this brings up an perfect example of the first poster's point. Smoking cigarettes was socially acceptable at one point. Now, it's considered a bad, unhealthy habit. I've known quite a of people who hide, or attempt to hide, their habit from their friends. And I'm quite sure that a good number of parents have taken money from their kids piggybanks to buy cigarettes.

She never did.

Try Utah some time. Great place, interesting culture, and occasionally, secret coffee stashes.