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PostPosted: Wed Jan 14, 2015 2:23 pm 
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I found this article online today. I know it's incredibly long, but well worth the read IMO. Out of respect to the author I didn't want to edit his content to shorten it.

If you want to skip the BS, go straight to the bottom to see that this Dr. definitely supports the idea that addiction IS A DISEASE, and presents fantastic scientific studies as evidence.

Addiction: A Disease or a Choice?
Kevin McCauley, M.D.

Alcohol. Marijuana. Nicotine. Cocaine. Heroin. All these drugs begin with plants. Even a drug like crystal meth can trace its origin to the Ephedra plant. Drugs exist throughout nature, and their use to produce intoxication occurs in animals far older than man.(1) As long as blood has flowed through human veins, drugs have flowed with it, and wherever you find the phenomenon of intoxication, so too will you find the problem of addiction.

Of all the questions we can ask about addiction, there is one question that stands out. All the other questions about addiction begin with this one, and everything hinges on the answer. The most important question about addiction is simply: Is it really a disease?(2)

When I first came to treatment for my own problem with addiction, my counselors told me that addiction was a disease. As a physician, I was skeptical. Addiction is not a disease. It is a choice. Diabetes is a disease. The diabetic didn’t choose to get it. But the addict did have the choice to start using drugs. Cancer is a disease. It befalls unfortunate people through no fault of their own. But addicts? They do this to themselves.

That made sense to me, but the more I expressed my sympathy for the argument against calling addiction a disease, the more I was told by my counselors that I was in denial and needed to surrender.

Well, they were right—I did! But as a doctor I believe that patients have the right to ask questions, and as a patient I wasn’t satisfied with the answers I was getting. A lot of people told me that addiction was a disease, but very few of them could defend their position. And I had to know.

So I decided to find out for myself, and that set me on a journey that has taken the last ten years of my life. Along the way I’ve come to realize that this question is far more complex than it looks, and that finding the answer involves more than medicine and science. This path travels through philosophy, law, politics—even history. I began my search just trying to make sense of my own addictive behavior. I quickly discovered that I had stumbled across the greatest intellectual puzzle of our time.


The Choice Argument

There are many arguments against calling addiction a disease, but the best argument I’ve ever heard is one I call the “Choice Argument.” The Choice Argument says that addiction can’t be a disease because drug taking is a behavior, and all behaviors are choices.(3)

The Choice Argument goes on to say that even though an addict might tell you he can’t stop drinking or using drugs—that he’s powerless over drugs and alcohol—really, he can stop anytime. That’s right: Addicts can quit anytime they want. You just have to help then make the right choice.

To show how easy it is to help an addict stop drinking or using drugs, the Choice Argument suggests this simple experiment. I take a bottle of alcohol, pour out a glass, and offer it up to the alcoholic. But when the alcoholic reaches for the glass, I add a small twist. I pull out a gun, point it at his head, and say, “Oh, but if you do take that drink, then I’m going to blow your brains out.”

Most alcoholics will choose not to drink.

That’s the Choice Argument’s point: With a strong enough threat, I can get addicts to stop their behavior in a way that I can’t for real patients with real diseases. Diabetes, for instance: You can’t put a gun to the head of the diabetic and have any hope of helping him lower his blood sugar.

The Choice Argument draws a distinction between behaviors and symptoms. In the case of symptoms, free will plays no part. We don’t hold patients responsible for their symptoms because they can’t choose not to have them. That’s why punishing and coercing real patients is inappropriate. But drug taking is a behavior. Free will does exist, and addicts are responsible for their behavior because they can stop if they choose to. You just have to motivate them to make the right choice.(4)

The Choice Argument is the best argument I’ve ever heard against calling addiction a disease. But it has problems, and in the end I think the Choice Argument is wrong because it fails to take into account some exciting new research about the brain—research that shows that our capacity for choice is far more complicated than we ever imagined. Is addiction a disease or a choice? The short answer is that addiction is a disease of choice, a disorder of the very parts of the brain we need to make proper decisions.


What Is “Disease?”

Our modern concept of disease—what doctors call the “Disease Model”—is only about 100 years old. It emerged from germ theory—from the work of early microbiologists such as Louis Pasteur and Robert Koch.

The Disease Model says that you’ve got an organ. It gets a defect. And as a result you see symptoms. It doesn’t matter what the organ is: bone, liver, kidney, whatever. The defect is a physical, cellular defect: Cells die, cancer develops, an infection perhaps. And if a person has that defect in that organ, he or she will show certain signs and symptoms.(5)

A hundred years ago, doctors knew that this new, modern, scientific definition of disease would make the new, modern, scientific profession of medicine powerful too. They also realized that they had to figure out what was a disease, and what wasn’t. Since it was easy to see how broken legs and diabetes fit the Disease Model, doctors ruled that these were diseases, and that the people who had them were patients. But it was not as easy to see how addiction fit the Disease Model. What was the organ? Was it the brain? What was the nature of the defect? One hundred years ago, no one could answer these questions. It didn’t help that the symptoms of addiction often looked like willful bad behavior. So when doctors could not readily fit addiction to their definition of disease, they declared that it was no longer a disease, and that addicts were no longer patients. That didn’t mean that addiction disappeared. It meant that another group in our society had to handle addiction: the criminal justice system.(6)

Today in the United States we have 2.3 million people in prison. Most of those people are there for drugs or alcohol, or for the things people do on drugs and alcohol. When we reach numbers like 2.3 million, this ceases to be a criminal justice problem. This is a public health catastrophe.(7)

If we knew the organ involved in addiction, if we understood the defect, and if that defect in that organ explained addictive behaviors, unpleasant as they are, then addiction would fit the Disease Model. Our present incarceration binge would end. For nearly 100 years medicine has been unable to do that. And the problem of addiction has fallen largely to the law. Until today.

In the last 20 years there has been an explosion of understanding about the brain and addiction. Today neuroscientists do know the parts of the brain involved in addiction. They know the nature of the defect. And that defect in that organ shows that the behaviors of addicts are, in fact, symptoms of a disease.(8)

The Frontal Cortex and the Midbrain
There are two areas of the brain that are important in addiction. One is deep inside: the midbrain. The other is on the outside: the frontal cortex.

During all our conscious lives, all that thinking, feeling, and speaking, everything we see and hear and taste and touch, occur in the cortex. But it is the frontal cortex in particular that is the real triumph of evolution. Morality, judgment, personality—all the things that make a conscious, self-aware being—are realized there. The frontal cortex is where we evaluate the world, where we weigh options and understand consequences. This is where choice is conceived. The frontal cortex is also where we give the things emotional meaning. This is the part of the brain where we attach. So this is where a mother loves her child. The frontal cortex is where we select our romantic partners, and our friends. This is where we give things moral and spiritual meaning.(9)

Doctors once believed that the defect of addiction was here, in the frontal cortex. If this was the thinking, moral, loving, social, spiritual, and choice part of the brain, then drugs must somehow break the cortex to create all those bad addict behaviors. It’s a powerful idea: drugs work in the frontal cortex and addiction is caused by a moral failing, a personality disorder, or bad upbringing. There’s only one problem with that idea: It’s wrong.

Addiction does not occur in the frontal cortex, and drugs do not begin their work here. Drugs work deeper down, in a far older part of the brain, called the midbrain.

The midbrain is part of our survival mechanism. It does not think. It does not make choices. It does not understand consequences. The midbrain does not think about the future. It handles the here and now—the next 15 seconds. It gets us from moment to moment alive. The midbrain tells us to eat. It urges us to defend ourselves, even to kill. It fires our sex drive. These are all behaviors crucial for survival. And to make sure we do these things, the midbrain makes them pleasurable.

Ordinarily, the frontal cortex keeps the midbrain in check. It exerts a top-down control over the unconscious survival impulses of the midbrain. But, in addiction, something goes wrong in the midbrain such that this top-down control fails, and the midbrain becomes more powerful at guiding behavior than the cortex is. In other words, something goes wrong in a level of brain processing long before morals or personality or choice.

We know that drugs work primarily in the unconscious, survival midbrain, and not the rational, decision-making cortex, because of a famous experiment performed in the 1950s on mice. Dr. James Olds and Dr. Peter Milner found that a mouse will press a lever to deliver a tiny electric current to two very small and very specific areas of the brain. One is the ventral tegmental area (VTA). The other is the nucleus accumbens (NA).(10)

Not only will a mouse press a lever to stimulate these two areas of the brain, that’s all he will do. He won’t eat. He won’t mate with other mice. If you put an electrified grate in front of the lever and shock the mouse, he won’t step off the grate. The mouse will continue to press the lever—ignoring all these other survival drives—until he dies.

Olds and Milner had discovered the pleasure centers of the brain. Our brains have these same two areas, and the nerve pathway that runs from the NA to the VTA is known as the “pleasure circuit.” Mice will also press a lever to deliver drugs to these same areas. And again, that’s all he will do: He won’t eat. He won’t mate. He sits on that electrified grate and fries—and keeps on pressing that lever for drugs until he’s dead.

It may not seem all that surprising that mice can get addicted to drugs, but a mouse has no personality, a mouse does not weigh the moral consequences of pressing the lever, nor are there mouse gangs selling drugs to other mice. And yet they can still become addicted.

Studies like these dramatically weakened the idea that addiction is caused by bad morals, or a personality disorder, or a bad social environment. These things may accompany addiction, but they cannot be the cause of addiction.

What happened in these mice studies is that the drug hijacked the survival mechanism of the midbrain. Now the drug is in the number one survival spot. In fact, the drug and survival are so close together that, as far as the addicted midbrain is concerned, they’re the same thing. For the addict, the drug and actual survival are indistinguishable. And when that happens, we cross the line into true addiction

Most people—around nine out of ten—are on this side of the line: They are nonaddicts. For those nine out of ten people, the drug is just the drug. But when we cross the line into addiction, the drug is not just the drug anymore. The drug is life itself. If the alcohol abuser gets a DUI, what does he do? He quits! The abuser can bring the negative consequences of his drinking to bear on his decision-making because, for him, alcohol is just alcohol.

But the choice is not the same for the alcoholic. He wants to quit. He’s tried to quit. He’s endured catastrophic consequences because of his drinking. Yet, try as he might, he cannot quit because alcohol isn’t alcohol anymore. It’s the main way of getting through the next 15 seconds alive.

So, in addiction, something goes wrong with the very part of the brain we use to tell those things that are good for survival from those things that are harmful. Neuroscientists refer to this as the brain’s hedonic capacity. We can simply call it our “pleasure sense.”

The Brain’s Pleasure Sense
We can tell the difference between things like broccoli and things like chocolate cake. If we are starving to death and someone brings us a truckload of broccoli, we have to be able to know that broccoli will not save our life from starvation. Chocolate cake, on the other hand, will save our life from starvation. Our pleasure sense helps us identify and prioritize those things in the world that are good for survival.

In addiction, this is the sense that breaks. If you can’t perceive light correctly, that’s called blindness. No one will question your morality if you’re blind. If you can’t perceive sound correctly, that’s deafness. No one will throw you in jail or take away your child if you’re deaf. But that word pleasure is very morally loaded. People with a defect in their ability to perceive pleasure are far more likely to be seen as immoral.

Addiction is a defect in the brain’s ability to properly perceive, process, and act upon pleasurable experiences. And because this brain disorder is about pleasure, the patients who have it are seen in moral terms and go to prison by the hundreds of thousands.(11)

The Pleasure Construct
When the brain creates a pleasurable experience, it brings different levels of brain processing together into a pleasure construct. The best way to illustrate this is to think about something pleasurable, for instance, a cookie. But let’s choose a very special cookie: a madeline, made famous by the French author Marcel Proust. In his legendary passage known as the “episode of the madeline,” Proust describes the phenomenon of involuntary memory. When he put the madeline into his mouth, it brought back a flood of memories and emotions from his childhood. He didn’t ask for those memories to return—they lay dormant for years until they were triggered by the taste of the cookie.

This is how the brain creates a pleasurable experience. It combines rewards, smells, tastes, places, memories, and even emotions together into a single sensation. We don’t experience these different levels of processing individually. The brain weaves them together into a unified perception: a “pleasure construct.” In addiction, something goes wrong at every level of that processing as the brain tries to generate a pleasurable experience—and fails.


The Five Theories of Addiction

There are five theories currently used in neuroscience to explain addiction. These theories don’t contradict; they fit together quite nicely because each theory describes what’s going wrong at each level of brain processing as the brain creates a pleasurable experience.

The first theory deals with the genetics of addiction—with the blueprint that creates the brain.(12) The second theory describes what happens in the midbrain, where the earliest, unconscious reward processing starts.(13) Wrapped around that reward processing are the memories and emotions that are the next part of that pleasurable experience.(14) Eating a madeline cookie relieves the stress of hunger, so next the stress system in the brain is involved.(15) And as we go from level to level of brain processing, we climb higher and higher until finally we find ourselves in the frontal cortex, the part of the brain where we attach emotionally and make choices.(16)

Genes. Reward. Memory. Stress. Choice. This is the pleasure of eating a cookie deconstructed into its separate parts.

This layered aspect of brain processing means that each level of brain processing contains the one that came before it. If there’s a problem in the first level of brain processing—genes—that problem will be passed up to the next level of brain processing—reward. If there’s a problem in the reward level, that will then become part of the next level—memory. The problem in memory processing will then be found in the stress processing. And by the time we reach the frontal cortex—the area of the brain that processes choice—things have gone very wrong indeed.




Genes
We all have a femur. Therefore we are all at some risk of breaking a leg. The same with the brain: Because we all have a hedonic system in our brains, we are all at some risk of becoming addicted. Some people, though, are more likely than others. The blueprint for their brains—their genes—leaves them more vulnerable to addiction.

Genes can create differences in how people respond to drugs. Dr. Marc Schuckit at the University of California, San Diego, has found a genetic difference in how people respond to alcohol. Some people are genetic “low responders.” It takes more alcohol to get them drunk, so they drink more. Their genes put them at higher risk of developing alcohol problems. Other people have genes that make them “high responders” to alcohol. They are less vulnerable.(17)

Somewhere between 40 and 60 percent of the vulnerability to addiction is genetic. But genes are not enough. They can get a person to addiction faster, but something in the environment has to turn those addiction genes on.

Reward
Take a madeline cookie. We eat it. It tastes good. And we say, “Yum!” At the very core of that “Yum!”—the very earliest processing of a rewarding experience—is the release of the chemical dopamine by the nerve cells—the neurons—in the midbrain.

Neuroscientists used to think dopamine was the sole chemical of pleasure. But now they understand that dopamine handles just one particular but very critical element of pleasure. Dopamine tells the brain when a reward is salient—noticeable, important—and when that reward is better than expected.

Dr. David Redish at the University of Minnesota explains dopamine’s role like this: Say you’re at a gumball machine and you want to buy a gumball. So you put in your quarter, and due to a freak of gumball machine physics, you get . . . two gumballs!

This is when the midbrain releases dopamine.(18)

Dopamine tells the brain that this reward was better than expected—especially good—and to pay attention to it because it might be especially good for survival, better than other things in the past.

So let’s say you put another quarter into the gumball machine. And this time you get one gumball. This time the neurons in your midbrain do not release any extra dopamine. It is not that the gumball doesn’t taste good. It’s just not a reward that was better than expected.

Just to push your luck, you put one more quarter into the gumball machine. And this time you get no gumball. Now the neurons in the midbrain release less dopamine because this reward was worse than expected.

It is in this way that dopamine acts as a learning signal to help the brain identify, and then prioritize, new and unexpectedly good rewards over older, predictable rewards. Dopamine is a chemical of pleasure, yes, but it handles a very specific piece of pleasure.(19)

What all natural pleasures have in common, things such as food and sex, is their ability to release dopamine. But drugs cause huge surges of dopamine, far greater than the brain was ever meant to handle. Drugs fool the brain into thinking that they are much, much better than expected.

Every time the addict uses the drug, their brain gets the message that the drug is better and better than expected (even though it’s not), the drug has greater and greater value (even though it doesn’t really have that value), and higher and higher priority (even though it shouldn’t get that priority), and the drug climbs the survival list until finally it is in the number one spot. Now, for the addict, the drug is survival.

It’s this irrational assignment of value, in spite of cost, that lies at the heart of one of the most frustrating features of addiction: continued drug use despite negative consequences.

Memory
Once the brain finds something good for survival, it has to remember it. To do this, the brain uses another chemical: glutamate.

Glutamate is the chemical of memory formation. It lays down memories of natural rewards, such as food. But drugs cause such huge surges of neurochemicals that glutamate locks the drug into memory. And everything that goes along with the drug—the smells, the place, the people the addict was with at the time—becomes part of that memory. They are now drug cues, and if the addict is exposed to a drug cue, the other thing glutamate does is begin the motivation to go get the drug. Glutamate is the chemical of drug memory, and of drug seeking.

The dopamine neurons in the midbrain send their reward processing up. They project from the VTA to the NA, and then to the frontal cortex. Now the frontal cortex becomes involved—it sends glutamate neurons back down to the midbrain.

As the brain constructs an experience of pleasure, the neurons going up release dopamine, and the neurons going down release glutamate. Normally, this up and down communication enables us to recognize and learn those things in the environment that are good for survival.

Dopamine says, “Hey, this is important!”
Glutamate says, “Okay, I’ll remember.”
Dopamine says, “Hey, I really want this!”
Glutamate says, “Fine, then go and get it.”

That’s the way this elegant but fragile mechanism in the brain was meant to work—for food, for sex, and even for madeline cookies. Drugs go straight to this mechanism and wipe it out. Each use of the drug ravages the brain’s delicate physiology, sweeping away everything in its path. With time, deep channels are carved into the brain. Drug pathways become stronger and stronger. Normal pathways become weaker and weaker.

Dr. Steven Hyman at Harvard University calls addiction a pathological overlearning of the drug and all that goes with it. This isn’t a normal memory. This is a drug hyper-memory. And these memories may be permanent. They wait patiently and leave the addict vulnerable to relapse, even after years of abstinence.(20)



Stress
Three things are known to cause relapse: (a) drugs, because they release too much dopamine, (b) drug cues, because they affect glutamate, and (c) stress, which releases a neurohormone called corticotropin-releasing factor, or CRF.

The theory that explains the role of stress in addiction was developed by Dr. George Koob at the Scripps Research Institute in La Jolla, California, and Dr. Michel Le Moal at the University of Bordeaux in France. Koob and Le Moal refer to the brain’s stress system as the anti-reward system because CRF acts to counter dopamine surges.(21)

The brain maintains this balance, or homeostasis, around a set point, much the way the brain maintains body temperature around a set point of 98.6 degrees. But with the repeated dopamine surges of drug use, the stress system becomes chronically overstimulated. The brain can’t maintain homeostasis. So it gives up on homeostasis and reverts to what Koob and Le Moal call “allostasis.”

Allostasis is an attempt to regain stability through change. And what changes? The brain’s hedonic set point. In a desperate attempt to restore balance in the face of chronic drug use, the brain resets its pleasure threshold. Balance is restored, but at a cost. Normal dopamine releases from natural pleasures no longer register. The brain’s pleasure system goes flat. Psychiatrists call this state “anhedonia.” The brain is no longer able to derive normal pleasures from normally pleasurable things. So what does register? Things that pour out so much dopamine that it can reach the new reward threshold. And what things do that? Drugs!

Dopamine surges cause the brain to lock onto the drug. From now on, anytime the brain faces rising levels of stress, it goes straight to what it knows is best at relieving that stress—the drug! And this connection of the drug to survival is below the level of consciousness. Relapse can be under way long before the addict is ever aware of it.

Choice
Finally, we find ourselves in the frontal cortex, where the brain processing that deals with choice occurs. All that problematic processing before, in genes, reward, memory, and stress, arrives here—where the problem is only compounded. Far from being aloof from what happens below, the frontal cortex is entirely dependent upon it. Rationality, judgment, and choice are only possible if the hedonic and emotional processing the cortex receives is accurate. Free will, it turns out, is completely contingent on the proper function of feeling.

The theory that describes what goes wrong in the frontal cortex during addiction was developed by Dr. Peter Kalivas at the Medical University of South Carolina and Dr. Nora Volkow, the director of the National Institute on Drug Abuse. They recognize that dopamine is important in the early stages of addiction. But the final pathway in addiction is the glutamate neurons projecting back down from the frontal cortex.(22)

Kalivas and Volkow have found abnormal activity on the brain scans of addicts in two particular areas of the frontal cortex: the orbitofrontal cortex and the anterior cingulate cortex. These areas are critical for attachment and making choices. Kalivas and Volkow believe that the abnormal activity here is the basis of the overpowering importance the brain gives to drugs, and the uncontrollable urge to seek them.

In addiction, the normal top-down control of the frontal cortex over the midbrain simply fails. The addict’s prior commitment to stop, his memories of what happened the last time they relapsed, the love he feels for his family, the punishment waiting for him if he drinks again—these things are invisible to the addict.

Kalivas and Volkow call this state in the brain “hypofrontality.” What was once a healthy, loving, decision-making cortex is reduced to a shadow of its former self: overactivity in some areas of the brain, desolation almost everywhere else.

This is what lies behind the denial, the personality changes, the risky behavior, and the breathtakingly impaired decision making and lack of insight that characterize end-stage addiction. Addiction begins as a disorder of genetics and pleasure, but it ends as a disorder of choice.(23)

Craving
The brain has a powerful tool to protect the connection of the drug to survival. That tool is called “craving.” Craving is a difficult concept to understand because we use the word craving all the time. If I say, “I crave chocolate!” what I usually mean is, “Gee, I really want chocolate a lot!”

That is not what the addict means when he craves. The addict is up in the middle of the night, staring at the ceiling, not able to sleep, pulse at 100, sweat on his brow, thinking over and over: Just one more time. Just one more time, I want to feel the burn of that alcohol as it goes down my throat and every cell in my body saying, “Thank you!!!”

That’s craving. And make no mistake—that is genuine suffering.

It is the presence of craving that defeats the Choice Argument. You remember the Choice Argument: Addiction isn’t a disease because the addict can stop anytime he wants. Put alcohol in front of the addict, and when he reaches for it, put a gun to his head, and he will choose not to drink.

It’s true that if you put a gun to the head of the addict, he can, in the moment, choose not to drink. But even though the addict isn’t using, he’s still craving. He doesn’t have the choice not to crave. Once that connection of the drug to survival has been carved into the brain, you don’t actually have to have drug use anymore to have the disease process of addiction active.(24)

The Choice Argument fails because it measures addiction by the addict’s behavior. In doing so, it misses the most important feature of addiction to the addict—the craving.


Addiction Fits the Disease Model

Now we have a working definition of addiction: Addiction is a stress-induced defect, acting on a genetic vulnerability, in the dopamine and glutamate reward-learning system of the limbic brain, and the emotion-choice capacity of the frontal cortex, resulting in the symptoms of loss of control, craving, and persistent use despite negative consequences.

We have organ, we have defect, and we have symptoms: We have met the burden of proof. That is why we can say, without the least shyness, that addiction is a disease. And something very important happens once addiction became a disease: Addicts become patients.


Conclusion

The brain is a land that has only recently opened for our exploration, and as our journey progresses, many of the things we find along the way may be threatening because they may question our long-held beliefs about the nature of choice and personal responsibility.

But far from weakening our concept of choice, I think this new neuroscience strengthens it because it shows us that choice is a very precious, very human capacity: one that needs to be nurtured, and practiced, and on occasion repaired.

In the end, addiction is about choice. It’s about choices like this one: What kind of a society do we want to be? Do we want to go down as the greatest incarcerator in human history? Or do we want to be the one that uses this new knowledge to make a finer distinction between badness and disease?

Addicts aren’t thought to contribute much to society; their behavior is so shocking that we hardly recognize them as patients. But addicts do give something very precious to all of us: They teach us how choice works. When do we have it? When does it fail us . . . or we fail it? What are the conditions under which choice best operates, and how do we set those conditions so that people can make healthy choices in accordance with their values?

These are questions that philosophers have struggled with for thousands of years. Addicts are trying to tell us those answers. If we choose to listen, we might know a great deal more about who we are, what we can do, and where that will take us.

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PostPosted: Wed Jan 14, 2015 2:45 pm 
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You're right, a very long read. I did the old Evelyn Woods Speed Reading thing to get through it quickly. Learned that method back in grade school.

What I remember hearing in AA years ago was that doctors wanted it named as a disease so they could get insurance to cover treatment. Otherwise it was considered a personality defect, or a defect of character.

For me, I didn't choose to be an alcoholic/addict. The first time I got drunk I fell in love with it. First time I took a pain pill I fell in love with it. The cravings were up and running. It took years to develop into a condition where I couldn't stop on my own. It took either something really bad happening because of my behavior or my health going south on me. Then comes a moment of clarity where you know where you're headed if you don't stop. Some people get sober then, some wait until they've lost so much physically, mentally, and spiritually, they then seek help. Some just never do and die.

Not sure if my 2¢ were worth the reading but that's my take on it.

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PostPosted: Wed Jan 14, 2015 3:29 pm 
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Blah blah blah.

If you can quit based on your own will power, simply by choosing not to use, you may have a dependence problem, but you're not a real addict. Addiction is about a complete failure of willpower, no matter how bad life circumstances get, which is a disease.

A lot of non-addicts simply don't get this, and that's why there are so many treatment methods (designed and operated by non-addicts) which don't work long term.

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PostPosted: Wed Jan 14, 2015 11:27 pm 
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I agree with you JI. I don't buy into the addiction as a choice either. I'm not sure if anyone will ever get through the whole article but near the end it goes into great detail about how the actual pathways of the brain are changed and why we can't make any other choice but to use. Drugs become so entwined with the survival part of the brain that it begins to see drugs as essential to survival. There was a lot of great scientific evidence presented to that point (and many others).

I was afraid some people would only read the first few paragraphs and get the wrong idea about the point it was making. Maybe I should go back and edit it a bit. If you skip down to the last few points you will see what I mean.

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PostPosted: Thu Jan 15, 2015 10:44 am 
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Hi QHG2, there's a very interesting video series available online, which I came across on FB (will post a link if I can find it).

The vids are created and presented by a doctor who was treated for drug addiction. He set out to prove that addiction is a choice, only to arrive at exactly the opposite conclusion by the end of his exploration of this question.

BTW, yes, I didn't read the whole article -- guilty of 'contempt prior to investigation' for sure :oops:

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PostPosted: Thu Jan 15, 2015 10:32 pm 
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Qhorsegirl,

I just read that entire article, it took awhile cuz in still having trouble with getting kicked off, but it's a problem with my device, and I'll have to save for a new one. That's why I'm not online much. Sorry.

Anyway, that was absolutely the most interesting reading about addiction as a disease vs choice, that I've ever read. I absolutely do not believe it's a choice and have had this discussion/debate with quite a few people. Although I'm pretty good at getting my points across, and explaining myself, this will definitely be helpful in providing a much more detailed and informative explaination than I ever have before. Thank you so so so much for sharing this with us. I hope everyone will find the time to read this. Good stuff Q!


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PostPosted: Fri Jan 16, 2015 12:30 am 
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Hi Q,

That is a great article, especially for those of us who want to understand how addiction forms and why it qualifies as a disease.

Could you please link the article from where you found it?

Thanks,
Amy

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PostPosted: Fri Jan 16, 2015 1:48 pm 
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I can't find the link to the article itself, but here's the website.

http://www.addictiondoctor.com/

It is the Institute for Addiction Studies. There is a lot of good info there, Dr. McCauley even has a movie based on the research he presented in the article.

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PostPosted: Fri Jan 16, 2015 6:15 pm 
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Here's a trailer for the vid series that I mentioned above:

https://www.youtube.com/watch?v=wxiKVQR90VM

I remember reading once that addiction-related drug craving originate in the 'caveman' part of the brain, where appetites and drives are both powerful and untempered -- I wonder if this is the same part of the brain mentioned above in the article.

-- ji

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