Globalization of Addiction

What Hacker News says

1. pdfernhoutJul 2020
   Better options are available than prescription drugs in almost all cases. Almost all psychiatric medicines are essentially placebos -- often with harmful side effects including psychosis and where treating side-effects lead to a treadmill of medications. See: "Deadly Psychiatry and Organised Denial" by Peter C. Gøtzsche https://www.goodreads.com/book/show/26214735-deadly-psychiat... "Deadly Psychiatry and Organised Denial explains in evidence-based detail why the way we currently use psychiatric drugs does far more harm than good. Professor, Doctor of Medical Science, Peter C. Gøtzsche documents that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the United States and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. Gøtzsche explains that we could reduce our current usage of psychotropic drugs by 98% and at the same time improve patients' mental and physical health and survival. It can be difficult, however, to come off the drugs, as many people become dependent on them. As the withdrawal symptoms can be severe, long-lasting and even dangerous, slow tapering is usually necessary. In his book, Gøtzsche debunks the many myths that leading psychiatrists - very often on drug industry payroll - have created and nurtured over decades in order to conceal the fact that biological psychiatry has generally been a failure. Biological psychiatry sees drugs as the "solution" for virtually all problems, in marked contrast to the patients' views. Most patients don't respond to the drugs they receive but, unfortunately, the psychiatrists' frustrations over the lack of progress often lead to more diagnoses, more drugs and higher doses, harming the patients further."

   For people facing psychological issues, see the resources I've collected in the "Health and Wellness" section of this reading list I have put together: https://github.com/pdfernhout/High-Performance-Organizations...

   If you can only look at one resource, read or watch something by Stephen Ilardi, PhD, author of "The Depression Cure: The 6-Step Program to Beat Depression without Drugs", whose advice is built around this quote of his: "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life."

   Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally adapted for and what they continue to need with these six components:

       * Brain Food [supplement with Omega 3s; remember your brain is mostly fat]
       * Don't Think, Do [avoid excessive rumination by doing things]
       * Antidepressant Exercise [aerobic exercise is medicine]
       * Let There Be Light [get natural sunlight and supplement as needed with vitamin D3]
       * Get Connected [engage in face-to-face social activities regularly]
       * Habits of Healthy Sleep [get enough sleep by following basic guidelines]
   

   There are many other books as like the excellent "Why We Sleep" by Matthew Walker or many on nutrition (e.g. Fuhrman, Weil, Mackey, etc.) that examine aspects of this issue -- but what makes Ilardi's book so useful is bringing so many of these ideas together in a historical context. Ilardi says his advice is general and some people with specific traumas underlying their depression may need additional specific help (such as in "The Body Keeps The Score" book on recovery from trauma mentioned below).

   Other books that address specific aspects of depression and related issues of addiction, trauma, and perfectionism (and how they are at root deep cultural issues related to recent Western lifestyle changes) include:

       * "Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions" by Johann Hari. From the last chapter of the book: "You aren’t a machine with broken parts. You are an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you’ve been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated."
       * "Chasing the Scream: the First and Last Days of the War on Drugs" by Johann Hari
       * "The Globalization of Addiction: A Study in Poverty of the Spirit" by Bruce Alexander
       * "In the Realm of Hungry Ghosts: Close Encounters with Addiction" by Gabor Maté, MD
       * "The Story You Need to Tell: Writing to Heal from Trauma, Illness, or Loss" by Sandra Marinella
       * "Writing Hard Stories: Celebrated Memoirists Who Shaped Art from Trauma" by Melanie Brooks
       * "The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are" by Brené Brown
       * "Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead" by Brené Brown
   

   For people dealing with the special case of a specific trauma for themselves or a loved one, consider reading "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Bessel A. van der Kolk. As the blurb for that says, "Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children. Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring -- specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy -- and a way to reclaim lives."

   For those facing specific issues related to suicide for themselves or a loved one, a key book is: "Out of the Nightmare: Recovery from Depression and Suicidal Pain" by David Conroy. By reconceptualizing suicide as an involuntary action that occurs when total pain exceeds resources for coping with pain, David Conroy provides a morally neutral way for organizations and society to think about suicide prevention in a productive way. Rather than focus mainly on intervening in a crisis, organizations and societies can rethink their operations to reduce participant pain and to increase coping resources. This helps everyone -- not just those who have reached a threshold where pain is very close to coping resources. Aggregate pain includes physical pain, emotional pain, and social pain. Reducing pain in any area by even a small amount may bring a person below a threshold for suicide. Similarly there are many types of coping resources from interacting with a friend, to going to a funny movie, to receiving adequate health care, to interacting with a pet. There are also some short-term coping strategies like denial or drinking which may have long-term negative consequences that become new sources of pain when done to excess.

   As David Conroy says: "Suicide is not chosen; it happens when pain exceeds resources for coping with pain. That's all it's about. You are not a bad person, or crazy, or weak, or flawed, because you feel suicidal. It doesn't even mean that you really want to die - it only means that you have more pain than you can cope with right now. If I start piling weights on your shoulders, you will eventually collapse if I add enough weights... no matter how much you want to remain standing. Willpower has nothing to do with it. Of course you would cheer yourself up, if you could. Don't accept it if someone tells you, "That's not enough to be suicidal about." There are many kinds of pain that may lead to suicide. Whether or not the pain is bearable may differ from person to person. What might be bearable to someone else, may not be bearable to you. The point at which the pain becomes unbearable depends on what kinds of coping resources you have. Individuals vary greatly in their capacity to withstand pain. When pain exceeds pain-coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources. You can survive suicidal feelings if you do either of two things: (1) find a way to reduce your pain, or (2) find a way to increase your coping resources. Both are possible."

   (I write this in memory of my friend from Princeton, Robin Rochlin Cooperman, M.D. Psychiatry, 1963-2010. I can wish that she was still alive to talk with about all this newly emerging information about increasing wellness in a wide variety of ways beyond prescription pharmaceuticals. And also I write this in memory of other friends I have lost along the way...)

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2. justratsinacoatAug 2016
   >ctrl+f "rat park"

   Not found!? Well, I'm just the motile conglomeration of vermin for the job! "Rat Park", a utopia for rats, is (IMO) a critical component of the pushback against the disease model of addiction. An illustrated summary can be found in this lovely comic [0], while more interested parties can peruse the works of Dr Bruce Alexander, in the form of a blog-retrospective [1], or a slightly more technical presentation to the Canadian Senate [2], or his excellent book, The Globalization of Addiction: A Study of Poverty of the Spirit [3].

   A layman-readable synthesis goes something like this: folk wisdom holds that some drugs are insanely addictive, as an inherent property of the drug. But this has generally [4] been borne out by introspective interviews of inveterate drug abusers and highly technical experimentation on lab animals (mostly social animals, like primates and rats). Introspection, for most domains of psychological study, is never used and treated as hearsay (it's not a contentious claim in psychology that people aren't good at examining their own mental states in a scientifically useful way). The methods of the experiments on social animals like rats and primates often dictate cramped, isolated and impoverished conditions. The "Rat Park" study took normal lab rats and placed them in an enormous array filled with nesting-boxes, large open areas, wheels and toys. The control rats, by contrast, were treated in every way identically to a standard addiction study -- tiny cage, no comforts, no stimulation but for a human changing their litter tray. Various experiments ensued, but even with different experimental treatments, the researchers couldn't induce addiction in the rats of Rat Park, while even fiercely bitter, heavily-diluted morphine-water was the choice of the isolated, imprisoned rat.

   The orthodoxy of invincible permanent addiction was vanquished in these animals (and the minds of the researchers), by providing a more stimulating, spatious environment filled with fellow rats with whom to interact. This might say something important about the nature of addiction in other social animals, like humans.

   [0] http://www.stuartmcmillen.com/comics_en/rat-park/

   [1] http://www.brucekalexander.com/articles-speeches/rat-park/14...

   [2] http://www.parl.gc.ca/content/sen/committee/371/ille/present...

   [3] https://scholar.google.com/scholar?q=The+Globalisation+of+Ad...

   [4] It IS true that you can see pretty drastic rewiring in the ventral tegmental area (which covers, generally, reward systems, drug addiction, strong emotions) with things like nicotine and cocaine, so the picture is probably more complicated than 'it's purely a social problem', but the ascendancy of the dogma of the disease model of addiction functionally prevents further study. Note that the Rat Park paper was very difficult to publish and received no attention for years.

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3. billjingsSep 2015
   I have a short list of books that I recommend that have changed my worldview. First and foremost on that list is Bruce Alexander's _The Globalization Of Addiction_: http://www.amazon.com/The-Globalization-Addiction-Poverty-Sp...

   If you've got the bug, that book is not going to help you. It'll just tell you how screwed you are. If you don't have the bug, I think that book might help you understand the problem.

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4. hollerithMar 2013
   IMHO there is already too much acceptance of obsessive thinking and addictive habits in Silicon Valley culture (and in American society as a whole).

   Although not all obsession or addiction is bad, anything that encourages or pulls a signficant fraction of the population (of Silicon Valley or America) even more in that direction is.

   I wish I knew of a well-written book or article explaining how addiction damages communities, but I do not, so here is a badly-written book: Bruce K. Alexander's Globalization of Addiction.

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