Abuse and Addiction

Abuse-Addiction

see also:  Abuse-Addiction Articles ,    Abuse-addiction: PTSD, vulnerability factors ,   and   Neonatal Abstinence SyndromeLetter about ‘addiction to wealth and power’ to APA

SUBSTANCE USE DISORDERS   and   psychological-behavioral addictions;   contagion of abuse-addiction behaviors

This post deals with the broad mismanagement of substance use disorders and dangerous psychological-behavioral addiction. The contagion  of substance use disorders and dangerous psychological-behavioral addictions are hardly addressed. While focusing on substance use disorders, dangerous psychological-behavioral addictions are broadly underappreciated; most are not recognized as pathologies that need treatment. While it is known that substance use disorders and psychological-behavioral addictions are highly contagious, they are rarely seen as preventable epidemics, epidemics, whose spread can be stopped by treating the abuse-addiction patients and preventively address vulnerable individuals, particularly in young people.

Abuse basically means doing something to feel better, because of a reward feeling, because it feels ‘right,’ and/or to relieve internal pressure to do so, in spite of a theoretical knowledge that it is not ethical, bad for self and/or others. Much of the time, the knowledge that it is ‘wrong’ is suppressed. The abusers distract themselves or reason that the behavior’s ‘wrongness’ is not important. In abuse behaviors, the persons usually feel that they are in control. An abuse pattern can be at least temporarily stopped when it is important to hide it.

Addiction essentially means that an abuse pattern has become a first priority, virtually always competing with other priorities, such as being a good parent and worker, always following high standards of ethics, etc. Addiction behaviors continuously compete with healthy priorities, being loving, caring, reasonably diligent, ethical, etc. Addiction patients feel that they lost control, even though, with new motivating factors that are supported by strong emotions, people often stop an addiction pattern.

Addictions are contagious, they must be seen as epidemics and pandemics. To put things into perspective – we must admit: our modern institutions are horrible when it comes to anybody observing the “big picture.” Why has the response to the corona virus pandemic been terrible in the U.S. while other countries did fair to very well? In April, the U.S. reached more Covid-19 related deaths than the annual death rate from the opioid epidemic – however, while covid-19 has no cure and is only preventable by way of proper behavioral precautions, the highly contagious opioid use disorder is cheaply treatable, with methadone, in milder cases buprenorphine, combined with targeted psychotherapies (these medication assisted treatments (MAT) work like nicotine patches, greatly decreasing craving while hardly interfering with normal functioning and emotions). But governments and our profit-driven health care system have been sabotaging these treatments!

MAT (medication assisted treatment) works very well in containing opioid addiction. Anybody who becomes addicted, learning to use heroin while vulnerable or moving from pain medication misuse to addiction, these patients do very well with long-term (1.5 to several years), combined with targeted psychotherapies, addressing PTSD, depression and anxiety disorders, young people having a sense of life being meaningless, etc.

Many addiction patients may respond to psychotherapies that address ethics and meaning in life, goal setting, healthy social contacts, developing interests, learning cognitive stress management and generally healthy lifestyle that includes physical exercise, meditation and contemplation, etc. Patients must learn to largely accept all realities, including traumatic past, real dangers, discrimination and other injustices, and likely losses, disorders, etc. Patients need to learn to forgive self and others as much as possible, being kind to themselves and to others. However, accepting realities should include working towards improving situations, institutions, etc. at least for the benefit of others. [There is no “justice” – everybody is different, same punishment for same infraction may hardly harm one but destroy the family of another, and society cannot make up for people’s inequalities, their disorders, accidents, bad luck, etc.; however there is injustice in the sense of authorities purposely applying rules and laws differently in people who differ in ethnicity, religion, socioeconomic status, etc. Still people who are treated badly do best when accepting realities.]

Some self-suggestions, following meditation and while feeling non-judgmental, that may be broadly helpful: “Nothing is important – except my positive directedness” – problems are only important at times when we can help and consider possibilities. “I expect nothing – but keep doing my best.” “The past does not define my future” at any time, we can do our best to move forward, no matter what memories and habits we acquired, and what consequences there will be due to earlier mistakes.

Prevention of severe addictions starts with addressing vulnerabilities and often psychotherapy approaches that are similar to those helpful in addiction treatment. ‘Minor’ addictions should be addressed. Nicotine is a frequent a gait-way drug.

Difficult substance use disorder patients may need long-term low-intensity residential treatments that address all aspects of patients’ psychological problems. Psychological treatment cannot be compressed into one to six months’ intensive in-patient treatments, and ‘spiritual’ approaches (AA, NA) have limited benefits, other than benefits from social connectedness.

‘Bad’ habitual behaviors, like “over-grooming behaviors” – nail biting or scab picking – should not be called addiction, Healthy exercise routines are not addictions either.

Many psychological-behavioral addictions are not yet broadly appreciated as psychiatric disorders.

In his New York Times article [Bill Gates is the Most Interesting Man in the World, NYT 2020, 5/23, p. A22] Timothy Egan refers to the conspiracy theory propagators as “fevered minds,” “delusional,” and part of the “lunacy community.” We must consider these people to suffer from addiction disorders, comparable to gambling, sex, eating behavior addictions, and computer gaming addictions.

In addiction to wealth and power, probably the most devastating of all addictions, people commit highly unethical acts for further gains, harming many and destroying their lives and legacy. A large number of highly successful people end up in courts because of their addiction-driven transgressions. Many spend much more time amassing more wealth than enjoying healthy relationships with loved ones.

The drive to rise in status has no natural point of satiation, as healthy eating or sex have; in small groups, it may have been adaptive to strive to become the alpha male or matriarch. Since the development of agriculture, animal husbandry, and life in large towns, leadership lost its natural limits and since societies became anonymous, inhibitions to governing in inhumane ways decreased.

  • Addictive consumerism is related to addiction to wealth and power. In the addiction stage, people are never satisfied. They crave the short excitements when buying something new, they compete with family, friends, and particularly neighbors, and they often become deeply indebted. Move from unwise buying to abusive consumerism (or “shopping addiction”) to severe addiction may be gradual and very insidious.
  • Conspiracy theorizing is a particularly contagious addiction that is often linked to other addictions (including addiction to wealth and power); patients’ wild theories feel like revelations and elevate their esteem among fellow addicts.
  • Theological theorizing is similar, people believing to have an exquisite understanding of the will of God or Allah, their faith superseding sciences and broadly held ethical views. Hyper-religious people may not be able to handle the discrepancies between mythical and poetic old texts and real life experiences, common sense and sciences; hyper-religiosity may lead to psychosis, addictive theorizing, inhumane thinking, and even terrorist behaviors.

These psychological-behavioral addictions must be recognized as dangerous psychiatric disorders. They must be treated, sometimes against a person’s will. However, so far treatments have not yet been established. Psychotherapy probably must focus on:

  • Only sciences lead to progress and agreements between people. Religions, dogmatism, ideologies, etc. divide us and prevent rational work towards progress.
  • Much that people speculate and theorize about has no benefit other than maybe influencing people politically, and it distorts people’s worldview, distracts from valuable pursuits, etc.
  • Patients need to strive towards a healthy lifestyle (reasonably healthy nutrition, exercise and use of body, meditation and contemplation). Our social needs include fairly close, loving relationships within families and groups. Tolerance and forgiveness should help accepting differences among people and avoid judging others.
  • Ethics in the broadest sense of the word is most important in order to find meaning in life.
  • Accepting realities is essential, including personal abuse histories, injustices, accidents, and diseases. Blaming is natural but we must attempt not to give into it; we must work towards forgiving self, others, fate.
  • People must learn that there is diminishing return when reaching a higher standard of living – too many possessions make life complex and often lead to interpersonal difficulties. We should strive towards a ‘standard level of comfort.’
  • People must also acknowledge that animals, humans included, usually live outside a range of ‘comfort’ and we seem to benefit from often adjusting to physical strain, high or low temperatures, etc.
  • Religion has to be limited to being part of a culture; it cannot serve to answer our lives’ basic unknowns and the content of traditional religious teachings can hardly give meaning to our lives. ‘Faith’ is not the answer, and people who make efforts to have faith frequently realize that they fail to truly believe.

Religions must never attempt to teach facts or incorporate local traditional beliefs into their morality, other than passing on a culture’s history and traditional poetry and legends that may include wisdoms. Religions’ functions should be limited to celebrating groups’ connectedness, traditional art, and group members’ transitions such as births, adoptions, adolescence, marital commitments, maybe midlife stage, retirement, deaths, etc. Religions may also communally celebrate seasons and anniversaries of for the culture relevant dates. People must acknowledge: we cannot grasp or know realties concerning a god, creation, eternity, etc., least what a God’s will is. There is no indication that natural developments have purpose, somehow result from a divine plan, etc. Life is basically random and often cruel; there is no ‘justice.’ We may influence our and others’ future but have no control over anything.

Literature:

Contagious Addiction: Opioid Prescriptions Increase Likelihood of Family Members’ Use. 18-Jul-2019 11:05 AM EDT, by American Sociological Association (ASA)     https://www.newswise.com/articles/contagious-addiction-opioid-prescriptions-increase-likelihood-of-family-members-use

How do drug problems evolve over time?     https://www.psychologytoday.com/us/blog/science-choice/201612/drug-use-epidemic-phenomena

Drug Use as Epidemic Phenomena  A Contagious Disease Model for Researching and Intervening in Heroin Epidemics.   Patrick H. Hughes, MD, Gail A. Crawford, MA    https://jamanetwork.com/journals/jamapsychiatry/article-abstract/490703

 

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