xiphias: (Default)
[personal profile] xiphias
So, someone in a comment thread on my friends list pointed to a book by Thomas Dalyrimple, in which he claims that opiate addiction is a myth, and that, indeed, nobody ever gets addicted to opiates; they just THINK they do, and society coddles them.

Something like that, anyway.

How do I find out if he's a crackpot, or if his ideas are worth considering?

(no subject)

Date: 2012-08-31 11:31 pm (UTC)
From: [identity profile] tylik.livejournal.com
Well you could go up onto PubMed and read the neurobiological literature about opiate addiction. Damn straight it's addictive. It re-wires your brain. To want more. And it's really well documented.

(Probably well documented in other disciplines as well, if in different ways.)

(no subject)

Date: 2012-08-31 11:35 pm (UTC)
jjhunter: Drawing of human JJ in ink tinted with blue watercolor; woman wearing glasses with arched eyebrows (JJ inked)
From: [personal profile] jjhunter
Look at his sources. Does he reference peer-reviewed studies by himself or others? Do the 'methods' sections of such studies sound reasonable? If addiction were a 'myth' the way this guy claims, then what alternate hypotheses does he give for the biological mechanisms scientists have identified as corresponding to addiction?

If his theories have no reference to scientific method whatsoever, they aren't theories the way science defines theories ("well-substantiated explanation[s] of some aspect of the natural world, based on bod[ies] of facts that have been repeatedly confirmed through observation and experiment") - they're unsubstantiated opinions, and he might as well be a 'crackpot' for all the weight such opinions offer.

(no subject)

Date: 2012-09-01 12:41 am (UTC)
redbird: closeup of me drinking tea, in a friend's kitchen (Default)
From: [personal profile] redbird
"Society coddles them" is a red flag, so I'd start by asking whether that's Dalyrimple's phrasing, your friend's, or your snarky summary. And what on earth about encouraging people to go through withdrawal symptoms (which ex hypothesi are optional) constitutes "coddling"?

(no subject)

Date: 2012-09-01 12:58 am (UTC)
navrins: (shortsword)
From: [personal profile] navrins
Having spoken at length with several people in recovery from opiate addiction, and more briefly with several actively involved in it (including participating in hearings about whether they need to be involuntarily committed for the safety of themselves or others around them), I have a hard time seeing any evidence of coddling going on. People die of opiate withdrawal - not often, but often enough. So, while Dalyrimple might not be a crackpot, he's got a LOT of evidence to re-explain if he's right. It sounds to me like the same kind of idea as the "you can't get pregnant from rape" idea - the kind that sounds good if you don't actually know anyone affected by it, and justifies what someone thinks ought to be done, but is contradicted by the facts.

(no subject)

Date: 2012-09-01 02:22 am (UTC)
From: [identity profile] jim-p.livejournal.com
Thomas Dalrymple is a British prison psychiatrist. I read one of his books: "Life At The Bottom". I found it thought-provoking. One of his observations in that book is that a prevalent attitude among prisoners and other folks in trouble is passivity: life is something that happens *to* them, rather than something they have some influence on. When describing a stabbing, the perpetrator would say "the knife went in" rather than "I shoved the knife into him"... as though it were the *knife* rather than the wielder who had agency and volition. Interesting thought.

If what you say about him checks out, though, my opinion of him would drop several notches...

(no subject)

Date: 2012-09-01 02:27 am (UTC)
From: [identity profile] tober.livejournal.com
Addiction and physical dependency are two somewhat disparate but related phenomena. For example, I think most reasonable people would hold that it's possible to be addicted to gambling - on the other hand, it would be very difficult (at best) to claim that there can be (direct) physical dependency on gambling. With respect to opiates, the evidence that physical dependency is possible (and, indeed, likely under certain circumstances) is tremendously good. The evidence that the brain has opiate receptors is overwhelming - we know where the receptors are, how they're structured, and, to a considerable extent, how they function. Further, [livejournal.com profile] navrins is right, people have died from opiate withdrawal, although that is pretty rare. It's common, though, for opiate withdrawal to be extraordinarily unpleasant and, further, as far as I know, all people who become sufficiently habituated to opiates will experience at least some of the symptoms of withdrawal. That said, though, at least the acute phase of withdrawal, if someone dependent on opiates is suddenly totally deprived of them, lasts at most a matter of weeks. At that point, as far as we know, the physical dependency is over and the person's brain has returned to something resembling its state before the dependency developed. That said, though, it seems that addiction can remain indefinitely. What's really going on at that point is far less understood, ditto for why some people are more susceptible than others. Moreover, there really isn't a good understanding of how to treat addiction (there are multiple methodologies and as far as we know the efficacy of all of them is mediocre) whereas we actually know a fair amount about how to make acute opiate withdrawal less dangerous and more comfortable.

In summary, then, I'd say that if Dalyrimple believes that physical dependence upon opiates does not exist, he's a crackpot. If he believes that addiction (in which case why stop at opiate addiction, as I figure that all addictions are doing pretty much the same thing in the brain) is (and I'll be charitable here and put it differently than you did) a phenomenon that is highly dependent on society and human interaction and circumstances and a variety of other things then he's probably advancing a reasonable theory... but if he boils it down to "this wouldn't happen if the addict weren't coddled" then he's probably also a charter member of the Ayn Rand fan club, or something like that. Whether that makes one a crackpot or not I will leave up to you.

(no subject)

Date: 2012-09-01 09:15 am (UTC)
From: [identity profile] wordweaverlynn.livejournal.com
In addition to all the excellent advice here, you could spend some time with an addict going cold turkey.

(no subject)

Date: 2012-09-01 10:18 am (UTC)
From: [identity profile] xiphias.livejournal.com
It seems odd to ding prisoners for that, since it's something that EVERYBODY does, no matter where on the socioeconomic scale they are.

(no subject)

Date: 2012-09-01 12:58 pm (UTC)
From: [identity profile] domiobrien.livejournal.com
Well, I went through large amounts of NIDA training, and was at one time an active trainer/educator for several NIDA courses-- Drugs in Perspective, etc. I have worked with addicts of various kinds. Opiates are certainly something you can be physically and psychologically dependent on, and tolerance does build, but there are some social/occasional users of opiates. Opiate withdrawal is LESS dangerous than alcohol withdrawal for long term-heavy users, and more alcoholics (percentage-wise) die in detox than opiate "addicts". (Addict/addiction is a slippery concept which keeps being redefined.) But the experience of withdrawal is heavily colored by expectation. So, no, it's not true that people don't get addicted to opiates. But a great deal of what is written about addicts, addiction, etc has a lot more to do with what we believe then what is really happening-- much like the rest of life.

(no subject)

Date: 2012-09-01 02:00 pm (UTC)
From: [identity profile] cakmpls.livejournal.com
Applause for your last sentence!

(no subject)

Date: 2012-09-02 02:55 am (UTC)
From: [identity profile] adrian-turtle.livejournal.com
Consider the distinction between "if he's a crackpot," and "if this is a crackpot idea." A person can do sensible research on some topics (chemical bonding, transistors) while being stubbornly and spectacularly wrong-headed on other subjects (vitamin C, eugenics.) A history of being a crackpot would make him less credible...but one guy's personal credibility can't come close to supporting that kind of claim, anyhow.

That said, I have a problem with anybody saying, "society coddles" opiate addicts. What society is he looking at, for all love? Is it just that he thinks the ongoing War on Drugs should be nastier and more punitive? If there is research somewhere showing that physical addiction is much less of a problem than psychological addiction for opiate addiction, a person of good will would present it in terms of "so treat it as psychological addiction," or "isn't this an interesting bit of pure research that may turn out to be useful someday when we know more." It takes *spectacularly* bad faith for anybody in the 21st century to claim opiate addiction is a myth, whatever the mechanism of that addiction might be.

(no subject)

Date: 2012-09-02 10:41 am (UTC)
From: [identity profile] fatpie42.livejournal.com
Not terribly relevant, but I saw a bit of this documentary on young offenders, many of them involved in knife crime. While it might be true that all people have this kind of mentality, it becomes pretty disturbing in the context of murder. This one kid said of a particular knife attack, after stating how sorry he was for what happened, "well, what can I say, if I he wasn't there it wouldn't have happened". It's one of the few points where the interviewer felt they needed to challenge interviewees on they had said, but here I don't know if it's precisely what they said or what I was kind of screaming internally but I remember the interviewer saying "I HE wasn't there? If YOU weren't there it wouldn't have happened."

Not sure why you mention socioeconomic scale. It's the mentality of prisoners as a whole that Dalrymple was apparently studying, not just the poorer ones. Or did I miss something?

(no subject)

Date: 2012-09-02 10:46 am (UTC)
From: [identity profile] xiphias.livejournal.com
Maybe I keep getting thrown by the fact that I'm an American. As an American, I forget that, in other parts of the world, non-poor people can be arrested, too.

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