Illicit Drug Use Not Always a Problem

Here are three articles about illicit drug use pointing out that the drugs themselves aren’t always a problem (and many also come in prescribed versions).

It is the criminalization of drug use that causes chaotic and destructive behavior and imposes such high costs on society (court system, incarceration, law enforcement).

Except for the legality, using illicit drugs is not much different than using alcohol. Some cause far less physical or social harm than alcohol and some are even less addictive, so we cannot claim “illicit drugs are bad for you”.

A Key Truth About Avoiding Addiction

How a Famous IQ Study Revealed a Key Truth About Avoiding Addiction – Filter – by Stanton Peele – Feb 2019

What makes you live longer? What makes life more satisfying? What enables people to resist addiction?

These three questions have an answer in common—a remarkably good piece of news about which we should continually remind ourselves.

The answer is certainly not simply to stop taking opioids for chronic pain, when no other treatments have been able to relieve your pain. 

Chronic Pain After Cancer: The Role of Opioids – part 2

Chronic Pain Following Treatment for Cancer: The Role of Opioids – Ballantyne – 2003 – The Oncologist – Wiley Online Library – Jane C. Ballantyne –  Dec 2003

This is part 2 of a long article (part 1 here) making very reasonable arguments for using opioids after cancer treatment when chronic pain persists. Her views used to be reasonable, but now she’s one of the most adamant anti-opioid zealots.

Stable Pain Treatment

Ideal chronic opioid therapy, assuming the pain and disease are stable, uses a stable dose of opioid medication

Often, chronic pain is constant and unremitting, and in that case, long‐acting drugs and formulations given round the clock are useful. Round‐the‐clock dosing allows many patients to achieve maximum functionality, without the need to focus on the next dose of drug and without the swings in analgesic level associated with as‐required dosing.  

Difference Between Drug Addiction and Dependence

Is There Really a Difference Between Drug Addiction and Drug Dependence? – Scientific American Blog Network – By Jonathan N. Stea -November 2019 (repost)

As a follow-up to a previous post, Addiction vs dependence | National Institute on Drug Abuse, here’s an article from the Scientific American pointing out the messy confusion between the two created by the DSM-5.

It is no secret that misinformation about addiction is rampant in popular media. One particular area of misinformation concerns what language gets used when describing topics related to addiction.

all sorts of individuals—medical professionals, journalists, parents, people who use substances, people in recovery—incessantly argue over terminology such as “addiction,” “dependence,” “abuse,” “misuse,” “habit-forming,” “recreational use” or “medicinal use.”  

In Defense of the Concept of Addiction

In Defense of the Concept of Addiction – by Stanton Peele – Jan 2020

The term—and concept of—“addiction” is regularly frowned upon or even attacked by people in our field. But it won’t disappear, nor should it. There are four groups or schools of thought that de-emphasize or disparage “addiction.” And their reasons for doing so all have value.

Psychiatry:

Psychiatry in the latest DSM-5 claims it didn’t want to stigmatize people with the term “addiction”, so it completely muddled the difference between doing something regulated and appropriate on a regular basis (taking prescription opioids) versus binging on street drugs (heroin, amphetamines, cocaine), becoming addicted, and ending up overdosing. 

Most People Don’t Feel Euphoric From Opioids

Most People Don’t Actually Feel Euphoric When They Take Opioids, Study Finds | Live Science – By Nicoletta Lanese – Staff Writer – Oct 2019

Finally, someone is willing to state the truth, one that goes against all the rabidly anti-opioid media hype:

Opioids jump-start the brain’s reward system, provoking a burst of pleasurable feelings along with a dizzying drug-induced high. At least that’s what scientists used to think.

But mounting research suggests that the average person doesn’t actually reach this euphoric state on opioids, particularly not the first time they try it.  

Yet, this is exactly the kind of research that is not getting funded these days.  

Addiction vs dependence | National Institute on Drug Abuse

10: Addiction vs dependence | National Institute on Drug Abuse (NIDA) – Nov 2019

We have an entire government institute that is dedicated to handling drug abuse issues. NIDA is not connected to the DEA in any manner and has much experience and knowledge about addiction, but their expertise is being ignored.

Here, the true experts on addiction give a lengthy explanation of how the brain region leading to addiction is entirely separate from the region that controls dependence and tolerance.

This is a slide show with diagrams to illustrate the points they make. Click on the link of each section to see the slides.

…different parts of the brain are responsible for the addiction and dependence to heroin and opioids.

Only 1% Continue Opioids After Emergency Rx

Only 1 Percent of People Become Chronic Opioid Users After Hospital Prescriptions for Injuries, Study Shows – By Blake Dodge – Nov 2019

This destroys the myth of “heroin pills” that “cause” addiction after “just a few pills”. And this tiny fraction of patients could very well be the ones that suffered long term damage from the injuries that sent them to the ER in the first place.

People who are prescribed pain medication after they visit the emergency room for car crashes, falls and other types of acute injuries largely do not become addicted to opioids, a new study showed.

The results go against the widely held understanding…

It’s more like malicious ignorance due to a complete lack of understanding and, in some cases, a blatant refusal to understand. 

Difference Between Drug Addiction and Dependence

Is There Really a Difference Between Drug Addiction and Drug Dependence? – Scientific American Blog Network – By Jonathan N. Stea – Nov 2019

In my experience as a clinical psychologist and, dare I facetiously say, a Twitter addict, the most important and commonly confused distinction is between “addiction” and “dependence.”

And it is no wonder.

This deadly (to pain patients) confusion is due to the psychiatric “bible” which either unintentionally or intentionally erased the difference between the two.

The latest version, the DSM-5, now hides “addiction” as a category of “dependence”, even though these are two very distinct issues. 

More Reasons For Opioid Policy to Shift

Data From Germany Provide More Reasons For Policy to Shift From Prescription Pills to Harm Reduction – Cato.org – By Jeffrey A. Singer – Aug 2019

In February of this year, I co-authored a paper in the Journal of Pain Research explaining why there is no correlation between the amount of opioids prescribed and the incidence of non-medical use or prescription pain-reliever use disorder.

See my post on this paper: Non-medical opioid users were not pain patients

Now researchers in Germany have provided more evidence to pour cold water on the idea of any relationship between the volume of opioid prescribing and the incidence of opioid use disorder.