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Comment by lujim | Hacker News Reader

I've read that the way gambling engages the dopaminergic system in gambling addicts is more akin to physical addictions like alcohol, tobacco, or opiates. So maybe a better analogy would be "in the same way freely available opiates would enable drug addicts".

There often seems to be a sentiment of "Why congratulate a recovering alcoholic? I've never had a drinking problem so why isn't someone congratulating me." from those who have never experienced or been close to someone who is experiencing a never ending addictive loop. Generally this attitude comes from arrogance, inexperience, and youth.

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The vast majority of opiates, substituted amphetamines, and cocaine were available OTC for a myriad of ailments. Many Vietnam veterans were treated in hospitals with heroin, yet they didn't become addicted.

What it boils down to is that the addict is unable to achieve homeostasis with their environment. Unfulfilling relationships (both romantic and platonic), financial burdens, lack of a job, lack of intimacy all contribute to addictive behavior.

It's easy to blame a particular molecule for ruining someone's life. It's less easy to blame a system that turns men into machines.

Maybe, although I do believe that tons of good science has chimed in on the role of dopamine in the human brain. Give a smoker some chantix without alleviating their financial burdens or changing "the system" in any way and watch how long it takes them to want nothing to do with cigarettes. There is a complex biological process at work here that plenty of smart people spend their entire lives trying to understand.

Substituting one drug for another to treat a psychological or behavioral deficiency has been a popular prescription for a long time, and reciditivism has prevailed in a majority of cases, upwards of 90 percentile in alcohol and opiate abusers. JGI if you need sources, though those numbers are actively obfuscated to serve the practitioners, pharmas & lawmakers' self-interests; my knowledge comes from shared 1st hand experiences of acquaintances in ER, behavioral sciences & addiction treatment center personnel over the last 30 years.

edit: spell checker changed psychological to something u related & I added how long I've known these people.

Sorry I'm not a mental health professional or a physician and had to google "reciditivism" which appears to be a reversion into criminal behavior which is maybe a fancy word for relapse I guess. You are saying that medicine used to treat psychological or behavior deficiencies is of little or no value? Don't you think the shared knowledge of acquaintances is kind of anecdotal? If we are using anecdotes then I would add that I used chantix to quit smoking years ago and never looked back. It flicked an instance switch in my brain that gave me enough distance from that negative behavioral feedback loop to quit for good. Then I quit chantix and never took either again. For me it was (probably literally) a life saver.

I didn'y say pharmaceuticals are of little or no value, I said recidivist rates for alcohol & opium addiction are upwards of 90%. If a chemical imbalance causes harmful behaviors, then yes, pharmacology can be a lifesaver. My experience is admittedly anecdotal and should not be taken any other way. People who deal with addicts regularly(doctors, LEOs, therapists and family members) will have their own anecdotes, and together they form a pattern which, IMO, is swapping one drug for another isn't the panacea drug makers and their lobbyists would have us believe. There was a long discussion about an Asian weed the DEA made schdule 1 recently despite it not meeting any of the criteria. It is the opinion of many professionals that it IS a good instance of swapping one drug for another in opiate addicts, much like Chantix worked for your nic habit.

Good for you on quitting the cigs. If I may inquire, how long did you take it? Did it work the 1st time? Any disturbing imagery or dreams? I am genuinely curious, as I am a nicotine junky myself.

Ahh gotcha. Yes alcohol and opium are tough to keep people away from. Chantix worked the first time and within just a day or two made smoking a cigarette completely devoid of any pleasure. Zero problems with dreams.

The biggest epiphany you get from quitting smoking is realizing that cigarettes aren't inherently pleasurable, smoking one just removes the symptoms from nicotine withdrawal in a way that other nicotine replacements can't. While everyone seems conceptually know this, it's surprisingly hard to really get it to sink into your own brain. Truly understanding/believing that combined to a round of Chantix took care of things for good.

Awesome. I would very much like to quit and will give that a go. It's not the quitting I dread, it's the deep, perilous dread I feel when withdrawl begins, only an hour or two after the last. I know rationally I can do it, I go 6-8 hours a night nic-free while sleeping and am not jonesing when I wake up.

If chantix doesn't work for you my grandma used bupropion to quit. It was a wonder drug for her.

Obviously talk to your doctor.

> Many Vietnam veterans were treated in hospitals with heroin, yet they didn't become addicted.

And many did, I assume. Were there studies that unequivocally showed that the non-addicted had good jobs, stable relationships, and a purpose in life, etc? There are lots of stories of successful college students, etc., who start dabbling in drugs and spiral down despite having all their ducks lined up in a row.

It seems to me that it's just as likely down to genetics. Some people are predisposed to addiction to certain things, and some aren't.

As a dumb anecdote, I smoked briefly after college because my girlfriend did. When I stopped dating her, I stopped smoking. I tend to think that I'm probably not predisposed to nicotine addiction.

> It's easy to blame a particular molecule for ruining someone's life. It's less easy to blame a system that turns men into machines.

maybe it's not the "system" but the success of the system that is to blame ? All the homeless, impoverished, 3rd-world people dont have time to get addicted to things because they're trying to eat! I almost want to agree with you that its the unnatural constraints that capitalism puts us under. But at the end of the day, we as Westerners generally have money to buy dope/gamble/drink etc. The only place that money comes from is our collective prosperity. I say it's our collective prosperity that enables us to gorge ourselves on whatever vices we prefer. Look at how many celebrities implode because they have the money to buy whatever pleasure-substances they want.

Many third world countries have similar substance problems.

There are genetic factors at play that make some more vulnerable than others.

https://www.ncbi.nlm.nih.gov/pubmed/12635538

https://www.ncbi.nlm.nih.gov/pubmed/24878765

I can confirm this anecdotally. In my family tree, just considering my parents, biological uncles/aunts and first-cousins - out of a total population of 19, our family has had 8 distinct individuals who were either alcoholic, drug addicted or compulsive gamblers, for a total of 8 out of 19. I am one of those (in recovery since 1998).

I can now recognise the telltale behavioural signs that may indicate tendency to compulsive/addictive behaviour. I'd love to see a cheap genetic test for addictiveness made available.

There was a study of addicted vietnam vets where they compared the addiction rate after returning home (a major environmental change)

And I believe the vast majority stopped using, so environment has some reinforcing aspect to addiction.

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