Most People With Addiction Grow Out of It (2014) | Hacker News Reader

Most People With Addiction Grow Out of It (2014)

psmag.com

168 pointsdedalus125 comments

I think articles like this are dangerous to us addicts cause it solidifies the "this is just a phase" mentality that many of us have. They sampled 42,000 people, but how many others had to die, have their lives ruined, or ever worst, hurt someone they loved or end up in prison because of their addiction?

YES I'm sure some of us can quit on our own or can "grow out" of our addiction if we don't end up dead or in jail first. I'm sure there cancer patients out there who are cured and have never had a single treatment, but you can bet that most people with cancer get some sort of treatment and help.

Bottom line is, YOU DON'T HAVE TO GO AT IT ALONE. There is help available, so why not use it? AA, NA, HA ,CA, Wellbriety, going to therapy, medical professional, it's all there to help so use it. You doesn't HAVE to take 15 years to "grow out" of alcoholism if you can get the support you need to help you quit sooner.

Tonight I'm speaking at a DETOX and I suggest that they go through the 60 day RIT program that it offers so they have a better chance of beating their addiction. Again, please don't wait to get help. You don't have to fight this battle alone.

You're 100% right that people shouldn't have an attitude of "this harmful part of my life will fix itself". Although I don't think just observing that you'll likely "grow out" of it makes the article dangerous. People also tend to grow out of violent behavior (how many hyper-violent 20 v.s. 80 year olds are there?). That doesn't mean it's not harmful behavior when you're younger, or that it doesn't need to be addressed at that point.

But it's just as dangerous to propose that simply because you have issues in your life that some religiously-motivated program like AA is the way to go.

We should provide people with help that's scientifically developed and proved to be effective, and AA and its various sister programs are neither of those. They're just "get the drunks to worship god instead" programs. In recent years they've gained the thin veneer of talking about a "higher power" instead of "god", without becoming any more scientific or empirically-supported as a result.

If you have a problem with addiction start by talking to your physician, not a church group.

Are you saying that there are no statistics that back up AA as effective?

I am pretty skeptical of a claim like that.

Efficacy rates are low, but so is almost every other intervention available.

It works for some people. It's also completely free, which you can't say about medical intervention. Around here, detox and rehab facilities have 6 month long waiting lists and cost tens of thousands of dollars.

Are you saying rehab facilities also don't work compared to a control group?

I am skeptical about that too. I'd be surprised if both rehab and AA don't have a statistically significant effect on addiction treatment.

No.

People tend to expect that rehab will cure addiction, and become disillusioned with the reality that addiction is a chronic illness. Relapse rates are high in chronic illnesses, like diabetes and hypertension, the latter having a relapse rate of 50%-75% according to the NIH. Addiction is no different, and its relapse rates are between 40%-60%, even with ongoing treatment. Efficacy rates will reflect this harsh (and often very expensive or deadly) truth.

The success rate of AA is somewhere around 5-10%. Perfectly accurate stats are hard to acquire due to the nature of the disease of addiction, and the programs themselves intentionally do not track efficacy rate (after all, a program based on religious ideology instead of actual evidence has hilariously become the defacto prescription for drug addiction in the american legal system. Why ruin a good thing?). You would achieve a similar efficacy rate by giving addicts a sugar pill and telling them it was a miracle drug that cures addiction.

Also instead of taking the time to write out multiple comments expressing your doubt as to the efficacy of AA, you could've found the information you needed in a single google search.

So what's the solution?

Your perception of AA is based on ignorance. AA is not a "get the drunks to worship god instead" program... It is suggested that you find a higher power, but not required. Remember..."Our book is meant to be suggested only, we realise we know only a little."

I go to Agnostic meetings that don't involve any prayer or spiritual aspect, just a group of drunks gathered together helping each other to stay sober. So if the whole religious or spiritual aspect of the program leaves a bad taste in your mouth, try finding a secular meeting in your area: https://secularaa.org/tsml_meeting/

What am I supposedly ignorant about? That AA is a religious sobriety program? The next sentence of the "Our book..." quote you've cited is "God will disclose more to you and to us". So perhaps it's not not doing the work you think it is.

In any case, the motivation for my comment was to point out that many of these "xA" programs are inspired by the 12-step "AA" program. That program is not scientific, or even amenable to change as new evidence about the efficacy of sobriety comes in.

Rather, it's dogma. Whatever white-washing of AA's mention of "God" over the years as "higher power" doesn't change the fact that it's not science-based.

Does that mean it's completely useless? No, but as others have pointed out studies of its effectiveness are rather damning[1]. It just bears pointing out when treatments for addiction are discussed that AA is a dogma-based therapy, because many people suffering from addiction think AA is just what you're supposed to do.

1. https://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_An...

"That AA is a religious sobriety program" - exactly that. It is a suggested spiritual sobriety program with an emphasis on "suggestive". It's not a religious program what-so-ever. They use the word God to incubus whatever "higher power" a member chooses (or chooses not to) believe in. I'll give you that God was an EXTREMELY POOR choice for the word, but it's what everyone could relate to at the time. In any case, don't let the fact that God is mentioned in the book confuse you, it's already confused most.

This is disingenuous. The entire history of AA up to and including now (literally read any 12 step guide, 8+ steps mention God) is pushing a protestant christian philosophy that man is irreparably fallen and flawed and the only salvation is through a higher power, and that you must give up your self and any semblance of control to that abstraction.

It works for some, but anyone who says its not a christian organization is absolutely lying - its like taking the caramel coloring out of cola - its still cola, it still tastes like cola, you just took away the color that reminds people that its cola.

There are secular AA programs. I attend a couple in my area, have found them to be extremely helpful as a support group, and would not label them as a "church group".

Physicians aren't a cure-all, because there's no guarantee they've been trained in addiction medicine. After a few doctor visits and them hearing the word "anxiety", you might just leave with a new prescription to Xanax or some other benzo, which could be a virtual death-sentence for someone with a dual-diagnosis.

I’m agnostic and probably about as liberal as they come. My brother is atheist and getting and staying sober through AA. The “god” can be anything you want it to be, as it is for him.

That is not to say that AA is for everyone, but this advice to just “talk to a physician” as if that is the only fix is absurd. Look at how many people are hooked on opioids after “talking to their physician.”

True, but predatory church groups abound. Motivations for helping people with addictions ranges from compassion, to dispassioned dominance and exploitation, with most being somewhere in between (money). This is not to say that they are all bad, but peverse incentives seem more common than most industries, even when the intentions are noble.

Exploitive and dominance-motivated people exist in the medical sphere, as well.

I never understood the "god can be anything you want" line. Five of the steps involve accepting "god" as an authority over your life, including "His will for us" and the power to "remove all these defects of character". It reminds me of Henry Ford's infamous "any customer can have a car painted any color that he wants so long as it is black"; i.e. you can have any god you want, as long as it's at least a metaphor for a personal god that deserves authority over your decisions and well-being. Your brother might have no problem with that sense of authority, but plenty of atheists do (e.g. believe that if Yahweh existed, He would be a tyrant undeserving of worship).

You can reduce those to the authority of the laws of physics, if you want. Try defying the authority of gravity, for example. Then, have faith that the laws of physics will work in such a way that your brain will be altered and addiction no longer so strong.

How does physics "remove all these defects of character"?

It's accepted physics that all defects of character will be removed at the heat death of the universe :)

Removed, or frozen in perpetuity?

The only way to alter one's character are through physics, presumably.

Almost everyone I know who is successfully clean and happy in 12-step had long ago exhausted all the options: doctor, priest/preacher, psychologist, moving to a new town, "going to the gym", etc. Nobody would ever (myself included) do 12-step because we actually think it would work. And yet it has worked for me when nothing else did.

The disease model of addiction ( a la AA) has been thoroughly discredited by science. Indeed believing in the disease model is a primary determinant of relapse. The incredible work of Stanton Peele in the US is the route that "addiction treatment" should move towards.

Dr Gabor Mate has also done fantastic work on addiction. Stanton Peele seems to share some viewpoints with Dr Mate.

"Dr. Maté's approach to addiction focuses on the trauma his patients have suffered and looks to address this in their recovery"

https://en.wikipedia.org/wiki/Gabor_Mat%C3%A9_(physician)

>Bottom line is, YOU DON'T HAVE TO GO AT IT ALONE.

>if we don't end up in jail first

The former statement does not work because of the latter. Any additional person that knows about it is a risk to your freedom.

Can you elaborate on that if you see this? You're saying seeking treatment can increase the likelihood of jail? Not criticizing, I don't doubt it, but I'd be interested to know the ways that can happen. Your therapist / addiction specialist will snitch on you?

Yes, that's what I'm saying. I don't mean that a therapist will snitch on you, but there's always a chance. Maybe a cop doesn't like you and sniffs around for this stuff. Furthermore, there are a lot more people involved in therapy than just you and your therapist.

You don't have to go it alone, and some people benefit from help, but I think it's harmful to say people must rely on others, or in any way invalidate people's autonomous ability to escape addiction or overcome any cognitive obstacle.

I think that these articles are there to fight a common view that addicts are hopeless people that in no way can put their life back together unless they go through severe medical and psychological treatment.

The problem of wanting to "cure" addiction by using drastic measures like cold turkey or rehab is that it may not be the best course of action. Perhaps it is better for many people to acknowledge that the addiction is in fact "just a phase", and that a proper way of dealing with it would be to accompany the addiction so that the person wouldn't be harmful to himself and others, until the person reaches the point where they "outgrow" it naturally.

I have read, I can't remember where, that actually going cold turkey for hard drug (heroin, crack, etc.) addictions is a lot more effective than gradual decrease in use. Furthermore, many addicts have predisposed brains to addiction that makes them not able to moderate addictive behaivour.

I agree that rehab is not always the best solution, because it does not teach the user to wilingly bot use drugs, just forces them not too.

Not sure where you heard that but it's definitely not true for genuine opiate addiction which can actually kill you from the withdrawal. Addiction can be a serious medical condition that requires real medical attention, not just stronger willpower or something.

https://onlinelibrary.wiley.com/doi/full/10.1111/add.13512

>I have read, I can't remember where, that actually going cold turkey for hard drug (heroin, crack, etc.) addictions is a lot more effective than gradual decrease in use

You can't just group all "hard" (what exactly does this mean anyway? Is diamorphine "hard" but morphine not? Codeine? Tramadol?) drugs under one umbrella. You ESPECIALLY need the appreciate the differences between, for example, benzodiazepine (are these "hard"?) withdrawals and crack withdrawals. An addict withdrawing from crack/coke mainly needs sleep and nourishment, "cold Turkey" is a realistic option. An addict who is physically dependent on benzodiazepines will have a grand mal seizure and die if you attempted to force them to "cold Turkey". Gabaergic withdrawal (alcohol/ benzodiazepines/barbiturates/GHB) is a death sentence, opioid withdrawal (diamorphine/morphine/ methadone) sincerely feels like a death sentence but is very rarely lethal (and then almost always a result of dehydration), stimulant withdrawal (meth/coke) is never lethal. I've oversimplified greatly, but I think you get the point.

Also note how alcohol withdrawals are often lethal. Very few people classify alcohol as a "hard" drug comparable in seriousness to heroin, but from a physiological perspective alone, alcohol dependency is far more damaging to the user than heroin dependency. A dependent user could use opioids every day of their life and die at a normal age, completely healthy (the negative health effects from opioids are almost entirely a result of users being forced to turn to a black market). This cannot be said for alcohol.

Before advocating for any policy in regards to a serious public health issue, please at minimum read up on the literature regarding physical drug dependency, the differences between the major classes of commonly abused drugs, and which (humane) approaches other countries have tried which have yielded positive results.

I think you're broadly labeling "us addicts" here, which is sort of the point of the article. I outgrew my addiction (but I'm not suggesting that anyone who needs help just "wait it out!" - see below).

The article is essentially asserting that of the people who clinically qualify as addicts earlier in their lives, about half of those people don't by the time they are in their 30's, and that the pursuit of treatment doesn't necessarily correlate to that outcome.

That isn't to say that there are people who absolutely need to treat addiction as a disease, and that viewing the next drink as an existential threat isn't an important part to their recovery.

When I was a teenager and in my 20's, my drinking and drug use was out of control, and I did enter treatment including 12 step programs. Those weren't particularly effective at keeping me sober in part because of the mantra that "hey, you have a disease, and you don't have control". That's sort of a self-fulfilling prophecy to a younger brain.

What ultimately happened to me was that the life I wanted wasn't compatible with drug and alcohol abuse, and I moved on in my mid-20's.

I do occasionally drink now (in my 40's), but there's no fathomable way that I could see myself going back to what I did when I was young, and no clinician would diagnose me as an addict or alcoholic today.

So yes, the article is dangerous if you are part of the subset to which it doesn't apply. The question is whether we should be treating all addicts in the same way. One answer might be "use the disease model on all addicts because it may apply". Another might be to try to treat this as a leaning disorder.

Right now, we don't know the answer, so I agree with much of your practical advice: if you need help, it's out there, in the form of free communities of 12 step programs, as well as medical treatment programs.

I think about that often-quoted statistic about Vietnam veterans, most of whom used heroin while deployed, yet only about 5% came back and were full-on junkies. Stuff like 12-step is for that 5%...the folks who have already been to the doctor, the priest, the psychologist, and still can't get clean. Personally, I had to try everything else and completely run out of options before I was willing to try 12-step, which has worked. I also take meetings into detox, it's been very helpful for me and hopefully others. And of course, I don't believe there's any one way to get clean. I have my own experience, though, and that's what I can share.

Except that there is a huge social stigma around being an addict. There is a incentive to hide it.

while true... same can be said about anything against the normal... it will take time, but society will come around. this is already happening but slowly.

oh and if you don't believe me... https://twitter.com/AndrewStellman/status/107722796317793484...

Never had someone tweeted one my comments before :)

I was addicted to computer games for a while. I never even really liked gaming, but it was a way to tune out the horrible life at home. Eventually, I kind of trained myself to like games; it's really weird too, thinking back I was the kid who liked long-term gratification over short-term, but eventually gaming changed me.

After I moved out, it was an anchor of sorts and I started playing even more. By this point, my gaming habits definitely matched up with the definition of addiction - at one point, I even went ~2 days without sleeping and eating.

The big change for me was getting a job. I couldn't fuck this up (considering I had already flunked out of university, getting a job in my dream field was a miracle), so I quit computer games. I've "relapsed" a few times since and every single time it has been horrible. It consumes me completely. I have now also decided to basically cut out any easy-to-consume entertainment out of my life. I spend my free time on books, nature and sports.

Looking back, it's the experience of totally fucking up my life through addiction that has helped me beat my addiction.

> I have now also decided to basically cut out any easy-to-consume entertainment out of my life.

I am by no means addicted to easy-to-consume entertainment, but I'm worried that it does impact my ability to focus on boring but important things. Could you share what steps you took, or what process you followed, to cut those forms of media out of your life?

Has doing so reaped benefits besides more time to spend on other things?

I was extremely desparate when I realized I could no longer pay for my World of Warcraft subscription when I was a kid. To the point of trying to scam people to pay for my account, trying credit card number generators and all sorts of silly things.

I would wake up early in the morning, play the game until someone mentioned I should eat, I would eat, then continue playing, until someone mentioned I should eat, I'd continue playing until late at night, go to sleep and continue.

I was extremely addicted and attached to the game. I dreamt about it, I thought about it, fantasized about it.

1 year passed, I started 8th grade and all of a sudden WoW and other computer games were extremely boring. I could play them for about 30 minutes and would just get fed up with any game.

I was like that for years, and just recently I started Super Meat Boy and it had the same addictive fulfilling qualities that I felt when I was a kid, and I could spend hours on it. I completed the game, switched to playing others, but still couldn't get addicted to anything.

I rarely play games now. Max 8 hours total playtime per year.

> I dreamt about it

I would not believe that this was possible if the same thing didn't happen to me. Also about World of Warcraft. Just once.

The next day I got bored killing creatures on some side quest, a thought came through my mind ("what am I doing with my life?"), and I've never looked back.

Happened to me all the time. I fondly remember dreaming of an infinite minesweeper plane where I could effortlessly solve pattern after pattern, forever.

That's when I realized that dreams are a mechanism the brain uses to train itself in a best-effort simulation of recent new challenges. Probably for committing new learnings from conscious understanding roughly analogous to symbolic AI to subconscious pattern matching more similar to ML. Months after I remembered those minesweeper dreams, I was able to multitask any though process that did not involve eyes and hands parallel to the game, in fact I solved my fastest boards when my conscious mind was completely distracted from the game. (and it was an addiction, and I've grown or of it)

Dreams are some mixup of things that happened during the day. No need to read too much into them. I've dreamt of work, people, hobbies including computer games and cherished activities not practised for years at the time of the dream. Dreaming of "stuff that happened", basically.

Dreaming of stuff that happened can be useful if you take it seriously. I often visit experiences in sleep which, when they happened, had led me to say to myself, "I should think about that, figure out what I could have done differently, what might have been going through their heads."

Evolution doesn't tend to waste things. As long as some processing is happening, it might as well be put to good use.

I have the opposite "problem?". I have PS4 and good gaming computer with lots of cool games but just cannot get into them.

It's really weird to explain but sometimes when I'm alone and have free day I want to play games but at the same the moment I start them I just can't do it for some reason.

What kind of games did you play if I may ask?

I'm a casual gamer but at times I do lose grip on reality when playing certain games. I feel like understanding what causes the addictive behavior really helps.

For instance most RPG titles employ the same techniques as gambling, and gaming addiction is often equivalent to gambling addiction. Before getting excited about that item drop, think of it as just pure math (probabilty theory) and that it's nothing special about you finding that item.

Unfortunately this type of gambling in video games has a more severe form these days, with the increasing trend of microtransactions and "loot boxes". These can impact your wallet as opposed to just your time.

Congrats on your ability to recognize that it was a problem, and then intelligently bust out of it and move on. That's the stuff! Whatever 'that' is that enables us to fight and claw our way through ... I love those gritty people.

Not sure how to feel about this article. I'm about turn 28 and at various times in my past I have been addicted to cigarettes, methamphetamine, ketamine, heroin and tramadol.

I'm currently clean, however I feel like I am always just one small slip away from sinking into the abyss, it takes a concentrated effort almost every day to avoid this abyss, I certainly don't feel like I'm growing out of it. I am happily married and have a high paying job that I love, I'm generally really quite happy about life but still feel the darkness calling.

The study does not say that all recovers, only 75%. And with alcohol and heroin the recovery is longer, until the age of 35 or so.

I'd be interested to know a bit more about the method they used. Obviously anecdotal but when I started getting heavily involved in drugs my group of friends consisted of 7 people including myself, today only 4 of us are still alive, 75% recovery is not what I've experienced.

Not sure if it’s too personal or private so I’m sorry if it is but what made you get involved?

Yes OP there's an underlying reason to explain it. Without dealing with it, you never solve the problem

And to add to the question on "what made you get involved", I would be interested in knowing which drugs were they (opioids and heroin?)

Thank you, and sorry if it's too personal to ask

Same here. 28, and I've been trying to get rid of my cigarette habit for 5 of the 10 years that I've been smoking. I've quite often made it to the 2 month mark, but whenever something bad happens in my life, it's becomes way too tempting to fall back in to old patterns and just have one cigarette. And then another one, and then I might as well buy a pack...

Honestly cigarettes were probably the hardest for me to quit, the only way I finally managed to get beyond that initial climb was a close family member was diagnosed with lung cancer and died shortly after, this was enough of a shock to carry me through the hardest stage.

Yeah, it was the same for my dad; he quit smoking after smoking for 35 years (since his 12th!) after his doctor told him his lung function was dangerously low and he wouldn't last more then 15 years unless he quit.

Nicotine is one of the most physically addictive substances.

I quit smoking several times, even went a year without smoking, but eventually relapsed into it every time. What helped me quit for good was snus. It's still nicotine and I'm addicted, but as far as we know it's _a lot_ less dangerous than cigarettes. I guess vaping might do the same but that didn't work for me.

I am 28 and managed to give up a few months ago during one of the worst periods of my life after reading Alan Carr’s, The Only Way to Stop Smoking Permentantly. Read it.

The point of the article is that you, as the lucky most, now at 28, can keep yourself from making this one small slip when before you couldn't.

For smoking at least, look into Alan Carr’s, The Only Way to Stop Smoking Permanently. I’m not into self-help books, but this one really made sense and worked for me. I’m 28 by the way, and funnily enough, I started smoking and getting into drugs at 23. I have been around smoking friends a lot since reading the book, and have not had the desire for even a single puff.

You can apply the same ideas to drugs and alcohol, and he actually goes over that near the end of the book. I have still found myself snorting the odd line of coke when it has been laid out, but I haven’t bought any drugs since reading the book. I can’t really handle them now anyway. Last weekend I actually refused, which is a first in ages.

The book will help you to build the massive mental fortifications needed to realise that the abyss tobacco and other drugs create are shit and do you no good. Give it a go even if you’re not smoking currently.

I tried reading it, but stopped around the first pages when he boldly states something along the lines of "you don't smoke because it tastes good" (it was more than 10 years ago, my memory can be a little fuzzy). That was my main reason for smoking my whole life, I couldn't take the man seriously.

I stopped smoking a year ago without any effort: I just started to forget to do it, day after day, and one day realized that I no longer smoked on a regular basis. Guess it wasn't a real addiction after all.

I find it hard to believe that the smell and taste of smoking was actually pleasant to begin with, and more likely that you now have a positive association of the smell with the pleasant effects ("high") that you got from nicotine. Although I've stopped smoking marijuana now, I still really love the smell, very herby and fresh. My wife, on the other hand, absolutely hates it and can't stand it.

Why do you find it hard to believe that other people like it, considering your shared anecdote to the same effect?

I enjoyed the taste of some tabaccos as well, though the after taste was always unpleasant. Thankfully, smoking never became an addiction for me

"Why do you find it hard to believe that other people like it,"

Because if there was no nicotine high / dopamine response to smoking, then sales of cigarettes would fall to almost nothing indicating that 'what people like' is the 'dopamine'.

How can you say that with such certainty?

Vapes have been around for at least 20 yrs and have not replaced cigarettes in any way... nicotine pills are even older and continue without a significant dent in the tobacco industry.

" at least 20 yrs and have not replaced cigarettes in any way."

Vapes have not been common in any easily usable format for 'the last 20 years' - it's really only been in the last few years have the formats really been workable.

And they have vastly changed behaviour, especially where it matters - among young people. There is essentially a vaping epidemic going on right now in high schools, and vaping has actually replaced smoking and then some [1].

Also I should point out that vaping and nicotine gum, are not perfect substitutes for smoking, so it's also hard to compare.

Do you know what the sales of 0mg nicotine 'juice' are compared to those with nicotine? Almost nada. Without nicotine vaping, then 'vaping' simply would not exist - there wouldn't be enough demand to justify the market for it.

Essentially nobody buys cigarettes without nicotine i.e. 'just for the taste'. The market is essentially non existent for that product. Ergo, it's the 'high' they are after.

I say this as a former smoker/vaper.

[1] https://toronto.citynews.ca/2018/09/12/vaping-high-school-st...

I first tried reading the book a few years ago and also decided it was bullshit, but not for the same reason. The tone and style of writing certainly didn’t help.

Incidentally, even before reading it this time I believed that I liked the taste. I realised later that I really didn’t like the taste after all.

I commend you if you’ve managed to stop of your own accord without any effort. The problem is that a lot of people will try that like me and then fall back because they don’t have the mental framework to maintain the realisation that smoking is worthless.

Anecdotally, I found that coffee tasted much less good than I remembered it tasting after having given it up for a couple of months.

The point is that the reason you smoke, even when you're consciously trying not to, is because of chemical addiction.

Addicts build up a myriad of justifications for their addictions.

I liked the taste of cigarettes. They helped me wake up in the morning. I smoked to concentrate. I smoked to distract. I smoked to relax. I smoked so I wouldn't overeat etc.

At the end of the day, I didn't really smoke for those reasons. I smoked because cigarettes were chemically rewarding and I had become conditioned/dependent on smoking.

I should've clarified that I've smoked pipe. Never got the appeal of cigarettes, especially factory-made - they smell and taste horrible indeed.

The author covers pipe and cigar smoking too.

I never read it. I have to agree with you, though.

I loved [good quality] cigarettes and beer or coffee or whisky.

I don't regret quitting at all. I do wish I could enjoy it without getting addicted—but I can't. That said I don't like the smell anymore, and I have very little inclination to start up again. I don't think having a smoke would cause me to fall right back in anymore, but few occasions are worth it.

But yeah, always loved smokey smells and flavours (I love peaty scotch). So that premise you targeted is a bit naive on the author's part.

For the record, I quit without any aids outside of a bad illness for about a week and the desire to stop.

I found Narcotics Anonymous immensely useful.

It saved my life, my marriage, my sanity and my family.

that’s kind of how I felt reading this. “Congrats on growing out of it”, was all I really thought, while reading the whole thing.

Addiction should not be seen as abnormal, it is actually extremely normal. Humans and all other animals need to actually addict to activities as this is part of the survival mechanics needed to perpetuate the species.

However this addiction function exists at 'lower' level than the intellect, which is why its so hard for the higher function (the tiny conscious part) of the brain to stop an unwanted addiction.

You grow out of addiction when the lower level brain decides that your addiction is not actually required for you to get food or sex.

You can accelerate removing an unwanted addiction by paying very close attention to the mechanics of the activity and by simply introducing new activities especially if those activities are completed with food or sex.

I also believe addictions are a normal thing. But it's still a complex topic. E.g. what if food or sex are your addiction?

food and sex are two between others deep motivation, one of which is socialization.

as a weak example mice in lab choose socialization over drugs often.

"Addiction is a brain disorder characterized by compulsive engagement in rewarding stimuli despite adverse consequences"

You are confusing "addiction" with "reward". Addiction is not required nor beneficial.

Addiction is by definition disordered and adverse. Animals have motivation which governs our behaviour, but that doesn't qualify as addiction.

It may be more correct to say that motivation operates at a higher level than intellect. Motivation directs attention and overrides decision. The same mechanisms which make it hard to wilfully stop taking a drug make it hard for you to wilfully drown yourself or starve yourself if you decide to.

I'd say that you grow out of addiction simply because your motivational calculus changes. Maybe there's something new from which you can get an influx of dopamine (perhaps new people or activities), or maybe a near death experience with the drug now means the thought of it triggers a noradrenaline response, and the fear overrides the motivation towards it.

In my opinion this article is dangerous as not all prople grow out of their addictions, as we can see on the streets, or we cannot when it is hidden in houses, when parents abuse themselves and their kids when drinking alcohol. This article might suggest, ok I might be addicted but Ill grow out of it. So people dont want go for treatments. I havent got contact with my father anymore but his 50 now and Im fairly certain he did not stop drinking, as his dad until he died.

Edit. Writing from my phone

The article is not making the claim that everyone recovers from addiction on their own. It is refuting the opposite claim: that nobody recovers from addiction on their own.

The title is very misleading though. I would argue more people die from addiction than grow out of it.

The title is not misleading at all. The article does not say anything that disagrees with the title.

Also it cites several studies in support of its thesis.

OP pushing his addict mentality on others. It's an externalization of his/her insecurities

I think part of the conflict here is that addiction comes in a spectrum.

A large fraction of western middle class youth goes through a phase of rebellious experimentation with recreational drug use almost every one of them eventually grows or of it, either when they settle into jobs or after a long phase of stable, functional use that slowly becomes more sporadical than regular.

Sure, if you count in as "died from addiction" everybody who was essentially taken by old age, just earlier than what might have happened with a healthier lifestyle, then the majority turns again. But those numbers never really make sense, except for constructing alarmism. Everybody who merely "lost years" (as opposed to something closer to the cliche of overdosing on a public toilet) would have also lost years to burgers, pollution, sedentiarism and stress. Which one was the killer?

Dying from old age is a misnomer. Nobody dies from simply being old, something has to go wrong biochemically

You would really have to back up that argument with some kind of evidence.

Yeah. I wonder what kind of survivor bias is buried in this article, to be honest.

It's an interesting hypothesis but they lost me at the part about ADHD. I abused substances when I was younger until eventually I learned healthy, constructive coping mechanisms and now I've been happily sober for years. That's an example of maturity helping someone out of addiction.

Contrast that will ADD/ADHD. I'm not convinced it has anything to do with maturity or a lack thereof. Sure, mindfulness meditation helps quite a bit. But I think you can be mature, self sufficient, polite, etc, and yet still have ADHD, or immature, etc. and have ADHD. Not to say I'm a shining beacon of perfection with no room for self improvement, but the point is there's little to no correlation there.

I think the correlation they were getting at is - both are mental health conditions and both have a high rate of recovery during patients' early 20s.

While I agree with you that the correlation here doesn't have any direct relation to addiction based on the evidence provided (a study connecting ADD/ADHD to addiction would be VERY interesting), I think that the author included it to show that not all mental health conditions have a low recovery rate.

Children born at the end of the year are more likely to receive ADHD medication or an ADHD diagnosis than children born early in the year. This is according to a new study from the Norwegian Institute of Public Health. The researchers have examined ADHD diagnoses and ADHD medication use among 510,000 Norwegian children aged 6-14 years (born in the period 1998-2006).

https://chadd.org/adhd-in-the-news/most-adhd-medicine-used-b...

So many of the ADHD children are basically immature compared to the rest of the class, no wonder since the difference between the oldest and youngest are almost a year.

> Contrast that will ADD/ADHD. I'm not convinced it has anything to do with maturity or a lack thereof. Sure, mindfulness meditation helps quite a bit. But I think you can be mature, self sufficient, polite, etc, and yet still have ADHD, or immature, etc. and have ADHD.

There is a very good video about 30 essential things parents should know about ADHD

https://youtu.be/YSfCdBBqNXY

One of them is that when unmedicated on average a person with ADHD has the maturity of someone 2/3 of its age.

Its is just an average, but is relevant to think how different a 14 years old and a 21 years old are (or 20 and 30).

Everything I've ever learned about biology suggests the 2/3 rule is nonsense. Neither biological age nor maturity are linear, and they vary wildly from person to person.

Oh wow i am 2/3s of a person now... sounds familiar.

This headline (and note article is from 2014) is... not ideal. I think I take the most issue with "simply" -- as if recovering from any addiction is simple in any way.

First off, I am 100% sure some people do "simply" grow out of their addiction. But what does that mean? What life changes happened during that period of growth that caused addiction to be a more manageable personal issue?

For me, most recently at least, it was when I simply could not find a vein anymore. I had always had poor vein access and after close to 5 years of IV'ing black tar heroin, I had more abscesses than I had available veins. Muscling tar is not pleasant, often leads to an abscesses at the injection site, and has poor bioavailability, but if you are sick and have spent 20 minutes poking yourself at least 20 times (hopefully going through 2-3 syringes in the process as well, and having to deal with backloading your dose), the option becomes more appealing. All of this poking around looking for a flash leads to abscesses as well.

With a lifetime of poor vein access, I was doing all the things they did to me in the hospital when I needed an IV: heated blankets, hydration, using alcohol swabs, tourniquets, at least attempting to rotate injection sites, and so on. When I discovered my hands and feet had slightly easier access, I was elated, but that only lasted a couple years, and it really, really, really hurts to miss in your hands and feet.

Is that what they mean by "simply growing out of it"? If so, I feel kind of insulted.

Eventually, after simply not being able to get high via IV anymore unless I got lucky, I did one last big detox (probably at least my 20th, including 2 in-patient ones), went back to my suboxone doctor, and have been stable on a low-ish dose of the sublingual suboxone for several years now.

In my recovery I have been to hundreds of NA/AA meetings and volunteered with harm reduction groups and this concept of "I simply grew out of it" is not a common theme. What is much more common are things like 1) I couldn't stand sleeping outside anymore, 2) I got pregnant, 3) I ran out of vein access, 4) I had a real opportunity to stop using and took it (like rehab or strong social support or job support), 5) I was sick and tired of feeling sick and tired, and so on.

Just to be sure, I am not saying "simply growing out of addiction" via "natural recovery" -- as the article discusses -- is not a thing. It's just not enough of a thing to warrant much attention on. A sincere congrats to the people who grow out of it (and, like I said, I'd like to hear more about what that growth process looked like), now let's help the millions of others who haven't.

I appreciate your anecdote. I have no experience with heroin, but I imagine softer drugs with relatively mild or non existent withdrawal symptoms carry the kind of addiction kind you can grow out of. Say, pot, or various amphetamines.

It's so difficult to answer this as everyone's experience will be different. I do know that there were certain periods of my life where I didn't smoke pot because I was just very active with something or the other and did not want to be lazy. But I was probably using an upper during that time to "be productive".

There's also got to be some kind of chemical/medical aspect to how a certain substance affects you individually, apart from how it affects everyone else. I was more of a cafeteria drug user and got bored really quickly and the only objective was to be high(or low), not necessarily an obsession with one kind of drug. For instance, heroin withdrawals were never stereotypical for me. I'd always thought of it as a high wearing off, and would fix it with any other drug that was available, it didn't strictly have to be heroin.

I agree with you. I think the "I simply grew out of it" is a realization that comes when I think about it after a couple years clean. It's obviously not that simple, and there were many other factors involved. It's also the easiest answer when I ask myself why I'm clean, rather than the hundreds of other reasons I would actually have to list. So I think it might just be a lazy answer for most people who are clean. I know it is for me.

Good on you for staying clean, friend.

20 detoxes ? Holy crap, I salute your persistence. I was never a user, but 'rented' rooms (ok, I let em crash on my couch/stay at my house etc.,...OK, I was a fucking enabler, whatever) to several recovering (and non-recovering) H/meth/crack addicts. They all had legal and family problems that just buried them in never ending toil inside the system. I eventually picked up a case, and had to attend 20 something NA meetings myself. One of the most shocking things I remember was this old guy who had 20 years clean and then he relapsed. Wow. I just feel for these people that've fallen into this shit. I wish I could tell em something that would help, but I don't know...it's a terrible fork in the road.

First - I'm really glad that you are alive to post this, and it sounds like that wasn't a given based on your story.

I wanted to comment on one of your last sentences - that "natural recovery" doesn't warrant attention. I think there's a certain bias here given your own experience. If you go twelve step meetings, you'll find people who's lives were on the brink of ruin and who have pulled themselves back by living the steps. But I think even NA/AA would acknowledge that the percentage of people who walk into an meeting once who get sober and continue to attend meetings is small (if I had to proffer a guess, it'd be less than 10%, but I don't have a good basis for that). So the question is really "what happens to the other 90%"? Some will certainly die from their addictions, destroying themselves and the lives of their loved ones in the process. Others are going to "grow out" of their addictions. It may be that the percentage who grow out of their addictions is actually higher than the AA percentage (and that seems to be what the article implies). That actually _does_ merit attention (and I think we'll find that in most cases the growth mirrors some of the steps that you'd see in AA, just without AA).

Of course, those that _don't_ grow out of their addictions would be far better served working a program, and we don't have a good way to distinguish which group any addict is in, so that puts us back to where we are, which is in not knowing the best way to treat addiction. :(

(Personal note: I was clearly an addict and alcoholic in my late teens and twenties, and this period of time involved multiple trips to rehab, as well as AA/NA meetings. None of that "worked" for me, but what worked was the development of some additional maturity (late 20's) that was able to see a life that I wanted which was incompatible with my behavior. As an adult in my 40's, nobody would define me as an alcoholic or an addict. I'll occasionally drink, but drinking to excess really just doesn't fit into my life anymore.)

Makes sense. Drugs get boring. The euphoria fades. Then it becomes normal. And if chronic use continues, one eventually finds oneself, quite suddenly, in the grips of dependency. But then the appeal finally fades, too, when it becomes clear that the highs of yore that you still chase are gone forever - and suddenly it is worthwhile to brave the throes of a tapered withdrawal, or quit cold turkey, depending on the flavor of the poison.

But the cravings probably won't go away forever. The ever seductive siren of intoxication will whisper it's sweet songs into your ear, beckoning with lustful reveries of that familiar bliss that you once knew, nearer, louder in strife. Alas, with time, the voice softens, should you have the will to resist recurring temptations in the meanwhile.

Or you "upgrade" to smack.

Can't read the article for some reason. In any case, I somewhat agree with the title. Obviously it isn't going to be the case for every addict. Using/abusing just seems off-putting after a while, and is a major turn-off. I'm not sure how much this has to do with boredom, or a sense of "I'm clean now, addicts are losers, I'm not a loser any longer".

In my case, it was just a massive waste of a decade for little to no gain other than some momentary feelings of almost-euphoria. It's just so superficial and a kind of escapism, at least was for me.

Anyway, addiction is a lot more complex for generalizations, obviously. I met an older gentleman in rehab who was there for the 50-something time. That kind of put things in perspective for me.

This matches my personal experience with a variety of drugs, although I stopped short of hard opiates. A large proportion of people who took drugs with me when I was younger got out before things got nasty. Which isn't to say everyone - there was one guy in particular who got into cheap speed and the attendant unhealthy lifestyle so much that his skin turned yellow. But a three factors that I don't see mentioned in the article, which anecdotally seemed to predict quite a bit of the difference, were a supportive family environment, insight into the nature of your drug use, and money. Supportive families helped because when people felt they were doing too much they could drop out of that scene, head home and dry out for a few months. Insight was important because it gave perspective on where they stood in regards to how their drug use was impacting their lives, and before it got really heavy they could head home. Money - enough spare cash to get home and families with enough to support the returning kid - made this kind of flexibility possible. If you don't have many or any of those three things, it becomes much more difficult to make the decision to stop early enough - although even if you have all three it doesn't guarantee anything. I doubt I would have found drug use such a positive experience if I hadn't had that safety net.

I would say people do not grow out of it, as a previous video game addict (skipping school, classes etc, the whole nine miles), the conditions that creates and fuels the addiction itself (be it being asocial, home or money problems) simply vanishes as the time goes on. If it does not vanish, the addiction continues, and if they arise again, the addict relapses.

This is based on my experience.

Of course, you can not expect that many years of addiction to simply not have any residual effects, for example I still do play video games a lot but I can't say I'm addicted to the point of skipping my job or destroying my whole life. In my case, it is not that dangerous to play video games but for a substance addict, it gets extremely dangerous and they surely struggle harder than I do.

I think, instead of trying to cure the addiction first, the underlying cause of the addiction itself should be cured. After that, getting over the addiction becomes easier.

Edit: I see comments on people concerned of addicts treating their problems as a phase. It is not a phase, you need to get the bottom of the problem first. It can get extremely hard to fix the underlying problem, especially if you do not get any help, so do not treat the addiction as a phase, but treat it as a symptom of a much bigger problem and fix the problem first while treating your addiction.

Really an amazing insight perhaps not considered enough. But this:

"moving from a less structured environment like college into a more constraining one like nine-to-five employment, "

is telling.

I knew people in SF who just 'moved away' and the change in setting, the lack of immediate access to 'the party lifestyle' and all it entails, means they just 'shifted gears' and cleaned up immediately.

So I'm not sure if the 'aging out' due to brain developments is entirely the story here, rather than perhaps time allows for people to find other patterns of lifestyle.

Though I do think the point about '18 years old' is quite powerful - keeping teens away from bad stuff might seem to be quite a good idea.

... that said, there could be other factors at play: kids from 'good, conscientious families' simply may not be quite as likely to need to try alt things, and less likely to get caught up later in life anyhow. There'd seem to be all sorts of other correlating factors there, however valid the point may be unto it's own.

I have only one true addiction, and it is coffee.

Most “addictions” seem to be advanced exercises in bullshit artistry, from my perspective. But, the one that really throws me is compulsive gambling. This is the line where I draw clear distinction between chemical dependence, and... something else.

Compulsive gambling definitely isn’t bullshit. You can sense that it’s a very powerful, real habit that people lose control over.

Most other non-substance oriented addictions I tend to ignore, and gambling is my bellwether for nonsense.

Cigarettes, for example, are mostly nonsense. The nicotine in tobacco is such a mildly addicting component, that a deeper truth sits behind it: people who refuse to drop cigarettes are trying to dominate a negotiation, regarding personal choices. They want the freedom to make bad choices.

Cigarettes are easy to quit. The chemical dependence is pathetically tame. The people that insist on retaining the habit are really engaging in social signaling. They learned this aspect of power and status as teenagers, and this alone puts cigarettes in a station of nostalgia classified as comparable to first cars, first kisses and favorite music artists. That’s why people don’t quit.

Other substances are tougher, for sure, but chemical dependence is only part of the story. Controlling obsession is an entirely different skill. It’s nit just about willpower, but also about deepley held beliefs and self perception.

It’s not a new concept. It predates modern psychology with tales like Samson and Delilah and deriving strength from a lack of haircuts, or Dumbo’s magic feather. Superstition isn’t just about magical thinking, and can take root in daily rituals and bahvior.

That’s probably why people might seem to grow out of it sooner or later. At some point, life interrupts and breaks the spell, one way or another.

This model of addiction (chemical dependency + wanting the freedom to make bad choices) is not at all backed up by modern research, and reads like it is severely lacking in compassion and empathy for people who suffer from addictions - I feel sad hearing you call these people "bullshit artists" and labeling something that so powerfully controls and hurts millions of people (e.g. nicotine) "pathetic".

Is it up to you to dictate what other people's experiences are? If someone has a crippling addiction to sex (a non-substance oriented addiction), do you believe that you can tell them that what they are saying is "nonsense" and that it actually isn't an addiction, and that they just need to "have more willpower". How is that in any way helpful?

If you are open to hearing about what the medical, psychotherapeutic, and academic communities have been learning and working on in the past few decades around addiction research and treatment, A good place to start is the work of Dr. Gabor Maté: https://drgabormate.com/topic/addiction/.

I didn't think it was "widely denied". I thought this was well known.

There is a notable exception - smoking.

In my personal experience, cigarettes were far more difficult for me to quit than opiates/meth/etc or even alcohol. They are very sneaky that way.

Of course have you ever tried to get an alcohol or meth break at work? You get fired. (Granted if legitimate medical amphetamines or opiates they let you take the pill.)

In all seriousness smoking has more "habit/ritual" components to it given oral fixation - in addition to the chemical aspect.

Aren't most people addicted to sugar and a lot also addicted to coffee? Pretty sure they don't "grow out" of those...

Does this data take into account all those who died and therefore didn't "grow out"?

I think the biggest issue with the colloquial idea of addiction is that most people don't realize it's a lot more dependent on social circumstance than it is on the "reward circuitry". People don't become addicts because of any certain drug or mechanism, they do so because they're trying to "deal" with some sort of social issue.

Can confirm anecdotally. Used to be super addicted to the online MOBA game, "DotA 2" back when I was in college. Stopped playing it after moving out from home (deleted my Steam account, in fact), and I haven't touched the game ever since. Guess my prefrontal cortex wrestled back control away from my "monkey brain." [0]

[0]https://waitbutwhy.com/2013/10/why-procrastinators-procrasti...

Discussed at the time: https://news.ycombinator.com/item?id=8396375

Could be a quote from Pele Stanton https://peele.net

Some of us die.

So - build a monastry where free drugs are provided for simple work? Wait till the addicted get bored?

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