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Comment by lqet | Hacker News Reader

> One of the major reasons people can’t overcome it is because we’re not very good at treating addiction in this country.

I am often wondering about how addiction "feels". I don't consider myself being addicted to anything, and always wonder how an addiction actually manifests itself. Is it a pain? Is it comparable to being extremely hungry or thirsty?

Slightly related: a few years ago, I overheard a conversation between a fairly large woman and a child. The child said that it was hungry. The woman said: "Oh yes, that hurts". That struck me as odd, because even after eating nothing for 1-2 days, I never actually felt pain when I was hungry. It was surprising to me that some people seem to do, and it would have certainly explained why the woman was so heavy: I, too, would of course eat much more if being hungry was painful.

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I was a smoker for several decades. I would describe being away from a cigarette as "an acute feeling of thirst, but in your chest."

And when you decide to quit, it takes quite a while before you stop feeling that strange thirst.

Good way of putting it. It’s in the chest for sure. I’ve always thought of it as something missing in your chest - a type of emptiness. “Thirst” is a good metaphor.

for heroin it's ... hard to describe? one thing about heroin though is it is motivating as hell, at least in terms of motivation to _obtain heroin_ and you're going to do stuff that ranges from ill advised to ... very ill advised? anyway, thing i discovered is that if you stop taking the stuff, it takes a long time to find a replacement motivation. e.g. found myself waking up, discovering i didn't have an immediate need for heroin, and then, well that's it. nothing important to do here. it was ... annoying? fucking terrible? still is, so there's that.

It depends on the addiction. Opiate addiction comes along with flu like symptoms, insomnia, restless legs/arms AKA crazy legs, and an ever present anxiety that you really really want some that will make you do some weird shit just to get it. Other addictions are more subtle, some worse, but all of them I've experienced have the same feeling of stress/anxiety that can only be cured by the vice they are caused by. Many are all in your head, or, can be overcome by willpower, but definitely not opiates

> Opiate addiction comes along with flu like symptoms, insomnia, restless legs/arms AKA crazy legs, and an ever present anxiety that you really really want some that will make you do some weird shit just to get it. ... Many are all in your head, or, can be overcome by willpower, but definitely not opiates

Sure, but one can be dependent on e.g. SSRIs or SNRIs. But they aren't addictive!

Dependence + addiction is a special problem with opiates, I think you can die from withdrawals?

You can't die from opioid withdrawal. It's unpleasant and many people need help. But it's not like alcohol dependence which can kill people if they stop suddenly.

SSRI/SNRIs can be problematic. The difference is that SSRIs tend not to have the other features of dependence:

Seeking the meds when you run low; preoccupation with the meds; continuing to take the meds even though you know they're doing harm.

The two big dangerous things to withdraw from are alcohol and benzodiazepines. Opiates withdrawal won't kill you (but you'll want it to)

there could be some underlying pain or trauma or anxiety, and when you find a chemical that obfuscates it, your brain goes "oh I like this new feeling", and you start using that chemical as a way to mute the negative, often without realizing it OR realizing those underlying issues even exist.

then, the press secretary in your brain (the thing between your subconscious & conscious mind) goes into hyper-rationalization (denial) mode and you start to defend the amount and type of chemicals you use, even when they are literally killing you and those around you

If you're asking about what physical or psychological withdrawal from a drug feels like, it depends on the person, the chemical, and other variables. The worst opiates (Suboxone / Methadone) have 6 month+ withdrawal symptoms, and the faster ones are ~7 days. Hellish times. However, while abstinence frees you from withdrawal symptoms, unless the underlying mental issues are addressed it's likely you'll go back to the very same substance that got you here.

Addiction controls what you want, regardless of whether you like the thing you are addicted to. That's what makes it hard to beat by just white-knuckling it; whatever strength or will you have gets redirected against you.

You might enjoy some of the accounts in The Realm of Hungry Ghosts: https://www.google.com/books/edition/In_the_Realm_of_Hungry_...

Ever read a good book, or played a video game, and known that you have to stop now but thought "I'll just read another chapter / play one more turn"?

I would say that's basically how addiction manifests itself: even if you know that you're dealing with substance abuse, come on, one more time won't matter, will it?

And then there's also the comfort aspect: you're getting back from a hard day's work, you're feeling tired and cranky, you do deserve something nice, don't you?

N.B.: I'm not saying that not being able to drop the book or stop playing that game IS addiction, just that substance addiction might feel the same way.

N.B. 2:And I'm not talking here about the medical aspects of withdrawal, because that's not the thing an addict would usually experience (withdrawal would only happen because you're trying to stop or cannot get access to the substance you need).

> Is it comparable to being extremely hungry or thirsty

Not for me. I used to be a smoker and alcoholic.

For smoking, I just felt uneasy without it, like idk when you're anxiously waiting for something important.

That's the physical dependence and was only the first two weeks and relatively easy to overcome. I got dizzy and other withdrawal symptoms but you can fight through that for a couple of weeks. The other part is the ritual to it. E.g. like most people probably brush their teeth once a day, smoking after eating is just something you do, give in once and you're back to physical dependence.

Alcohol was different for me. Self medication. Once i solved the issues i was medicating (insomnia and stress) i... just stopped drinking and never missed it. The biggest adjustment here was getting used to not being drunk and figuring out what to do with all the time i had now.

Addiction to smoking is like a mixture of itch and thirst, to a certain extent. You can get other psychological symptoms, like irritability and anxiety, or physical ones, like headache, but mainly it's this continuous need of absorbing the substance, that never goes away. A bit like when you're itching and you can't scratch, or you're thirsty and you can't drink.

A guy I knew in college told me not smoking for him was like not eating. Not physically in the stomach, but those same urges and feelings that you'd better do something about it soon because it's important. It becomes the main thing you're thinking about until it's resolved and anything or anyone that gets in the way annoys you.

Hunger never hurt me, but I used to give into it quickly because it distracted me a lot and I enjoyed cooking and eating. The first time I dieted intensively it took about 5 days but I mostly stopped feeling it. It was more of a notice "probably a good time to eat" than a strong urge anymore. It was easy to reframe in my mind as a positive - this is the feeling of fat evaporating! Getting to that point can be tough though.

It depends on the drug.

For opiates and benzos it might manifest as stress and depression. For uppers, drowsiness and inability to focus.

It's compounded by the fact that the reason you started is usually that you suffered from those things to start with.

It happens to me with CocaCola. I have stopped drinking it, but when I waz i the process, the cravings it gave me were crazy. I NEEDED to have a coke.

Btw, in relation to the article, there was a Reddit user who ar some point wanted to "just try" this heroin thing and his message history depicts very amazingly hiw he spiraled to addiction.

I'm currently a Coca Cola addict. It's not unbearable, but I really have strong cravings regularly. It's not thirst -- I don't want water, I specifically want Coca Cola.

This beverage has no redeeming qualities, and I want to kick off this habit.

The beverage is fine, if you have it every few weeks, during heavy exercise or when trying to stay a awake on a long car journey. It's not a drink you should be drinking all day, every day unless you'd be happy taking caffeine tablets and having several spoons of sugar on top of what you're eating. I love coke and will have about 1 can a month on average. In America (and fast food places in general) it seems to be the norm to have sugary soft drinks with everything, which seems pretty weird to me.

Agreed, in moderation it's probably mostly harmless... but still, it's a disgusting sludge when you look at it objectively: a syrupy dark thing with excess sweetener/sugar.

However, it triggers some addiction mechanism in my brain, and I must drink it every day. No moderation for me -- it really is an addiction. I don't go to McDonald's: I drink it at home. Diet Coke, so no excess sugar, but I'm pretty sure Diet Coke is unhealthy as well, and I'm not sure those sweeteners are good for you anyway.

> I am often wondering about how addiction "feels"

It highly depends on the "thing" (it must not really be a thing). I would say "its the desire to plug a hole".

Do you drink tea? Why dont you drink tea without sugar? There are lots of answers to this question. It can be "it tastes better". Thats what your mind is telling you. It probably would be more healthier to drink tea without sugar but you still add sugar to it.

Thats addiction. And there are tons of other examples and its hard to determine it for every case. Addictions are deeply implemented in our brains. Eating, the urge to be close to people, getting complemented for things you do, all this is kind of an addictional behaivour.

Drugs can basically fill this already existing but empty receptors more efficient. Then your brain tells you to do it again. It will find reasons.

That was harder to explain than i thought. I hope it makes sense.

But certainly it is much harder for an alcoholic to stop drinking, than for me to stop putting sugar in coffee or tea? I actually did that 15 years ago because I was too lazy to buy sugar. It tasted strange for 4-5 cups, then I was accustomed.

Alcohol is very addictive. Its one of the few drugs that can actually kill you on cold turkey. Your body will sign that it wants it and it feels very bad.

I generally tried to explain what addiction is and what it feels like. It really depends on the matter.

I'd say that cigarette addiction doesn't really feel like anything. Mostly it's just like a feeling that you forgot something. Or a feeling that you didn't complete your to-do list. Then you get satisfaction when you're able to complete it.

Former smoker. You also get increasingly annoyed at anyone and everyone until you get to check off that box. Nothing feels complete, none of life's little victories or big disasters, until you've had a smoke to commemorate it.

To me, it always felt like there was something like a little pebble be stuck in my brain and there was only one way to get it out. Not physically, but in terms of how it affected me mentally.

do you drink coffee or soft drinks? Try not to drink them for 2 weeks.

I've done this several times, I have a headache for 24-48 hours then pretty much back to normal. Tolerance takes longer to reset obviously and I'm sure I get more energetic in subtle ways I'm unaware of in there... but I don't think it's remotely comparable to a serious addiction, from what I've read tobacco is probably the most widely accepted thing able to cause that level of addiction.

You don't get cramps from nicotine withdrawal, it's more a nagging discomfort and unease.

The worst is over after a couple of days off cigarettes too, but there's a thick trail for a couple of weeks and a long thin tail for a couple of years.

There's got to be more to this because even though I consume prolific amounts of caffeine I do not experience any pain on cessation. Yet, many of my coworkers do feel this pain.

Speaking as someone who cut out caffeine cold turkey, it's a different thing

I got stinking headaches for a week, but not an overwhelming urge to drink caffeine

When smokers quit, they almost always describe the urge to smoke rather than the physical side effects, often described more like hunger.

> I got stinking headaches for a week, but not an overwhelming urge to drink caffeine

This is exactly my experience after not drinking coffee for 1-2 days. Headaches that make the thought of drinking coffee slightly disgusting.

When source of addiction is not fulfilled for a long time it can have different effects on different individuals. It is not a generalised “feeling”.

Some people might feel a drive to do something completely non-rational, some might go into depression, some might even feel hungry.

Like trying not to scratch an itch.

Addiction is rooted in truama. It's almost impossible to become an addicted if you didn't have to endure (childhood) trauma. So addiction is often an attempt of escaping, or soothing that pain.

>Addiction is rooted in truama. It's almost impossible to become an addicted if you didn't have to endure (childhood) trauma.

Sounds like pop psychology. There are tons of extremely addictive substances.

Try one and you will get addicted after a while, even if your whole childhood was hugs and roses and ponies.

I'm not sure, I agree it sounds like pop psych crap and you'll develop physical dependence of course, but I suspect there's a big difference between people who can pick up smoking weed on a weekly or monthly basis recreationally and people who find a need to be high every waking minute of their day. People who take to drinking a bottle of vodka for breakfast and those who keep it to the odd occasion. I don't see why we wouldn't see similar for other, even more physically addictive drugs.

>but I suspect there's a big difference between people who can pick up smoking weed on a weekly or monthly basis recreationally and people who find a need to be high every waking minute of their day.

Maybe, but why would it be due to childhood trauma alone?

I can imagine someone with a happy childhood and a big 20-something or 30-something trauma (loss, divorce, various other issues) falling for drugs/alcohol addiction for the first time just the same.

Veterans who are given an opioid for pain, rarely got addicted if they had a warm and loving childhood, and lived a life with community and friends.

Veterans who had many Adverse Childhood Experiences (A high ACE score), such as coming from a broken home, or faced neglect and isolation growing up, were much more likely to become addicted to the opioids they were given to treat pain.

I'd say it's much more likely related to their existing support network (which is correlated to childhood situation). See the Rat Park study.

Do you have any evidence as basis for your theory?

>Veterans who had many Adverse Childhood Experiences (A high ACE score), such as coming from a broken home, or faced neglect and isolation growing up, were much more likely to become addicted to the opioids they were given to treat pain.

Veterans at that stage are also usually young, so if they came from a broken home, or had isolation growing up, they'd still return to something like that.

What about veterans that have build a succesful family and working life in between (aside from having had childhood trauma)?

Got a source for that?

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