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Comment by euthymiclabs | Hacker News Reader

Psychiatrist here. This is true, and most people find recovery eventually without a formal program. Working with a doctor can make it much less comfortable in many cases--and in the case of opioids, can offer several options that can be lifesaving by preventing return to use and overdose.

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"This is terribly wrong information, to the point of causing more harm to people who take it seriously."

^ this is generally correct for many of the classes of substances mentioned; however, it is also terribly wrong information concerning Opiate withdrawal.

I'm not sure in terms of case numbers - people can and do die from Opiate withdrawal due to vomiting and diarrhea leading to dehydration and/or heart failure due to elevated sodium levels.

This is clearly very preventable from a harm reduction perspective with the correct information.

Correct, dehydration-related complications are possible during opioid withdrawal, and I agree that it's hard to put a number on cases. The other significant risk is suicidality, which is very common during opioid withdrawal. In general, I tend not to recommend full, rapid, medically-supervised (or unsupervised) withdrawal from opioids, as the best option for most people is a transition to opioid agonist therapy with buprenorphine or methadone--which have profound mortality benefits. There are always exceptions--especially in people who prefer antagonist therapy with long-acting injectable naltrexone--but agonist therapy has the most data.

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