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Comment by xyzzy123 | Hacker News Reader

If you accept this as dogma ("always") then the reasoning becomes circular.

Overuse is then "proof" of the person's underlying problems.

That seems too reductive. Find me a person without "emotional / psychiatric problems"(!)

Substance use is multi-faceted. It can be modulated by availability (cost being a factor), social acceptability, religion, personal biology (eg alcohol intolerance), emotional state, age, physical addiction, history/habit, availability of substitutes (e.g. availability of heroin will tend to suppress use of krokodil), social supports and more.

To this way of thinking there was widespread heroin use among GIs in Vietnam because it was socially acceptable in context, widely available, people were bored, their usual social and emotional supports were not present, and for some, trauma.

You can change any of the factors above and that will influence how people use.

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> That seems too reductive. Find me a person without "emotional / psychiatric problems"(!)

This is objectively wrong. Could you find a person without OCD? No, you couldn’t under your framework because people use these names frivolously and in the context of their own lives. People use PTSD in the same way. Not everyone has these kinds of problems. That is super ignorant of you.

I can't be objectively wrong unless we agree (or you decide, I suppose) on some firm definition of what wellness or illness means, such as "by self diagnosis" or "according to a quorum of doctors diagnosing against the DSM".

Like yeah, a lot of people have OCD-like things going on. It's often fine though! A good psychiatrist will heavily weight "is it causing you problems in your life" before handing out a diagnosis or thinking about treatment.

IMHO what counts as wellness or illness is mostly societally constructed[1]. In various places and times for example, hearing voices or having visions is, if not "normal", accepted as something that can happen to anyone at various times in their life.

A person can be superbly well adapted and functional according to the norms and values of one social context yet be seen as deeply mentally ill in another.

[1] I do agree of course there are problems (often organic) that render people dysfunctional in almost any context. The situation is much more fuzzy for most.

It just shows how little you know. Like I said, you are very ignorant. There are specific biological pathways that are responsible for these major psychiatric illnesses. Many of them are metabolic. And because there are specific and quantifiable biochemical causes for hearing voices for example it’s possible for you to be objectively wrong about the whole thing as you very much are.

Why do you rule out drugs making people addicted? If some drugs can alter your consciousness, as they clearly do, why wouldn't some of them be able to get you addicted to them?

To be clear, I do agree that a lot of cases of addiction will start with emotional problems getting people into prolonged consumption. However, emotional problems can also get people into obsessive running, yoga or whatever. But after getting their mind straight people generally don't need to be careful and abstain from running due to risk of a relapse of obsessive running --- contrast this with drugs, most prominently alcohol. Risk of relapse only happens with drugs, because it seems to my layman mind that it's not the emotional problems that get people addicted, but substance abuse. Emotional problems get people into substance abuse, but it's the substance that creates addiction, not the emotional problems, because see example with running.

And there are other triggers that get people into irresponsible consumption (societal expectations, such as in military[1]) that aren't emotional problems. They nonetheless often end in addiction, because of what the substance is doing to people's brains.

[1]: I'm talking about what I've heard from my father from Soviet era military about nicotine. I don't know what it looks like now/in other countries.

Our emotional underpinnings motivate everything we do. My step mom is a hoarder. But she’s so smart and well adjusted that I didn’t recognize it until I was an adult because everything is perfectly organized and rationalized. But the core emotional issue of not being able to throw things away is there.

The vast majority of Vietnam soldiers who used heroin overseas did not continue using heroin after coming home. They weren’t using different kinds of heroin, therefore it is the person and not the material.

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