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Comment by bkeroack | Hacker News Reader

I don't dispute the article's thesis, but a significant part of the reason why addiction is skewed so heavily to the young could be because the most severe addicts die from it before reaching an older age. As in, you don't "age out", you "survive".

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That doesn't add up. By all estimates there are many millions of people addicted to drugs or alcohol in the US alone (as many as 20+ million). If we are to assume that the article's premise that addictions tend to have a lifespan of about 15-20 years or so is due to the fact that the addicts are dying then that would correspond to something like a million deaths per year. In the sub-45 year old population that would absolutely swamp every other cause of death.

Well, the cause of death for someone dying from their addiction is not always "drug overdose", but things like accident, murder, or suicide, which in fact are the top three causes of death for young adults.

Heart attack, respiratory failure, and other organ failure to boot. Tthe math of determining these "average" lengths of addiction are also troubling. When accounting for individuals that may have been addicted for three years, but died at the end of those three years, are we factoring in 3 years as the length of addiction? Are we weighting it in some other way along a point scale? The very title of that statistic is troublesome too: the length of addiction - it is unclear as to whether the lengths being measured and averaged share the same initial and final endpoints: The length of time elapsed between having no drug problem and recovery? Or, having no drug problem and death? Or, as I suspect a combined average, which renders the statistic useless.

I find troublesome that the author of the article (renowned neuroscientist and addiction journalist as cited) suggests that addiction is akin to a habit. The behavior itself is certainly habit, but the addiction lies moreso in the etymology and function of the habit than the actual repetitive behavior. For some, the addiction is distraction, for some escape, for others a sense of identity, and so on and so forth. To prescribe "outgrowing the addiction" as a solution is awfully simplistic, almost suggesting that if an addict could only replace that habit with something else, then all would be hunky dory. Well, in theory, sure. Maybe we can start designing rehab centers like they used to do traffic school - Improv Traffic School, Comedy Traffic School, Bikers' Traffic School - maybe Knitters Rehab: "We'll help you put down that needle, and pick up this one!" or Foodies Rehab: "Stop smoking that joint, and learn to smoke these ribs!" The possibilities are endless. But not likely.

How Americans die:

http://www.bloomberg.com/dataview/2014-04-17/how-americans-d...

This shows drug deaths as comparable to motor vehicle accidents.

(This includes both legal and illegal drugs, and poisoning from prescribed medicine, but I doubt that the rise in recent years is due to worsening quality of healthcare.)

The numbers still don't add up. Remember that mortality among 25-44 year olds is still incredibly low, and even so drug deaths are only one among several causes of death, not the majority cause of death. If you dig into the data you see that around 15k people die a year from drug related deaths in that age range. That's a big number but orders of magnitude too low to explain where the addicts seem to go as people get older.

According to the mortality data there would need to be much fewer than 1 million addicts in the 25-44 age range in the US for a majority of them to be dying before they get out of that age group, or even a sizable minority. And everything we know on addiction statistics puts that number much higher, at 10-20 million or more.

The data just isn't there. Addicts aren't going away because they are dying, period.

I think growing out of it is a big part, though. I knew a number of people who shot up in their late teens/early 20s who quit when they got older. The methheads I knew had a harder time, but a lot of them quit too. Of the people I knew who were hardcore drug abusers, very few died, and most grew out of it, which is what the numbers suggest. The ones who and the worst time of it were the ones who bought into NA/CA dogma, and took on addiction as a personality, rather than seeing it as a phase they grew out of. They also had the highest mortality rate, predictably. Tell someone they have no self control, and they'll binge the worst.

Some people who get hooked by drugs die, but addiction isn't nearly as deadly as it would need to be for the numbers to drop like they do, and statistically spontaneous remission is the most common way for people to kick the habit. Normally people grow out of it.

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