
Most People with Addiction Simply Grow Out of It - Mz
http://www.substance.com/most-people-with-addiction-simply-grow-out-of-it-why-is-this-widely-denied/13017/
======
0x420
As someone who struggled with cocaine, heroin and prescription opioid
addictions throughout my teenage years, this resonates with me quite a bit,
but I'm not sure if I agree with the conclusions the author is drawing. I got
clean with no help either - and yet, many years later, I still consider myself
"in recovery." I view my recovery as a never-ending process; even though I
haven't touched the substances themselves in ages, I'm still dealing with the
consequences. Just hearing someone mention one of the drugs in a conversation
is sometimes enough to make my mood plummet if I'm taken by surprise. I don't
really hang out in environments where they're easy to obtain anymore, but if I
ever find myself in one, even though I know on some rational level that I'd
never touch them again, part of me is in great distress because I'd have a
hard time saying no if they were offered to me. I think these types of
articles tend to ignore the longer-lasting, psychologically debilitating
consequences of addiction. It doesn't just end with going cold turkey. You
need to be able to look at your thought process and identify where you go
wrong, and I think programs like AA and NA give you the tools to do that.
Obviously, they don't work for everyone, and they aren't foolproof, but I'm of
the opinion that they still have some merit.

~~~
BigChiefSmokem
You don't have answer this but I have to ask, did you find some other less
severe addiction to cope - like marijuana for example? I ask because, well,
your username.

~~~
erikb
You can be addicted to marijuana? It's the first time I read this. Or is it
just something I interpret into your comment?

~~~
roel_v
Is this an honest question? I mean, really? I'm as pro-legalization as they
come, but it is well documented (and well known) that yes marijuana is
addictive. For example, you could start at
[http://en.wikipedia.org/wiki/Cannabis_dependence](http://en.wikipedia.org/wiki/Cannabis_dependence),
then
[http://scholar.google.com/scholar?hl=en&q=marijuana+addictio...](http://scholar.google.com/scholar?hl=en&q=marijuana+addiction),
and work your way through 5 decades of research from there.

~~~
erikb
It's shocking that everybody talks about legalizing but nobody talks about
that. Thanks!

------
anon_addict
I was a hardcore IV heroin and cocaine addict for 10 years. Contracted Hep C,
did 2 years in jail, and ruined every relationship that I crossed paths with.

After dozens of detoxes, jail, prison, several rehabs, and a year of
homelessness on the streets of NYC for an entire winter, I had had enough.

I moved to Cali and got back to my roots, computers. I picked up HTML / CSS
and started learning Javascript. I started doing websites for people
eventually I started a consulting business I later sold for a nice chunk. I
now have a profitable start-up and was recently offered a CTO position at a
Fortune 100 company.

I grew out of it. I don't want to get high anymore. It has been 10 years. I
don't drink or smoke weed, and have no desire to. I still have addictive
behaviors, but it just isnt an option anymore. Posting from a throwaway
obviously this is not something I am ready to share at this point in my life
but just wanted to relate for a brief moment.

~~~
pestaa
Thanks for your story. It must have been tough, rebuilding a whole life. Good
luck.

------
techtalsky
I'm a little shocked that out of 124 HN Comments (at the time of this
writing), no one has linked to or referenced the study in any way.

[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227547](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227547)

Did I read it? No, but I read the abstract and intro. Study was about adults
addicted to nicotine, alcohol, cannabis, or cocaine. 43k people total, about
12k people with a real DSM-IV diagnosis of addiction to one of these
substances. Eventual remission rates for these things were over 90% (except
nicotine, which was 88%).

The study is interesting, so let's start there. The results of the study
surprised me, personally. I wouldn't have guessed the remission numbers were
that high. I would have liked to see heroin, meth, or, far more pervasive in
this day and age: prescription opiates.

It's certainly nice to see good news, and I do consider the study a kind of
good news. The study obviously doesn't overstep its bounds or draw any big
conclusions. I'm sure the people who actually did the study knew and
experienced how damaging drugs CAN be in those 15-25 years before remission.

However, then we get to the article. The author runs the site substance.com
and has published a book and several articles with a strong point of view
about 12 step programs and the way young people with drug dependence are
treated in today's society. I do think she's bending the study a little to her
own aims, but I do appreciate her call towards sanity. It's a stretch, but I
don't think she's being unfair to use this study to support her approach.

I don't think soft-selling the total life destroying danger of drug abuse is
wise, and obviously it would suck if someone started taking drugs because they
read an article or study like this, but it's possible.

------
wuliwong
Isn't it possible that the issue is in the difficulty in classifying people as
"addicts" instead of concluding that most addicts just grow out of it? The
alcoholics in my family do not grow out of it. To a man (or woman) they just
deteriorate over the years and it is a very sad thing to watch. It seems
possible that what the author had and what my family members have are two
different afflictions.

>Moreover, if addiction were truly a progressive disease, the data should show
that the odds of quitting get worse over time. In fact, they remain the same
on an annual basis, which means that as people get older, a higher and higher
percentage wind up in recovery. If your addiction really is “doing push-ups”
while you sit in AA meetings, it should get harder, not easier, to quit over
time.

Clearly the author is questioning the progressive nature of addiction but not
considering the well known issue of defining addiction. Furthermore, to my
understanding the "progressive nature" of the disease is not referring to the
difficulty in quitting but rather the severity of the abuse of the substance.

~~~
Dylan16807
There _may_ be different fundamental types of addiction but what the author
described sure sounded like 'addiction' to me.

~~~
tjradcliffe
It is always very dangerous and misleading to argue about abstract categories
as if they were real things outside of the minds that make them. "Addiction"
the label we use for a category we impose on the objective reality we observe.
The OP is questioning the utility of that categorization based on more
extensive observation of that objective reality.

In particular: there is evidence that the population we now group into the
category "addicts" may in fact include two sub-populations, one of which "ages
out", one of which does not. We currently have a "lumped model" of addiction,
which associates certain additional features with the phenomenology we use to
assign something to the category.

For example, if we find a person who is a chronic user whose use is negatively
impacting their lives and who seems unable to stop, we are going to label that
person an "addict". But the members of that category also get assigned other
attributes for free. In particular, the current model of "addiction is a
disease" says that anyone who fits the external phenomenology is also never
going to get better without "treatment", or at best is very unlikely to do so.

But that association of "uncontrolled harmful use" and "its a disease" is a
purely theoretical construct that may be wrong.

For comparison: I once worked on the genetics of a particular type of cancer
that had two very distinct outcomes but which presented identically in a
clinical setting. A physician I worked with described it as being incredibly
frustrating, because she could literally see two patients in the same day who
were apparently in the same condition based on histology, stage of the
disease, everything, but ten years later one would be watching his daughter
graduating from high-school and the other would have been dead for nine years.
Simply because the diseases _looked the same by some measures_ did not mean
they _were the same thing_.

So it could well be that the same external phenomenology is present in two
quite different conditions. It would be extremely silly to argue that one is
"really" addiction and other is not, because "addiction" is just an abstract
category we created to subsume different instances of similar phenomenology.
We could call one grue and the other bleen, for all the difference it would
make.

The possibility of two quite different underlying conditions presenting
similar symptoms is one that has been realized often enough to be worth taking
seriously, and when it occurs in things like the cancer described above _no
one ever makes the argument 'well X sounds like it is really cancer type Y to
me'_. Yet when the question of addiction comes up, many people say precisely
that, and I am at a loss to understand why.

~~~
jnbiche
Extremely well-said. I've observed different kinds of addictions in people,
and I'll be damned if I'd ever think of classifying them in the same way, even
if that's what a typical psychologist would do.

------
sterlingross
From my experience and observations, most people don't grow out of being
addicted, they simply shift their focus of addiction.

This often goes unnoticed because there are many people who are addicted to
things that the majority of society wouldn't consider an addiction. One might
give up an "unhealthy" addiction for a socially acceptable one. Or their
unhealthy addiction may simply shift, from one substance to another, or one
activity to another, or one interest to another.

The more I've observed addiction the more I've realized that we are all
addicts. I am addicted to water, yoga, meditation, HN, reddit, coding, etc.
I've even come to realize that we are actually addicted to certain types of
thoughts or ways of thinking. Addiction to "negative" thoughts is what results
in "unhealthy" behavior.

I am currently addicted to observing myself for potential patterns of
addiction and have gone so far as to create a simple app [1] that in a way
takes control of the decision process away from myself. It produces a simple
"yes" / "no" response and I'll ask it throughout the day if I realize I have a
choice to make. "Do I go to yoga today?" -> "No".

The process of giving up control of my decisions was unnerving at first, but
the more I practice it, the more peaceful I have become.

[1] [http://www.holyspiritsays.com](http://www.holyspiritsays.com)

~~~
matwood
The coin flip decision making is an interesting and fun experiment. Sometimes
when going out with friends we'll leave all decisions for the night up to the
coin. It is freeing and irksome when a choice does not go the way you want.

~~~
sterlingross
I totally agree. I actually started out using a coin, but I got too
embarrassed walking around the store, standing in front of a bunch of choices,
and flipping through options. The was one of the motivations to create the
app, since it is much more socially acceptable and easier to use, than
catching a quarter over and over.

------
Mz
FYI: I don't entirely agree with this article. But I posted it in part because
I seriously loathe the AA "disease" model.

My dad drank heavily when he was in the army. He fought in the front lines of
two wars. I think he did it at least in part so he could sleep because alcohol
helps suppress dreams (and, thus, also nightmares). About four years after he
left the army, he swore off alcohol and basically never touched it again.

I loathe the taste of alcohol and, for most of my life, rarely have touched
the stuff. But I did have a nightcap almost every night for a year at a time
when I was very ill and doctors didn't really know what to do for me. At some
point in there, it was not unusual for me to have two doubles with dinner --
the equivalent to four drinks. So I imagine I could have been classified as an
alcoholic at that time. But when I got some answers and started getting
healthier, I was happy to stop drinking. Like my father, I never attended AA,
never wrestled with trying to resist temptation or whatever, etc.

In my father's case, I think it helped with psychological trauma. In my case,
it helped me survive illness at a time when I didn't have good answers and
wasn't getting adequate medical treatment. I have read or heard plenty of
other stories that look to me like they fit one of those categories.

So I think the article oversimplifies things in suggesting it is just a
developmental disorder, but I am thrilled to see a piece talking about the
reality that most folks drink less as they get older, without getting any
treatment. I really, really dislike the AA model.

~~~
DanBC
> At some point in there, it was not unusual for me to have two doubles with
> dinner -- the equivalent to four drinks. So I imagine I could have been
> classified as an alcoholic at that time. But when I got some answers and
> started getting healthier, I was happy to stop drinking.

2 glasses of whisky a day is not healthy but it's not alcoholism.

This is a bit tricky to describe but I'll do my best: let's assume you had two
US doubles per day. Wikipedia says that 89 ml per drink. Let's round that up
to 100 ml each drink. English public health has a concept of "units" to
describe drinking amounts.

200 ml * 40 (the ABV of spirits) = 8 units per day.

Recommended safe limits are 3 to 4 units per day (without saving up to binge).
You should try to have a couple of drink free days each week.

So, 8 units per day is over that level and increases the risks of harm.

Looking at definitions we see "alcohol misuse" which include "harmful
drinking" and "alcohol dependency".
[http://www.nice.org.uk/guidance/qs11/chapter/development-
sou...](http://www.nice.org.uk/guidance/qs11/chapter/development-
sources#definitions-and-data-sources)

> The definition of harmful alcohol use in this quality standard is that of
> the World Health Organisation (WHO) The International statistical
> classification of diseases and related health problems (ICD-10): "a pattern
> of psychoactive substance use that is causing damage to health. The damage
> may be physical (for example, hepatitis) or mental (for example, depressive
> episodes secondary to heavy alcohol intake). Harmful use commonly, but not
> invariably, has adverse social consequences; social consequences in
> themselves, however, are not sufficient to justify a diagnosis of harmful
> use".

> In ICD-10 the 'dependence syndrome' is defined as: "a cluster of
> behavioural, cognitive, and physiological phenomena that develop after
> repeated substance use and that typically include a strong desire to take
> the drug, difficulties in controlling its use, persisting in its use despite
> harmful consequences, a higher priority given to drug use than to other
> activities and obligations, increased tolerance, and sometimes a physical
> withdrawal state".

Looking at the English guidelines for treatment we see that medically
supervised withdrawal starts when you're drinking 40 units _per day_ \- that
would be a one liter bottle of 40% whisky every day.

Here's the full guideline:

[http://www.nice.org.uk/guidance/qs11/chapter/introduction-
an...](http://www.nice.org.uk/guidance/qs11/chapter/introduction-and-overview)

And here's the bit for lower end:
[http://www.nice.org.uk/guidance/qs11/chapter/quality-
stateme...](http://www.nice.org.uk/guidance/qs11/chapter/quality-
statement-11-psychological-interventions-and-relapse-prevention-medication-
for-adults)

~~~
Mz
That's interesting. If you or anyone else wants to do the math, the only thing
I tolerate okay is Kahlua. So I was generally having either mudslides at
Applebee's or Kahlua Cappuccino at Red Lobster (often with an extra shot --
two drinks with an extra shot each is four shots of alcohol).

According to Wikipedia
[http://en.wikipedia.org/wiki/Kahl%C3%BAa](http://en.wikipedia.org/wiki/Kahl%C3%BAa):

 _Since 2004, the alcohol content of Kahlúa is 20.0% (21.5% alc. is still
available only in Ohio[citation needed]); earlier versions had 26.5%._

This would have been around 2001-2002 in California. So, you should use the
26.5% figure. I don't know what a "shot" is considered to be. I mean as a
standard measure. I assume there is a standard measure of "shot" though. So
what would 2-4 shots of Kahlua a day be? Is that "alcoholic"?

Just curious. I never thought of myself as an alcoholic. I was clear I did
this because it knocked back the extreme physical pain I was in at a time when
pain killers did little or nothing for me and doctors weren't being especially
helpful. I just wanted to hurt less and I wanted to SLEEP. So, I would have a
drink with dinner or before bedtime, because nothing else was doing a helluva
lot for me.

~~~
DanBC
I was using Wikipedia to get the size of a US shot of 89 for a double and 44
ml for a single.

The sum to get UK units is:

Serving size in litres * ABV value

So 44 ml * 4 shots * 26.5 abv / 1000 conversion from ml gives 4.5 units per
day.

A doctor (and obviously I am not a doctor) might ask you to cut back a bit,
but that level of drinking is normal.

Did you feel urges to drink other than those shots? Did you experience bad
things from alcohol but continue drinking? Did you find it hard to stop? I
think some of these things would have been used to assess whether it was
problem drinking or not.

~~~
Mz
Like I said, I wasn't struggling with alcohol. I was struggling with a health
crisis. I never thought of myself as alcoholic. But I was drinking _daily_ for
a while there, which is part of why I say I think some folks would view it as
alcoholism.

It was a long time ago. I was also sometimes on medication, I was in a whole
lot of pain, horribly sick, etc. So my memory of the details isn't exactly
perfect here. Thus, I can't say how often I had the equivalent of four drinks
per day vs 1-3 drinks or how long the 4 drinks level lasted (in terms of
weeks/months). I do know it started at one drink and went up over time, which
is another thing that would make a lot of folks go "Yup! Alcoholism!" I just
know that for about a year, it was relatively rare for me to not drink alcohol
at some point during the day because when I didn't, I was in tremendous pain
and could not sleep. I did try different things, including vodka, and I
vaguely recall getting seriously drunk at one time with some ... liqueur of
some sort. (Again, I imagine that would look damning to some folks.) But what
ended up working for me was Kahlua, usually with dinner.

Thank you for doing the math.

------
bkeroack
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".

~~~
InclinedPlane
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.

~~~
tsuyoshi
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.

~~~
skinnybatch
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.

------
mm_throwaway
Here is one addiction I wish I could grow out of: benzos and other benzo like
drugs such as Ambien (zolpidem). I've been on them for almost 9 years, and
they are unbelievably hard to quit. I take them for my insomnia. I don't have
to take much (10mg of Ambien for example), but without them I'll lay awake in
bed for 8 hours not getting any sleep. I've done all the sleep hygiene stuff
such as CBT or forced sleep deprivation, but it doesn't seem to work.

I've been through various doctors, and I'm seeing a psychiatrist right now to
deal exclusively with the sleep issue. Apparently my GABA receptors are shot
from taking these drugs for so long. Unfortunately I have but two real
choices: taper quickly from the Ambien and deal with 3-6 weeks of little or no
sleep, or do a slow taper with Valium which only has a 20% success rate.

Not sleeping for days really, really sucks.

~~~
Theodores
Have you tried getting an allotment and digging it? All of it, two feet down?
Working it from dawn to dusk with three short breaks?

Better still, hard manual labour on shifts in a factory where slacking off
stops production and is therefore not possible? Maybe in a hazardous
environment where you have to be alert to avoid getting burnt or injured by
machinery.

Seriously, put yourself through a few weeks in some industrial job and you
will not have sleep problems after that.

~~~
kar2014
I agree, I've seen it time and again, people taking multiple medicine for
sleep disorder and nothing works. What works is taking a manual job or if you
cannot take such a job, put yourself on treadmill and keep going till you fall
off, I mean an hour or two. And see how you sleep after that.

------
ugk
As a sober addict I really can't comprehend the "flavor" of addiction the
author describes. Most of my addict friends and acquaintances either worked at
sobriety or died from using. Actually most died. If someone can just stop,
most would simply say the person wasn't actually an addict.

~~~
tjradcliffe
I've seen this comment about "wasn't actually an addict" or "not really an
addiction" in every discussion of this story, here and elsewhere.

I'm very curious as to why people say this, because it doesn't seem to add
anything to the discussion or take it in any useful direction. I'm not
trolling here: I really don't get it, and it bugs me a bit because it seems to
distract the discussion from things that might be useful (and I've contributed
to that distraction here, likely... sorry.)

Consider a similar case: small round blue cell tumours
([http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1867426/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1867426/)).
These present identically in routine histology done on biopsied tissue, but in
fact consist of four different types of underlying disease.

Neuroblastoma was identified in the 1800's. Non-Hodgin lymphoma wasn't fully
classified until the 1960's. At no time did anyone say, "That's not actually a
small round blue tumour" because that would have contributed nothing to the
discussion.

If we treat "addiction" as a name for a set of symptoms that may arise from
several underlying conditions, some of which can be corrected adequately by an
act of will on the part of the individual and some of which cannot, we can
start to ask interesting questions like:

1) How do we identify each type of underlying condition?

2) Are there more than two underlying conditions? Is there a more complex,
more useful taxonomy?

3) Given the existence of a population that ages out or chooses to stop, are
there ways that we can intervene to help them that exploit the specifics of
their underlying condition that are different from what has proven to be
effective in the population that does not age out and is not able to choose to
stop?

And so on. All of these are useful, important, valuable things to say. "Then
it's not really an addiction" is not.

~~~
codescorrectly
Ive heard this sentiment most often in 12 step program meetings.

------
benbreen
I've noticed that articles like this almost always fall back on implicit
"brain as computer" metaphors: "systems involved in love and sex are coming
online," "impact of the drugs on the developing circuitry itself." Anyone know
of an article that discusses this? It seems to be everywhere in writings about
the brain but rarely acknowledged. As for the article itself - I think it has
a valid point but is overly flippant about the risks of addiction and relapse
later in life. Just because it's statistically less likely than in youth
doesn't mean addiction is a "developmental disorder" as the author suggests.

~~~
calpaterson
It's explicitly named in Philosophy of Mind:

[https://en.wikipedia.org/wiki/Computational_theory_of_mind](https://en.wikipedia.org/wiki/Computational_theory_of_mind)

~~~
benbreen
Thanks for the link - although I'm referring more to the (potentially false)
analogy with present-day digital computers as opposed to the claim that the
brain is a type of computational instrument, which is hard to find fault with.
It's interesting how different eras apply their own en vogue technologies to
understanding the mind. (I.e. Descartes and other late 17th and 18th c.
thinkers visualized mental functions as clockwork-like mechanical
interactions, the 20th century witnessed lots of "brain as factory" imagery,
and now we're stuck on the brain as a network of computers).

~~~
gmarx
Humans best understand systems by analogy to systems they already understand.
We best understand systems we have built ourselves. It ends up limiting how we
think about problems and which problems we can understand. For example, to
model the circulatory system we needed experience with plumbing. You see the
same kind of thinking in electronic circuit models.

Brains aren't computers but some aspects are analogous to computers. Some day
we may create new systems that further our understanding of the brain and the
mind

------
nemo
Unfortunately 12-step dogma has persuaded a lot of people that addiction is an
inescapable fate, an innate disease/magical curse that can only be managed by
joining their religious program for life. The worst part of this is that the
12 step myth of powerlessness creates a self-fulfilling prophecy. It's so
colored the popular imagination of what addiction is and how to treat it that
when the fact that the majority of people who are addicted to some substance
do so by spontaneous remission, it seems surprising, even though that's what's
normal.

~~~
csorrell
I feel the same way about the 12 steps. I sat in on a number of meeting when I
was younger and it was clear to me at the time that a many of the people there
were really involved with the scene because they enjoyed wallowing in self
pity and powerlessness. NA/AA gives people an excuse to be weak, and it's
often used as a crutch that further enables the "powerless" in avoiding real
responsibility.

------
adamtucker
Is Addiction linked to Environment...?

Researcher Bruce Alexander of Simon Fraser University conducted an experiment
called Rat Park, in 1978. From that wikipedia page:

Alexander's hypothesis was that drugs do not cause addiction, and that the
apparent addiction to opiate drugs commonly observed in laboratory rats
exposed to it is attributable to their living conditions, and not to any
addictive property of the drug itself.

To test his hypothesis, Alexander built Rat Park, an 8.8 m2 (95 sq ft) housing
colony, 200 times the square footage of a standard laboratory cage. There were
16–20 rats of both sexes in residence, an abundance of food, balls and wheels
for play, and enough space for mating and raising litters. The results of the
experiment appeared to support his hypothesis. Rats who had been forced to
consume morphine hydrochloride for 57 consecutive days were brought to Rat
Park and given a choice between plain tap water and water laced with morphine.
For the most part, they chose the plain water. "Nothing that we tried,"
Alexander wrote, "... produced anything that looked like addiction in rats
that were housed in a reasonably normal environment." Control groups of rats
isolated in small cages consumed much more morphine in this and several
subsequent experiments.

~~~
Mz
In pictures:

[http://www.stuartmcmillen.com/comics_en/rat-
park/#page-1](http://www.stuartmcmillen.com/comics_en/rat-park/#page-1)

------
girvo
That's what happened with me. I'm an ex-heroin addict, clean for two years as
of August 30th, after being addicted for 7 years prior. I just had enough...
Luckily, Australia has a great support network for my situation, and I can't
thank Biala enough for their help. Now I'm kicking ass and taking names :)

My only disagreement is that I still think I'm recovering. I think I always
will be, and I've accepted that. No rest for the wicked, I suppose. In
addition, I took advantage of opiate replacement therapy, as cold-turkey was
just too painful at the time (struggling with depression meant that the
emotional side of withdrawals was dangerous for me). I'm finishing my taper in
two months, after starting on 28mg of suboxone :)

~~~
JacobAldridge
Congratulations on 2 years clean. Good luck with the tapering.

------
erikb
People grow out of it? Seriously? I don't like seeing addiction only in the
traditional way of hardcore drugs, alcohol, etc. There are loads of addictions
that aren't even recognized by doctors as such, but are quite far spread. Most
of all cigarettes (I don't know any person who gets treated for cigarette
addiction), sugar, gambling, virtual realities like tv shows or digital games.
In Germany I feel over 50% of the people around me smoke. In nerd circles
around me over 80% of people are addicted to either sugar, caffeine, or
gaming. In my family I even have 2.5 cases of serious alcohol addiction that
is neither treated nor recognized by the addicted. And I live in a middle
class family. In lower class families it might be much worse. Maybe I
misunderstand the article, but I think saying that most people grow out of
addiction is way off reality. I'd argue most people on this planet are hooked
to at least one thing, and nearly nobody drops their addictions.

I personally are certainly addicted to sugar. If I don't get my
coloa/chocolate/icecream, I feel tired, hungry, sad, and am sometimes in pain,
can't think about something else but sugar, and sometimes even walk long
distances in the middle of the night in the worst of weathers to get to a 24
hours shop to buy something, if I don't have something at home. Telling this
to doctors just yields them saying I'll get diabetes (or might already have
it) if I don't change my behaviour, which is pretty much what I already know.
Requesting general addiction treatment or food advisory training is not
covered by my health care, they say.

------
blacksmith_tb
The author asks rhetorically why this is a contentious theory - but it seems
like wording alone has quite a bit to do with that. A claim like "many people
with addictions simply grow out of them" is already much easier to accept than
"most people". Of course, there do seem to be some sorts of addictions, like
alcoholism, that if anything correlate more strongly with late adulthood,
which makes them resistant to this explanation.

------
talles
> This is one of many reasons why I prefer to see addiction as a learning or
> developmental disorder, rather than taking the classical disease view.

I always thought that myself but is the first time that I see an article on
it.

Most, if not all, addiction studies/reports/data/whatever doesn't count the
people that overcome their addiction on their own, or at least on their own
without causing major problems.

I would be really glad if this was discussed more often.

------
b1daly
I think the author has an important point to make, which could be helpful for
those struggling with addiction and find that the model of the disease and
total abstinence suggested by 12 step groups doesn't fit in some.

Anecdotally it seems to square with my observations of long time friends.

That said, I do think that there "a thing" that has aspects of a disease. The
belief structure was created by folks from e early part of the 20th century,
so there concept that the disease was a permanent affliction was probably just
not correct.

I tend to look at addictions as a subset of obsessive/compulsive disorders,
which has an additional chemical feedback loop enhancer.

Overall, our understanding of mental illness is woefully undeveloped. Most
cases are diagnosed by interpretations Of subjective and self reported
symptoms. The last time I looked at a discussion of this related to the new
DSM, the very low interrator reliability I the diagnosing of mental illness
was scandalous. Doesn't mean it's not a real thing though.

------
curioshop
I smoked a lot of marijuana since I was 23 till about 26.

I experimented with cocaine, heroin, MDMA, crystal meth for about a month when
I was 25.

Heroin was scarily addictive. I remember smoking from tinfoil turned black and
mixing other drugs.

I stopped because I got asthma and started coughing up blood. It was opiod
withdrawl is the worst but I never touched drugs again.

Anytime I think about my experience, it sends cold sweat, thinking how I
could've done it. This is also good because I know the cold sweats keep me
away from every repeating this. Its bad because I constantly think about the
health implications of smoking heroin, crystal meth for about one month, and
the rest of year smoking marijuana that smelled like febreeze.

I hope I'm okay I haven't gone to check with a doctor tho.

------
ggchappell
I wonder how much this phenomenon varies from one addictive substance to
another. For example, obviously there are a lot of people who remain addicted
to tobacco long past their mid 20s.

Also, is it possible that some of these people who are considered to have
grown out of their addiction, simply substituted one addiction for another?
I've heard that the rate of tobacco use among recovering alcoholics is very
high. It's true that they're probably better off being out-of-control smokers
than out-of-control drinkers. OTOH, I wouldn't say such people have really
grown out of their addiction.

------
Stronico
I think it is useful to separate out the concepts of substance abuse from
substance addiction. If the article just dealt with who experience powerful
cravings and withdrawals (the most common definition of addiction, and the
most useful as far as I can tell) then it would be much more insightful.
Instead it seems to equate addiction with heavy use and recklessness.

------
fnazeeri
Interesting point: "The data supports this idea: If you start drinking or
taking drugs with peers before age 18, you have a 25% chance of becoming
addicted, but if your use starts later, the odds drop to 4%. Very few people
without a prior history of addiction get hooked later in life, even if they
are exposed to drugs like opioid painkillers."

------
joshmn
I'm not a psychologist but I've had a pretty fucked up mental state for many
years. The same can be loosely said mental illness - for it is just that, an
illness.

Having said, I'm still waiting on the day that I don't need to reach for my
bottle of Vyvanse (Adderall, only exponentially less shitty and more amazing)
every morning.

------
jessaustin
A possibly-related book I've been meaning to read is _High Price_ by Carl
Hart.

[http://www.amazon.com/dp/0062015893/](http://www.amazon.com/dp/0062015893/)

The thesis seems to be that the entire concept of "addiction" is misleading
and inimical to efforts to reduce drug use.

------
Daghrollo
Many people I know that suffer from addictions have carried them through to
their later life and continue to function as part of society and generally
keep their habits to themselves. I do wonder if they have accounted for this
in this study. I am not saying they are incorrect but it is just a thought. =D

------
iopq
Does anyone else find the 1 pixel shadow on the text off-putting? I had to see
why the text was blurry on purpose. Found the shadow and disabled it.

------
rickmode
If you grow out of an apparently addictive behavior, doesn't that -- by
definition -- mean it was not an addiction?

OK, I know the definition of an addiction is that the behavior is having a
significant negative affect, but there must be some notion of lack of control
too, I would think.

I know plenty of my friends in college drank quite heavily. Afterward it
tapered off. And some of had quite bad grades during that time. But no off us
ended up as alcoholics after college. This was 20+ years ago, so one would
assume real alcoholism would become apparent in this timeframe.

~~~
gph
Do you just read headlines and then comment? I mean the author addressed your
point within the first few paragraphs, yet you don't seem to be incorporating
any of that into your post.

~~~
rickmode
I'm believe I'm asking a valid question.

I read the article last night when it came up on /r/skeptic. The author
describes a sort of adolescent addiction due to underdeveloped inhibitions of
those who having reach their mid-20s. The thesis seems to say that some
addictions are situational, like the distinction between a normal situational
depression and a clinical depression (one that does not trace to a person's
current life situation).

To restate my question: is what the author describes actual an addiction?
Perhaps only those addictions that don't resolve themselves are addictions.

So instead of describe the situation as the author does -- some addictions
resolve themselves -- perhaps the definition of addiction needs to be refined.

------
gojomo
[http://en.wikipedia.org/wiki/Survivorship_bias](http://en.wikipedia.org/wiki/Survivorship_bias)

------
Animats
Except for nicotine. That lasts a lifetime.

~~~
lolo_
Actually nicotine is apparently not the addictive part of smoking, rather
other chemicals in tobacco are.

Anecdotally I can confirm I've smoked e-cigarettes quite heavily for a few
months then stopped cold turkey and had zero withdrawal or cravings, but I
occasionally feel a desire for smoking a cigar quite strongly despite having
them at a rate averaging a few a year.

EDIT: Not _majorly_ addictive, rather than not addictive at all.

[ref]:[http://www.gwern.net/Nicotine](http://www.gwern.net/Nicotine)

------
vonnik
Strangely enough, this is also true of religious cults.

------
vacri
_By age 35, half of all people who qualified for active alcoholism or
addiction diagnoses during their teens and 20s no longer do_

And half don't. That's still a huge number, and they're not "simply growing
out of it" two decades later. "Just wait a couple of decades, you _might_ get
better" is a crappy position to take.

And "chronic" means "recurring", not "permanent for the rest of your life".
You can have a chronic problem that goes away after a while.

------
michaelochurch
Mental illnesses also have this stigma of permanence, and it's also inaccurate
and damaging. Plenty of people "snap out" of schizophrenia, or stop having
bipolar symptoms, or have a few depressive episodes over a decade and then
never again. We don't know why remission happens to some people and not
others, but it definitely happens. We just don't understand these diseases
very well. (I tend to think of depression and bipolar, for example, as
symptoms common to multiple diseases.)

Time of diagnosis has a major effect on how your disease is modeled (the term
I would use instead of "diagnosed"). Technically speaking, if you've ever had
a manic episode, you're considered to have Bipolar I, the most severe version.
If you're 28 and had one at 17 and never again... you probably don't have
Bipolar I. That could be cyclothymia aggravated by a hormonal or sleep
disturbance. It could be a one-off. Perhaps out of a fear of getting it wrong,
the medical assumption is that a person who's had one episode is prone to
having more. That might be a good policy for doctors (i.e. don't prescribe
certain medications to people with histories of depression, or (hypo|)mania)
but it's not a great model of how mental illness actually works. Some cases
get better with age, and some get worse, and we really don't know why.

As addiction is a mental illness with behavioral complications, I'm not
surprised. An episode of addiction is something one has to be aware of for
one's life, but the treatment (don't use the drug) is something that,
evidently, many people follow perfectly.

------
giancarlostoro
I don't know if I'm the only one experiencing blurry font, but it distracts me
from reading anything said.

~~~
talles
Me too.

There is an annoying _text-shadow: 0px 0px 1px_

~~~
InclinedPlane
Folks do that because it looks "good" on safari on macs and don't realize it
looks horrible elsewhere.

------
gameshot911
I liked the "Make us a habit" newsletter signup prompt at the bottom of a
story (and website) about drugs/addition.

------
joesmo
I couldn't agree more. The myth that addiction always needs some sort of
intervention or treatment is quite false, yet it is constantly perpetuated by
the media, doctors, and groups like AA/NA. There is a huge interest (and
sometimes profits) on behalf of these groups to perpetuate this myth, of
course, to the detriment of the people who suffer from addiction. I'm glad to
see that the conclusions based on data differ from the uninformed propaganda
that typically dominates this topic.

------
RickHull
I take issue with the headline, and I didn't see any support for it in the
article -- that people _simply_ grow out of addiction. Treatment or not, we
can call that process of reducing one's addictive behaviors _growth_ , but I
don't think you can find any addicts -- former or otherwise -- their families,
or addiction treatment specialists, who would call that process _simple_.

~~~
jalanb
Actually, speaking as a former addict, I would call it simple.

Damned hard, fucking painful, betimes hopeless, ..., but the most consistent
memory from my early recovery was the simplicity of the process. There really
was only one thing important: stay clean.

In my own case I aimed for staying clean for 2 years. And for those two years
that was not "the most important thing", it was the _only_ thing that
mattered. Other factors helped too (supportive family was next most
important), but I think I would not now be clean without the _simplicity_ of
that bright line rule of 2 years.

[http://en.wikipedia.org/wiki/Bright-
line_rule](http://en.wikipedia.org/wiki/Bright-line_rule)

~~~
RickHull
Rules may be simple, but adherence to them is not. For some, it may be
impossible. Consider the first 2 rules of dating:

    
    
        1. Be attractive
        2. Don't be unattractive
    

The rule for winning is simply to score more points than the other team.
Immortality is governed by the simple rule: _Stay alive_

None of these are simple processes, and it diminishes the discourse to treat
them as such. I am thankful for your counterexample to my challenge, but I'm
not convinced that, if asked sincerely about how you have managed your
recovery from addiction, you could possibly sincerely respond: _I simply grew
out of it._

------
andyl
Yet another HN article that minimizes the perception that drugs can cause
harm.

Yes it is true that most people grow out of addiction.

But many do not. In my circle I count four dead, many more damaged by drugs.

~~~
pessimizer
I can count 7 or 8 dead. I know more that died from things other than drugs,
though.

~~~
wuliwong
Yea but there are a lot more "things other than drugs" than drugs, right? So,
your stats make drugs sound very dangerous.

------
rando289
The author equates "not seeking professional help" with "growing out of it",
which I don't think is right. However, he gets a lot right, and links to
studies. My personal two biggest problems with 12 step: insistence on
believing in a godlike thing and it's dogmatic unchanging nature which ignores
science.

------
venomsnake
I think that most people just get bored/burned out with it.

------
pessimizer
This can't be true if we're still going to use the (useless) metaphor of
demonic possession to describe every aspect of substance abuse.

~~~
lnanek2
I've seen some ministries report a 50% success rate re curing addiction for
people who join. So social recovery forms of drug treatment are very
successful and might include things like exorcism and whatnot as part of
belonging to the flock, I suppose.

Sure, we know from science and Occam's razor that devils and gods probably
don't exist, but that doesn't mean participating doesn't show proven benefits.
Although the studies that show the benefits of religion tend to find
attendance means more than believe, so it is more of a network and support
effect than anything actually spiritual.

~~~
wuliwong
The problem with using Occam's razor to disprove the existence of some sort of
god or spirit of the universe is that there isn't any explanation. Remember
it's "the simplest explanation is usual correct." We really don't have any
explanation, ultimately as to origins or what is really happening at a
fundamental level. What are photons? What are electrons? What is space-time?
This pesky big bang thing. And then you have Goedel's incompleteness theorems
which basically tell us that no amount of math or logic will ever fully
explain this universe. While there may not be some old fella with a big white
beard floating around in the upper reaches of the atmosphere, I tend to think
the actual "truth" is far crazier.

[http://en.wikipedia.org/wiki/G%C3%B6del's_incompleteness_the...](http://en.wikipedia.org/wiki/G%C3%B6del's_incompleteness_theorems)

~~~
wuliwong
BTW, I feel like I always come across as a crazy person when I say this stuff
but I really don't see a flaw in this. The basic premise is that there isn't
going to be a logical explanation of "the universe." So, that seems to lead to
the conclusion that any complete explanation will have to contain some
illogical portion. I feel like once you accept that, all bets are off as far
as feeling comfortable in our cozy little science bubbles.

