
Addict Pride? - jamesbritt
http://www.thefix.com/content/neurodiversity-autism-addiction-strengths-advocacy8555?page=all
======
bpatrianakos
I actually _am_ an addict (heroin, 4 years sober) and besides my day job as a
developer I'm also on the board of a non profit that is about helping addicts
and their families (you may have seen me on CNN a few weeks ago talking about
it in fact). So I have personal experience with this and I also have access to
some really smart people doing research on this exact thing. I can tell you
that this article is true but dangerous.

I've been arguing for years that the same traits that make people like me
addicts are the same ones that can help us achieve more than what "normal"
people can. It's a blessing and curse. More often it's a curse. Before I get
into what's wrong with this story, I'll say what's right. Addicts tend to be
impatient, impulsive, risk takers who often feel more vividly than others.
We're often perfectionists and harder on ourselves than anyone else would be.
We can also be incredibly insecure and many of us self medicate. We
internalize a lot of negative feelings about ourselves and choose a path of
self destruction or a pursuit of perfectionism in ourselves. We can take our
impatience and work harder, faster to achieve what we believe (many would
argue mistakenly) should be accomplished right now. Right now doesn't have to
literally mean that but it does mean sooner than what anyone else would expect
from themselves. Failure to achieve this makes us continue using. The
frustration makes us give up and instead just use drugs to feel the
satisfaction we would have felt from any accomplishment. Our perfectionism
lets us pay great attention to detail. Our desire for a dopamine rush can
allow us to take on great challenges and see them through to the end. And our
tendency to be risk takers let's us take on goals with very uncertain
outcomes. In fact, I'd argue that an addict mind is the perfect kind of mind
for a startup founder. It's the kind of mind prone to taking big risks,
working fast, and craves the rush of satisfaction, the sooner the better.

But addicts don't start out that way. Most underachieve. That's because we
live in a society that isn't set up in a way that helps us foster our "gifts".
Addicts need to learn how to channel these impulses for their own good and
that's tough because humans are wired to take the path of least resistance and
in the case of addicts, that path is of escapism.

The article is wrong when it suggests that maybe we should allow addicts
access to various substances instead of stigmatizing them. This line of
thinking only takes into account the physical dependency aspect of addiction.
Addiction is just as much about physical dependency as it is a way of
thinking. What do you do about gambling addicts or sex addicts then? Let them
gamble wi monopoly money and have sex still? Allowing an addict to continue
using will not help them. It may prevent the spread of disease and allow them
to function in society but it doesn't allow them to live up to their
potential.

Abstinence is the best treatment. Addicts should not be stigmatized. It is a
real disease. We should make every effort to get them help, and help them stay
clean. What we're missing now are programs that take an addict's natural
tendencies and channel them in such a way that it benefits them. That's a huge
challenge. After four years clean I still struggle and have my moments where I
feel like going out to the west side of Chicago and scoring. These times
usually coincide with me trying to cope with something or accomplish a
challenging task. The sad thing is that I don't think most addicts can get the
kind of help I'm proposing even if it were widely available because you really
can't spot an addict until they begin using and are already on their way to
destruction. It seems that only after they've been to that low point that they
can harness those "bad" tendencies for good. I'm really glad this article was
written. This is the first time I've seen this idea put forward and it really
makes me feel vindicated. The danger in this idea however is the part that
talks about simply allowing addicts access to their drug of choice so they can
function. Also, just putting forth the idea that addicts are neurodiverse runs
the risk of giving addicts an excuse for their behavior and an excuse to
continue with it. No matter what, the consequences of ones drug use and their
behavior while using is not acceptable under any circumstances. Addicts do
need our empathy and help but at the same time it's important to make sure
they know that what they're doing is not acceptable and needs to stop.

(By the way, you'll probably see me as a new account - I've actually been
around here as user billpatrianakos for over a year. My other account got hell
banned last week for some reason and I was so pissed I almost didn't come back
but I saw this post and just had to comment on it)

~~~
light3
You propose the article is wrong in that abstinence should be the best
treatment, further you propose that

'What we're missing now are programs that take an addict's natural tendencies
and channel them in such a way that it benefits them.'

Which seems to be the million dollar question, since everybody has different
personalities and beliefs, is there a common strategy to apply here?

~~~
bpatrianakos
I don't know. That's probably best answered by people much smarter than me.
It's kind of a catch-22 situation because before an addiction is obvious those
personality traits are hard to identify and even if they are identified do
they mean the person is likely to become an addict if exposed to a substance?
If you catch these personality traits in a non-addict it's easy to assume
they'll learn to apply them on their own and there's no reason to believe an
otherwise healthy person won't learn good coping skills. But then if that
person does become an addict you have to treat the disease and on top of that
help them funnel those tendencies for good. It's an uphill battle once full on
addiction takes hold. Sadly, most addicts do not recover and are just lost to
us. It's sad because a lot of them have incredible, above average potential.
While I do think we need to take treatment a step further like I mentioned
before, I actually feel more strongly about prevention. It's much easier to
keep a person off drugs to begin with than it is to stop them once they've
started. Both have pretty awful success rates but the former still has a
better success rate than the latter long term.

------
_delirium
I'd argue this is already to _some_ extent culturally accepted, but mostly
only in an "arts" context, and not generally in any formal discussion like
medicine. But in general culture, people often do seem to view, e.g., the
alcoholism of the absinthe-cafes era, or the drugs of the Beatniks, or the LSD
of the 60s-70s, as a type of personality and lifestyle that may, in some
cases, be at least worth respecting if not imitating. Mostly relates to the
arts, although there are a handful of other examples, such as Paul Erdős's
well-known amphetamines usage.

It seems like it does need a "why this helps me be productive" hook to
convince people it has an upside. Either you need to be an artist and go for a
"helps my creativity" angle, or else you need to be in some kind of focus-
needing occupation and use drugs you argue improve your focus (amphetamines,
off-label usage of Ritalin, etc.). Although, oddly, steroids for athletes
don't get the same cultural free pass there.

I think people probably will find any concept along these lines more
threatening than neurodiversity (possibly for good reason). People "wired
differently" often grew up that way, so there's a sense in which you accept
that's who the person is, and both they and others have gotten used to them
being that person (in some cases). Most such groups are also a smallish
percentage of the population, and you can't really "opt into" it on purpose,
so it's a fairly fixed set. Parents aren't worried that their non-autistic
teenager will one day decide to "experiment with autism", so there's less need
to stigmatize it as an option. But nearly anybody can choose to become
addicted to heroin, and a significant percentage of people who do, might
decide it was a mistake, yet find it hard to get back out of the addiction. So
it's a more "dangerous" concept in a sense, because anybody can opt into it,
but possibly not opt back out.

~~~
opithrow
I'm a reasonably successful software developer in my thirties, successful
founder of a well-known company in a certain industry. (And a 4-digit karma on
HN.) I'm also an opiate addict; I've been using for over 5 years. Not IV, just
OxyContin (time release oxycodone). I've also been diagnosed bipolar I[1].

Opiates allow me to conquer depression and major stress. Working at a company,
with massive investment, several employees, and need to keep coding, keep
morale up, lead a development team? Opiates turn what would be crushing stress
and keep me positive so I can focus on getting stuff done. But could I tell
our board about how I cope? Hell no.

There are many more folks in my position. Junkies give us opiate users a bad
name, just like meth-heads make stimulant users look bad[2]. So, it's just not
acceptable to mention usage, even when it's OK to say how "I'll really need a
drink tonight" or even take smoke breaks during work. Which is funny, as
opiates have very little heath side-effects (obviously overdose, but after
that, constipation is the only real issue).

And yes, I've opted out several times. Once, like Paul Erdos, I decided to
prove to someone that I could, and took a whole month off. Despite being on
the equivalent of ~100-200mg of morphine a day, it was not very hard. (Sure,
if you start IV'ing heroin, things might be different.) Overall, I decided I
do better with opiates than without.

Any excuses that remove stigma and get society closer to rational discussion
on drugs is an overall win.

1: Opiates are one thing that really work for depression. Mood stabilisers
that all doctors want to prescribe leave me content to do nothing - literally.
On them, staring at a wall all day is "just fine". Zombification.

2: Except most folks seem to think "meth" is some crazy other drug, not
related to what they give hyperactive kids. No one seems to know meth is a
legal prescription medication in the US. But then again, most folks don't know
Heroin was a trademark of Bayer (name goes with Aspirin).

~~~
crag
"There are many more folks in my position."

Us humans (other animals as well, by the way) have been self medicating
ourselves for - ever really. Michael Pollen wrote about this in "The Botany of
Desire". His brilliant look at our relationship with four plants that we use
to treat our "fundamental desires" of "sweetness, beauty, intoxication, and
control": the apple, the tulip, marijuana, and the potato.

Intoxication. We can expand it's list, of course, to include poppies, and the
coca plants. Our problem is that many abuse these. The people of South America
have been chewing the leaves of the Cocoa plants for thousands of years.
Without addiction destroying their societies. We need these plants. And mother
nature was good enough to provide them. :)

But we also need education. And in American, we'd rather "just say no". Then
be honest about being a human being and our need for intoxication.

And when I write intoxication I don't mean falling down drunk. That's
certainly part of it - to have a moment of rest outside our our heads. But
it's also, like the post above stated - to conquer depression, stress and
(I'll add) anxiety.

------
mvzink
Foucault's treatment of psychiatry comes to mind. He raises the possibility
that psychiatry/psychoanalysis and mental normalcy are effects of bourgeois
dominance/the capitalist system: on some level, we care about individual
behavior to the extent that it affects productivity.

I've often helped my dad as he volunteers with the homeless, and many of them
are 'not productive members of society' due to mental illness (often brought
on by drugs, including addiction but extending to permanent neurological
damage). My dad, and many others, are searching for ways to make productive
niches in society for people with 'mental disabilities'. I'm not sure I can
endorse addict pride exactly, but I certainly think cultural acceptance of
neurodiversity and addiction is a step in the right direction.

~~~
j-g-faustus
> to the extent that it affects productivity

I believe that's the key. In a similar fashion, we (society) don't want kids
to interfere with productivity, so we stuff them in kindergartens and schools
so they are out of our way until they reach their 20s and can be regarded as
fully productive. And we put old people in nursing homes for the same reason.

I wonder if the current practice of everyone hiring only "the best of the
best" is suboptimal for society as a whole, since it leaves a lot of potential
productivity on the society table: Someone with a disability might be (say)
only 5-10% as productive as the average healthy adult, but add up everyone
with some sort of disability and it sums to a nontrivial amount of
underutilized capacity.

But I'm not sure. It's a game of numbers: There are administrative costs to
hiring and managing (say) 10-20 people to do one person's job. If the "less
productive" part of the population is small enough and the productivity
difference between "less productive" and "more productive" is large enough, it
could be a net productivity win to pay the "less productive" some small amount
of money to go away and stop bothering the "more productive".

Which is essentially what we do today.

~~~
_delirium
What I think's _particularly_ problematic is that it's a very specific kind of
institutionally-oriented productivity as well. Now, there truly _are_ people
who cannot function in society in any reasonable way at all (severely mentally
retarded, some kinds of psychosis, etc.). But there are a wide range of people
where context matters a lot to how problematic or beneficial something will
be. I think there are some philosophical problems with defining mental
normalcy and illness so strongly based on the oddities of a particular era's
employment conditions, even if descriptively it's true that someone out of
sync with them will have practical problems.

------
jakeonthemove
Pride!? As far as I'm concerned, my ADHD can go f&&k itself! I don't know how
many times I cursed and cried because I just couldn't focus on what I need to
do, instead finding myself doing some BS that didn't matter. I'm more easily
distracted than a rabbit, and sometimes am amazed at how little I give a crap
about anything that doesn't matter to me in the short run.

There are many factors at play, though, and maybe some people like their
"neurodiversity". The way I see it, it's just a way to cope with the fact that
these diseases are (currently) for the most part untreatable.

~~~
_delirium
I think it varies greatly based on the specific condition and your
circumstances. It's quite possible that _some_ are closer to tradeoffs than
unmitigated negatives, while others aren't. The positive/tradeoffs view seems
to most actively be argued by high-functioning people with Aspergers, and
considering that many _do_ contribute quite interestingly to society in ways
they might not have if it were "treatable", that's at least plausible to me.
That's still consistent with considering ADHD to not be of those cases.

Another way of viewing it is that there is a dispute over where to draw the
line between "normal human variation" and "mental illness". People agree at
the extremes: there must be _some_ variation in personalities and cognitive
styles that is not mental illness (e.g., introversion is not a mental illness,
but a personality trait), and also some that seems pretty clearly "ill" (like
some kinds of psychosis). But where between them to draw the line is less
obvious, which is why psychiatrists get together every few years to debate it
in a revision to the main diagnostic manual. Besides Aspergers, one active
area of debate within psychiatry at the moment is the paraphilias: is being
into S&M a mental illness, for example, or just natural variation within the
diversity of sexual preferences?

------
invalidOrTaken
I think there's a grain of truth here, but holy schnikes does it need to be
treated carefully.

I never got into drugs, but I'm pretty sure that if I did I'd be a hopeless
addict. I _have_ had longstanding issues with video games and internet use.
They contributed to my failing out of school.

That said, sometimes I wonder if it doesn't make me a better programmer. I
lose focus with long debugging cycles, so I write better tools or learn my
existing tools better. I have difficulty with routine tasks, so I've learned a
lot more about automation (learn your editor, unix utilities, and a scripting
language, kids!).

But heroin, man...not something you want to be goofing around with lightly.

~~~
BasDirks
I guess I could be called an addict.. to video games. Even made some $$$ with
it, traveling around Europe for free.

But damn straight will I not drink more than 1 bottle of wine a week. I just
don't need it. I enjoy a nice bottle on the weekend, but I just don't give a
damn for more; I have too much fun activities in my life to choose from that
don't benefit from being tipsy/drunk.

What do you live for?

------
DanBC
Neuro-Diversity has parallels with physical disability. It's common the hear
people say that their disability is not a problem, but the way society reacts
is. (For example, someone in a wheelchair may not mind being in the wheelchair
until they find a shop that has a step and no ramp. The wheelchair is not the
problem; the lack of a ramp is.)

I would tend to agree with that.

I find it harder to agree that addiction is similar. I'm glad that the article
points out the serious problems associated with addiction.

I strongly agree that current law-enforcement action for addiction is not
working and is probably harmful to society.

The article has a bit of correlation / causation stuff going on. It's hard to
know with an individual whether MH problems are being self-treated by drug
use, or were caused by drug use, or a bit of both. And it's impossible to say
for the population of drug users. When people with problems turn to drugs I
think most people would rather solve the problems than allow drug use.

~~~
lubujackson
I would say the focus on "addiction" in the article doesn't seem right. Maybe
"addictive personalities" would be a better fit, since if you're talking about
people's innate neuro-type(?) it doesn't have anything to do with addiction to
a specific drug or World of Warcraft or whatever.

------
gyom
I find it interesting that this article puts forward the idea that people who
are having problems right now (ex : those with autism and addiction problems)
might turn out to be ideal candidates for some future technology. Maybe
they'll just sync more easily with the brain interfaces.

With that kind of logic, though, someone could make a case about how having a
low percentage of psychopaths could be a good thing for times that call for
that kind of behavior (probably in some war situations). And I'm not talking
about their psychopathy being beneficial to them, but them being beneficial to
their tribe / village in those situations.

Anyhow, I don't have a particular example in mind and I'll refrain from giving
a bad example instead.

------
lubujackson
A refreshing perspective. I think we really need to identify the "levers"
here, like you might be more focused but more likely to be OCD or addictive;
you might be great at computation but suck at subtle interaction, etc. I
really like the focus on concentrating on emphasizing strengths rather than
muting weaknesses - I'd much rather have great focus AND know how to deal with
addictive behaviors than just wipe out that characteristic.

------
azakai
Maybe I'm pedantic, but the term "neurodiversity" is a little premature. We
don't actually know what causes autism or for that matter a tendency to
addiction. It might be neuronal, or it might be genetic, hormonal,
environmental or something else or a combination of all of the above.

------
vbtemp
> " tolerance for repetition that characterize her condition are also pretty
> much a recipe for success in ... computer science"

Obviously, the author knows nothing about computer science, since a tolerance
for repetition is pretty much a recipe for failure in computer science.

~~~
Johngibb
I know where you're coming from, but I'd like to present a counterpoint based
on a potential misunderstanding.

On the one hand, repetition expressed as writing the same code over and over
again smells of poor engineering. Abstraction, code reuse, refactoring - all
and productive means to avoid repetition.

I don't think that's what's the parent meant though. There IS a lot of
secondary repetition in our field in terms of sitting at same desks every day,
working long term on the same project, fixing similar types of. Ifs,
responding to emails erc. Basically, the auxiliary facets that are required to
be a good coder but don't directly involve coding are pretty repetitious.

Don't get me wrong - there are alternatives for some of these, working from
home, better productivity tools, better management etc. but my experience in
this career after 5 years leads me to believe there is a somewhat intrinsic
aspect of repetition. To me, it's lot as assume, because as You were pointing
out that good code doesn't involve repetition and I agree and am ok with it
because of that.

------
powertower
Drug addiction isn't neuro-diversity, nor something that is an effect of a
special brain disorder.

Give me 100 random people, a year, the right environment, and some strong
opiates, and I'll give you back 95 addicts.

While some might be more susceptible to drug addiction than others, getting
addicted and forming dependence is nothing more than a process.

In general (outside the extremes of the dataset) your life's circumstances and
details are more important to developing (and maintaining, and quitting) your
drug habit than your brain chemistry is.

~~~
bpatrianakos
95 addicts is not what you will get back. There is a difference between
dependence and addiction. Dependency is something people are all generally
equally susceptible to. Addiction is not equal. Brain chemistry does have much
to do with addiction. Specifically, those with smaller prefrontal cortexes are
less able to make good decisions and rely more in their natural reward system
to make decision for them. In these people our primitive brain has more power
and drives them to seek pleasure despite the consequences. Continuing to take
addictive substances exacerbates the situation in two main ways. First, the
brain readjusts so it becomes less sensitive to being bombarded with huge
amounts of dopamine (tolerance) and, if taken at the right time (or wrong time
depending on how you look at it), it actually stunts the growth of the brains
decision making regions (mostly the prefrontal cortex and the worst time for
this is from 12 - 24). What do you even mean by environment? Are you implying
that if you make drugs available everyone takes them? That's wrong. Are you
implying that addiction affects some social classes more than others? That's
also wrong. Studies show that addiction hits everyone equally. We only
associate it with certain social classes because it's more visible, treatment
isn't as easily available, and it's more talked about. In addition you'll find
that different kinds of drugs are used between social classes but the rate of
addiction is the same. Upper class tends to use more marijuana and
prescription meds while the lower class use the more common "hard" drugs. Even
with opiates you'll find that for some reason people think differently about a
vicodin addition than a heroin addiction despite them being the same thing.

It sounds to me like your comment was based more on personal belief than any
hard facts.

~~~
powertower
You're basing 75% of your entire response on something I've never stated.

But to respond:

There are plenty of people with excellent decision making processes who ended
up as addicts.

It was nothing more than a process for them.

Doctors, lawyers, firemen, teachers, bankers, the list goes on and on.

You want to blame the pre-frontal cortex for the start, I blame using once,
waking up feeling great, a few weeks later taking some more, feeling great,
then 3 months later taking 3 times/week, then a year later 3 times/day.

~~~
bpatrianakos
But that's not how it really works. Not everyone who uses once does it again
and again. Many people are able to control themselves. I'll give you tel
examples. First, alcohol. Alcohol is an addictive substance so are you telling
me you can take 100 people, give them alcohol and then expect 95/100 to come
out addicts? Of course that won't happen. But a few will and those few are
predisposed because of either genetics or some underlying cause like
depression or poor coping skills. Now let's take substances out of the
equation because addiction isn't necessarily about substances and it'll help
to get people thinking about this differently. Sex and gambling are
addictions. A person isn't addicted to the sex or the gambling itself but from
the brains natural reward system being set off each time a person engages in
either. Now we all have sex but not all of us are sex addicts. Many of us have
lost more than we cared to part with at a slot machine or a card game but we
don't all become gambling addicts. Put 100 people in a situation where they
have easy access to those two things and even if all 100 partake only about 10
will come back uncontrollably. The statistics show 10% of the population are
predisposed to this. This isn't like lab rats where you can expect all of them
to become addicted and that's because the one thing that separates us from
them is our big prefrontal cortex. That cortex works perfectly in 90% of us
which is great because 100% of us are exposed to situations where we get a big
dopamine boost from taking some sort of action. If we didn't have that we'd
all be addicts acting on animal instinct.

It's a myth that taking something once will make you an addict. Well, it's
true and a myth. It's true in that no one knows if they're one of the lucky
10% who are predisposed to this and will wake up, take another and end up like
you say. But from a statistical point of view it's false for 90% of the
population. Your description of taking it once, liking it and going back for
more is accurate but it only holds true for a small number of people and
doesn't take into account the different factors that play into what really
makes an addict. It's far more complicated than that.

~~~
powertower
> But that's not how it really works. Not everyone who uses once does it again
> and again. Many people are able to control themselves.

Again, you're responding to something I've not stated.

Taking a substance once does not make someone an addict.

What I've stated is it's the process that eventually leads to it. And that
everyone is susceptible to it on some level _given the right life
circumstances_ (bad relationships, bad parents, boredom, too much money and
time, certain friends, access to drugs, etc).

------
rsanchez1
Reading this, something occurred to me. If we are to champion
"neurodiversity", should we not aim to accomplish neurodiversity in each
individual, instead of neurodiversity in the population? By that, I mean
diversity in neural activity, such that it doesn't reach extremes
characterized by autism, depression, bipolar disorder, etc. In that sense,
isn't embracing autism, depression, bipolar disorder, etc. actually the
antithesis of "neurodiversity"?

