Drug Policy Needs More Centrists (NYTimes OP-Ed)

[Bebek Sincap Ratatosk]

What is your definition of addiction?

Physical or Psychological dependance. That is, a 'need' based on some sort of negative effect if you don't have the object of addiction. I have never met anyone that meets either of those criteria. Maybe they exist, but I know a lot of smokers...

[Nephew Twiddleton]

So you guys basically send a messed up kid to therapy to treat his marijuana abuse kid gets less messed up and stops smoking up? Im just making sure i understand that right.

[AFK]

What is your definition of addiction?

Physical or Psychological dependance. That is, a 'need' based on some sort of negative effect if you don't have the object of addiction. I have never met anyone that meets either of those criteria. Maybe they exist, but I know a lot of smokers...

So what would you say to the educated, licensed substance abuse counselors who do assess individuals (using evidence-based, science-based practices), youth and adults, to meet the above threshold?  Are they wrong?  If so, why? 

[Bebek Sincap Ratatosk]

What is your definition of addiction?

Physical or Psychological dependance. That is, a 'need' based on some sort of negative effect if you don't have the object of addiction. I have never met anyone that meets either of those criteria. Maybe they exist, but I know a lot of smokers...

So what would you say to the educated, licensed substance abuse counselors who do assess individuals (using evidence-based, science-based practices), youth and adults, to meet the above threshold?  Are they wrong?  If so, why?

Because that's the view outside their cell...

In the instances where I know the people involved, its because they lie to the counselor and tell them what they want to hear so they don't have to deal with jail time. I don't know of a single one of them that actually stopped smoking as a result. Is that the norm, or do I simply know the few outliers? I dunno.

[AFK]

So you guys basically send a messed up kid to therapy to treat his marijuana abuse kid gets less messed up and stops smoking up? Im just making sure i understand that right.

Well, technically, I myself don't send anyone anywhere.  I'm prevention, not treatment.

But a kid, or adult, goes to a treatment agency.  They will go through an in-take process where they go through an initial screening to make sure they qualify for treatment.  If they do they will have a more thorough assessment which may be a self-administered tool, an interview, or combination of the two.  This would be a protocol that has been researched and peer-reviewed and found to have reliability and validity.  Through this process, it will be established what kind of treatment protocol will be best for the individual.  They will then set up a treatment plan and implement that plan.  At the end of that plan, and throughout the plan, there will be constant evaluation to see where the patient is.  Adaptations may need to be made along the way depending on progress. 

Many come out of that in recovery.  Someone in recovery can always relapse.  We never characterize someone as "cured".  Roughly, it's somewhat analagous to someone in remission for cancer.  It's something that an individual needs to stay on top of, but without the need for the substance, they certainly should be enjoying a higher quality of life.  A key to this will be the kind of support system they have within their family and community.  If they come from a family of drug abusers, or run in a social circle with drug abusers, it could end up being quite challenging to stay clean. 

[AFK]

What is your definition of addiction?

Physical or Psychological dependance. That is, a 'need' based on some sort of negative effect if you don't have the object of addiction. I have never met anyone that meets either of those criteria. Maybe they exist, but I know a lot of smokers...

So what would you say to the educated, licensed substance abuse counselors who do assess individuals (using evidence-based, science-based practices), youth and adults, to meet the above threshold?  Are they wrong?  If so, why?

Because that's the view outside their cell...

In the instances where I know the people involved, its because they lie to the counselor and tell them what they want to hear so they don't have to deal with jail time. I don't know of a single one of them that actually stopped smoking as a result. Is that the norm, or do I simply know the few outliers? I dunno.

Scientifically, how are they wrong? 

[Nephew Twiddleton]

Do they treat for marijuana withdrawal? What sorts of medications do they use for it? What are symptoms of severe marijuana withdrawal?

[AFK]

Do they treat for marijuana withdrawal? What sorts of medications do they use for it? What are symptoms of severe marijuana withdrawal?

I'm not aware of any medical treatments currently available to treat the withdrawal symptoms, though it is something that is being researched.  Here is an example of one study that didn't have very good results.  But it also gives a little background on the nature of the withdrawal symptoms and how it can results in relapse. 

http://www.nature.com/npp/journal/v29/n1/full/1300310a.html

[Nephew Twiddleton]

Cant click from phone. Will have to look at later.

[Bebek Sincap Ratatosk]

What is your definition of addiction?

Physical or Psychological dependance. That is, a 'need' based on some sort of negative effect if you don't have the object of addiction. I have never met anyone that meets either of those criteria. Maybe they exist, but I know a lot of smokers...

So what would you say to the educated, licensed substance abuse counselors who do assess individuals (using evidence-based, science-based practices), youth and adults, to meet the above threshold?  Are they wrong?  If so, why?

Because that's the view outside their cell...

In the instances where I know the people involved, its because they lie to the counselor and tell them what they want to hear so they don't have to deal with jail time. I don't know of a single one of them that actually stopped smoking as a result. Is that the norm, or do I simply know the few outliers? I dunno.

Scientifically, how are they wrong?

Scientifically? Because they are part of the process, therefore their subjective BIP will affect what they expect, what they see and how they interpret what they're being told. Further, the subjective behavior of the 'addict' is involved... and we cannot objectively quantify 'truth' from 'lie' in these situations.

Perhaps in Maine you have guys that can? I only know about experiences second hand from the perception of the 'addict' in Ohio... and in all of them, the 'addict' saw the councilor as a rube. Did the councilor know that? I don't know. did the councilor include that as part of their scientific process? I don't know.

The young kid I mentioned, told me how he explained his 'withdraw' and his 'addiction' to the councilor. He told me it was bullshit.

[AFK]

What were the credentials of the councilor in question?

Were they licensed by the State of Ohio?

Did they used evidence-based treatment techniques? 

I guess where I'm getting lost is using the anecdotal evidence from people you know vs. a body of science.  Because there is a whole body of science behind behavioral health treatment.  In Maine, anyone who wants to be licensed MUST follow these protocols.  If they don't, they don't get licensed.  There are certainly private independents who may employ other techniques not backed by science.  I would tend to discourage an individual from going to one of these practices. 

Have you ever gone through a treatment program? 

[Bebek Sincap Ratatosk]

What were the credentials of the councilor in question?

Were they licensed by the State of Ohio?

Did they used evidence-based treatment techniques? 

I don't know... they were sent there by the courts after getting caught with possession, so I assume they're licensed.

I guess where I'm getting lost is using the anecdotal evidence from people you know vs. a body of science.  Because there is a whole body of science behind behavioral health treatment.  In Maine, anyone who wants to be licensed MUST follow these protocols.  If they don't, they don't get licensed.  There are certainly private independents who may employ other techniques not backed by science.  I would tend to discourage an individual from going to one of these practices. 

Again, I'm only telling you from my experience. Do the protocols account for the patient BSing the councilor? If so, then in those cases the protocols must have failed.

Have you ever gone through a treatment program?

No. The only time I got caught with weed by a cop he took it... and later gave it to a friend of mine that managed a strip club for some free dances. I kept a little idol of Shiva in my weed bag and my friend found it, recognized it and returned the weed and the Shiva.

I've never found a reason to enroll myself since my social and work life was great. When pot wasn't available, I never noticed any symptoms that would indicate physical or psychological dependence. As I've said several times, I suppose that such effects ARE POSSIBLE... I've never experienced them, no one I know has ever experienced them.

Though you know me, I figure almost anything is possible. I can't possibly know every stoner and every experience, so I'm sure that some people out there might have some serious effects.

I do know one guy that used to smoke pot. he'd always been a little weird, but after smoking he got seriously weird (talkiing to himself in the corner during parties weird). So we all sat down with him, said "Dude, whats up with this?" discussed it and he decided not to smoke pot. Several months later he ended up going into a treatment facility for schizophrenia. I don't think the weed caused the schizophrenia, but it certainly aggravated the problem while he was high. I am not ignorant of the fact that we're all individuals and we all have our own unique set of physical and psychological conditions. Pot is a drug that affects the brain and I have no problem accepting the fact that it can react differently in different people. Based on my experiences though, and the experiences of other pot smokers I've talked to, addiction, if it exists I think it must affect a very small minority of people.

Bear in mind though that I also accept the possibility that UFO's have visited earth. And I accept the possibility that we can break free of our Black Iron Prison by recreating it as a Golden Sphere of Possibility...

[AFK]

I would tend to think a good counselor worth their salt will know when they are being BS'ed.  The ones I know are pretty savy and tend to know when someone is filling them full of shit.  But, at the same time, if someone is in treatment and doesn't want to play ball, it isn't going to work.  While the science is there, the science can't extract an individuals heels from the earth. 

I would argue that isn't a failure of treatment, that is a failure of the individual. 

Of course, this can happen with chemical treatment regimens as well.  Like the guy prescribed cholesterol-lowering medications who makes nightly trips to KFC.  The patient needs to be on board with the program. 

[Nephew Twiddleton]

I would be inclined to think that you arent actually treating marijuana addiction rather than other psychological issues that lead to smoking too much. I've been addicted to nicotine (that happened very quickly) and ive had problems with drinking too much. Ive never wanted to get stoned more than every so often. The most i did was every weekend senior year of high school and that was partially due to my parents splitting up.

[AFK]

I would be inclined to think that you arent actually treating marijuana addiction rather than other psychological issues that lead to smoking too much.

Why?  Based on what?