Steve, N.Y.

[101N]

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So here is the question: Are 'accidental addicts' different than 'intentional addicts' in terms of neurobiology or treatment.

Steve thinks they are. Krantz argues that Steve is making a false dichotomy, and I'd agree with Krantz.

http://www.nytimes.com/2013/08/28/b...ion-in-boomers-part-2.html?comments#permid=13

Q. I am a pain specialist and have a question. Why haven’t addiction specialists sought to determine whether patients who are prescribed opioids for pain and ending up abusing and becoming addicted to these medications are the same physically and psychologically as those who began using these drugs for recreational purposes and developed problems with them? This seems to be a very important issue that addiction specialists seem to have completely ignored and simply lumped all opioid abusers together. — Steve, N.Y.

As far as the same treatment being effective for both groups, I would again ask her to cite her evidence. In fact, there is virtually nothing (1) on what works for those who had been started on the drugs for legitimate pain complaints.

1. http://www.ncbi.nlm.nih.gov/pubmed/23915328

 

[emd123]

Addiction is like pregnancy. Once you've got it, it makes no difference whether you planned it or not. Once it's done, it's done. Pregnant is pregnant, and addicted is addicted.

I think psychologically he's trying to separate them into two groups:

Those he can blame for their condition and those with someone else who is to blame. It doesn't work that way.

One way or another it's a terrible problem for someone to have and we should do everything we can to prevent it, identify it, avoid worsening it, and treat it when we can.

 

[Ducttape]

I would also agree. The neurobiology is not different. The psychological basis of addiction is also the same. Just presupposing the initial exposure making a significant difference in terms of treatment seems to be more presumptuous than based in actuality.

After all, don't most heroin users start with prescription narcotics? Something "unique" about these individuals make them turn to heroin, not unique to circumstances