The Future of Addiction

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Medical Approach to Addiction

What to expect in this episode:

 

  1. The medical approach. Treating addiction as a medical condition. The primary tool that we use for a medical condition is medicine.
  2. There are also non-harm-reduction, medical approaches to addiction.
  3. Predicting more and more complex pharmaceutical approaches to addiction in the future.

 

The Medical Approach to Addiction

 

The future of recovery I see it in 4 strands, 4 different areas. We’ve covered traditional recovery.

 

One that we’ve been in, but I think will become more sophisticated, is the medical approach. Treating addiction as a medical condition. The primary tool that we use for a medical condition is medicine.

 

A great example is Methadone, for opiate addicts, methadone is a substance that is similar to opiates, but reduces a lot of the harm that comes along with an opiate addiction.

 

So if you are using heroin, you need a drug dealer, you have to break the law. You don’t know exactly what you’re getting when you are buying a bag of black tar or powder from somebody’s probably not that trustworthy and you’re putting it in a needle and shooting it in your arm – its and incredibly harmful or dangerous habit to have, often deadly

 

The thought was, “can we come up with something  that is like heroin, but people can still function better, that we can distribute legally, to stop people from dying & falling apart?”

 

Methadone, in many ways, has been effective. There are huge downsides, whatever, it’s a medical harm reduction approach.

 

There are also non-harm-reduction, medical approaches to addiction.

 

Antabuse is an alcohol deterrent substance. If you’re taking Antabuse and you drink, you violently throw up. And it deters you from drinking – without getting you drunk.

 

Vivitrol is a blocker. Its been around a couple of decades, it’s not widely publicized enough.

 

But if you are an opiate addict and you are on Vivitrol, then even if you use opiates you can’t get high. It just blocks the effects of drug usage. It’s actually a great tool in the world of addiction.

 

I see more and more complex pharmaceutical approaches to addiction in the future.

 

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Traditional 12-Step Treatment

What to expect in this episode:

 

  1. Understanding the evolution of addiction rehab & recovery is important to understand where we are heading
  2. The 12-Step program is a spiritual program that evolved after psychotherapy failed to help
  3. This has become the foundation for most North American Treatment Programs, but the success rate could improve…

 

Traditional Addiction Rehab | The 12-Step Program

 

In terms of the future of recovery, I think we’re already in the midst of a rapid change in; let’s call it the recovery underground. To understand, first I think we need to understand traditional recovery and where that even comes from.

 

Traditional recovery is pretty much 12-step based in North America. Alcoholics Anonymous, Narcotics Anonymous everyone is familiar with that. The reason why traditional recovery developed in the first place is because the mental health and physical health systems that we’ve had historically weren’t helpful when it came to treating addiction.

 

So we knew very early on in 20s 30s 40s even before that, that Psychotherapy did not work with helping people to recover from addictions it’s a well-known historical fact. We’ve kind of forgotten that over time but it’s a well-known historical fact.  Alcoholics Anonymous came along as an interesting spiritual program with elements of therapy and morality and eventually community and literature that people started to get sober and people start to recover. That worked and works!

 

So traditional recovery in North America is 12-step and it was it was the dominant form of recovery for the… last eighty years let’s call it. The success rates that we see now, I think they’re controversial, to be honest with you, I think it’s a difficult question to ask, to talk about that, but let’s say the success rates are 15%. That might be generous that might be stingy,

 

it just isn’t good enough.

 

What are the Alternatives that are on the horizon for people in recovery?

 

 

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Marijuana Decriminalization | The Future of Addiction

What to expect in this episode:

  1. Exploring how marijuana fits in society
  2. Being Pro-decriminalization doesn’t mean there is no harm or side effects
  3. We’re in an interesting experiment to see what happens when we decriminalize a substance, the stigma goes away, & how that affects our society in general over time.

 

Marijuana Decriminalization | The Future of Addiction

 

I don’t think we really know over the long-term what it’s like to regulate self-medicating marijuana over 5 years 10 years 15 years 20 years and the impact that has on individuals and the impact that has on groups or productivity or our society as a whole.

 

So we’re in the midst of an interesting experiment to see what happens when we decriminalize a substance and the stigma goes away, which I think is a good thing, how does that affect our society in general over time.

 

So part of what will be understanding is what does society look like in relationship to mass consumption of marijuana over a long period of time.

 

Probably chill.

 

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Donald Trump & Addiction

What to expect in this episode:

  1. Donald Trump appears to suffer from Attention Deficit Disorder
  2. He has likely been prescribed methylphenidate, for decades
  3. Irritability, lack of sleep are side effects, so he likely has been taking benzos like Xanax to sleep, effectively putting him on a pharmaceutical cocktail long-term, locking in aspects of his personality as an addict would.

 

Donald Trump & Addiction

 

I have an interesting and controversial theory, I have no facts, this is just, shooting the breeze – I’m sure I’ll hear about it…

 

I look at Donald Trump, I look at his character structure, the little bit that we know about his history, and it’s clear that he suffers from some kind of attention deficit disorder.

 

He seems impulsive, not always so contemplative and thoughtful, and I imagine as a kid he was a lot to handle.

 

He also comes from a wealthy background, I’m assuming his parents probably had access to private doctors, psychiatrist, etc.

 

At some point in his development, his parents or whoever was in charge went, “this kid is pretty wild” and they put him on some kind of methylphenidate.

 

Something like a Ritalin or Adderall or something like that, and they used that to help him narrow his focus and be able to accomplish the task in front of him, school, etc.

 

I imagine him on this methylphenidate for 10, 20, 30 years – what happens if you consume methylphenidate, which is related to the class of drug that’s methamphetamine or speed, a stimulant, is… you begin to have side effects.

 

The side effects are irritation, lack of sleep, it stops working, you start to feel your focus starts to slip…

 

Usually what people do at that point if you’ve been on a methylphenidate for a long time, is you’ll take a benzodiazepine or sleeping pills and then you’ll begin to balance it out with different kinds of medication,

 

So my guess, when you look at Donald Trump, is that he’s been on a pharmaceutical cocktail for 40 years.

 

The reason why I think that is, most human beings in an interaction with the world would grow past some of the immature characteristics that we see in him.

 

The only way that somebody gets locked in that kind of way is either through extreme avoidance of yourself, which is hard to do or through some kind of addiction.

 

He also doesn’t drink and doesn’t get high. His brother was an addict and so he doesn’t medicate with those things.

 

So my guess is he actually got hooked on stimulants and then other drugs like benzos like Xanax and things like that to calm his nerves from the stimulants and it’s been locked in place for decades.

 

I think one day we’ll find that out.

 

 

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Suboxone Treatment | The Future of Addiction

What to expect in this episode:

  1. The immediate future of addiction is going to be dealing with the fallout of our current harm-reduction approach to the opiate crisis
  2. Suboxone or Subutex is currently subscribed widely to save lives but we don’t know what years of use will do
  3. It is widely known that suboxone is much harder to detox from than heroin, so what happens when all these people need or want to stop taking it?

 

The Immediate Future of Addiction | Suboxone and the Opiate Crisis

 

The most immediate thing I see on the horizon in terms of the near future of addiction is consequences of what we’re doing now with addiction.

 

The most immediate thing I see on the horizon in terms of the near future of addiction is consequences of what we're doing now with addiction. Click To Tweet

 

So, we have a gigantic opiate crisis in the United States, unprecedented really. One of the things that we’ve done to save people’s lives, understandably, is we’ve approached it from a governmental level and an Institutional level, and our approach has been harm reduction.

 

Which means finding medications that reduce the amount of harm caused by heroin and oxy and these drugs and so the consequence of that is we are going to have a generation of young people or some percentage of this next generation that is on some sort of opiate blocker or opiate substitute the most common is called Suboxone most common is called a Suboxone or Subutex and the first crisis we’re going to deal with in terms of the future of addiction as we’re going to have hundreds of thousands or even millions of people who have been on Suboxone or Subutex for 3, 4, 5,10 years and we don’t really understand on that scale the effects of those drugs long-term on the individual.

 

We don’t know how that affects people’s development over the long-term you know, what happens when you put it on 18-year-old on Suboxone how does it affect the development when they are 24. Maybe it’s hardly at all, maybe it’s a really big deal, we don’t really know. But my guess is it’s something we’re going to have to deal with.

 

As people start to have mental health problems years out of their development may be in relation to the Suboxone the questions going to be how do we get these people off of this drug? And, what I found in my own experience in treatment, is it’s actually harder to come off of suboxone than it is to come off of heroin – it’s actually well known. If you’ve been on Suboxone for a long time, you know, two, three, four, five years the detox is horrendous and often the depression is really heavy and lasts months if not years and so…

 

The immediate future of addiction looks like what are we going to do with this group of people who will put a bandaid on their situation that we had to do so they wouldn't die but they didn't completely heal Click To Tweet

 

The immediate future of addiction looks like what are we going to do with this group of people who will put a bandaid on their situation that we had to do so they wouldn’t die but they didn’t completely heal and they’re on this medication, maybe for life or maybe they want to get off and what do we do so that’s a new media crisis that we will be in the headlines in a couple of years.

 

 

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The Future of Addiction

What to expect in this episode:

 

  1. The drug and alcohol treatment industry tends to be very reactive
  2. How addiction works in relation to social phenomenon and social systems; increased anxiety and depression
  3. Prediction: Vaping, vaporizers & increasingly complex designer drugs.

 

The Future of Addiction

 

The question of what drug addiction looks like in the future is massively important. What I am experiencing working in drug and alcohol treatment is that we are very reactive. We’re in the midst of an opiate epidemic, methamphetamine use is also on the rise, and we’re so busy dealing with that we’re not looking at what’s coming down the pipeline, which I think is an important conversation to have.

 

I see addiction working in relation to social phenomenon and social systems, things that are happening in the world around us. I think the biggest thing that’s happening in the world around us, the biggest event of our time, is the rise of technology and the complexity of human urban life; and we don’t know how to deal with it. So we know how to engineer complex systems but we don’t know how to deal with our feelings. We’re not necessarily training our children to make their bed and do the laundry, even though they can be top scorer on Fortnite or whatever.

 

And so what I see is (this is already happening) I see massive growth in anxiety and depression which are internal disorders that come from coping with the difficulties of life. And so when I think about what’s happening in the future of addiction, I think of what’s happening in the future of mental health. My prediction is that there’s going to be more and more complex designer drugs.

 

Designer drugs are drugs where the molecular structure is modified usually from an existing drug for a specific application like Pharmaceuticals are designer drugs and what I see is a massive growth in designer drugs and their distribution online and so if you go online right now and you look up how many different kinds of drugs there are that list is growing more rapidly or drugs are coming out in the recipes are available and I think they’re going to be used for people to self medicate to treat feeling that they don’t know how to deal with a don’t know how to live into.

 

The other thing that’s happening is the way that drugs are being ingested is changing. There’s been maybe seven different routes of ingesting drugs for the last hundred years and when the vaporizer came on the scene I took notice. It was a new way to ingest a substance rapidly right that you can inhale and it’s also concealed you can flavor it however you want so the odor changes. We know that with marijuana THC and nicotine that you could… we have high schoolers that are running around vaping weed and nobody knows, nobody smells it so you can completely conceal it.

 

Now you can also Vape methamphetamine, you can also Vape dimethyltryptamine, in fact you can be anything that’s water soluble. So you can imagine the mix that you can see on the horizon as clever human beings all of these designer drugs all of these mental health problems and having a way to ingest them that’s hidden difficult for police officers and authorities to detect, parents, Etc.

 

So, I see a lot of complexity on the horizon and I see nobody talking about it. Interestingly I am not anti-drug. I think human beings have had relationships with two substances for all of history and it’s not a bad thing. The question is how we collectively deal with our relationship to drugs and alcohol, which is a really deep question.

 

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