Crack and meth addicts probably aren't as addicted as you think

boing
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Whether they were taking the $20 to buy more crack or not isn’t really the point… the point was that they wouldn’t be GETTING the $20 for several weeks, after they left the program. So, even assuming they planned on using it for crack, they were at least rational enough to make the decision “Okay, if I hold off on getting crack right now… I can better ensure my long-term access to crack.” And if they can make that decision, while I think it’s jumping a bit to say that they’re not addicted, it does cast doubt on the theory that “they’ll do anything to get their fix right now” and suggest they may be more functional than you’d assume. After all, if you can decide “if I don’t smoke crack right now, I can get $20 in several weeks to use on crack”, you can also decide “if I don’t smoke crack right now, I can continue to hold down my job and not ruin my life and continue to enjoy a small amount of crack regularly for many years.”

As for the medical ethics of being allowed to supply your test subjects with crack… I suppose it’s much like the ethics of supplying your test subjects with any other drug, which is usually one of the steps to get it approved. How else are the supposed to investigate the effects of a drug in a controlled way?

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… but there’s a world of difference between running a clinical trial of a potential new drug and giving test subjects crack cocaine. We’re not talking about testing crack cocaine to see if it might help lower cholesterol. Who cooked up the “pharmaceutical-grade” crack? It just doesn’t add up…

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They’re testing the effects of crack. They’re giving that crack to people who’d already use it (it doesn’t actually say, but I wouldn’t be surprised if they had a drug test as part of the condition to entry and if you’re not actually on crack already, you don’t get in the study), in order to study it in a controlled way, with doses that are the same every time (or vary with the specific outline of the experiment).

“Pharmaceutical grade” probably simply means that it’s actually crack cocaine, rather than cocaine mixed with baby powder, salt, etc, or whatever drug dealers do to make crack cheaper to sell at the expense of safety for the user and quality of the experience. Again, for science, that makes it controlled constant, rather than a widely variable variable, as it’d necessarily be if you just let crack addicts get their own crack (likewise, the amounts of crack they use would also be widely variable, and you couldn’t tell whether the differences between patient A and patient B were because whatever you were testing for has changed, or whether patient A just has a much better dealer).

Again, how else would you propose to scientifically investigate the effects of crack use? Or should we just put it in a lockbox and never study it systematically, and just do anecdotal observational guesses?

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You are referring to coping mechanisms, specifically self-medication. In my opinion, this is why these addictions are so hard to break. It isn’t so much the desire to get high as the desire to escape your life. And getting sober only means that you have to actually face your life. If a person hates their life and doesn’t want to face it, how are you going to talk them out of using the tool that lets them get away from it? Only comprehensive mental health treatment would do that. And our society has decided that it doesn’t want to pay for that.

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Well, yes, agreed. But I was thinking more about what humbabella said about cutters, and what salvarsan said about escapist/diversion behaviours, and it seemed like there’s a useful line to be drawn between a person who occasionally has a drink or two so they don’t punch their boss in the face (reasonable self-medication) and someone who destroys their own liver or brain by staying lit all the time (self-destructive behavior, like cutting).

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I’m not sure it’s even “getting away from” their life. Maybe for some it’s getting to their life.

If you were in constant pain, every day, all day, and were offered a medicine to help, would you take it?

What if it was only short-acting? And you shouldn’t operate heavy machinery while taking it? And it may cause drowsiness? And there is the potential for liver damage? And tolerance?

The pain is constant. And debilitating.

I would take it.

No doubt, we need better treatments or preferably prevention. But we have what we have and those options are expensive. And as bzishi says, socieity has decided it doesn’t want to pay for that.

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An acquaintance of mine was addicted to cocaine, heroin, and tobacco for a while. He was a writer, and had started using coke to get over writer’s block, then later started taking occasional heroin to ease the jitters from the coke (because that’s obviously a good plan…) He said that getting off the cocaine addiction wasn’t hard, once you’ve burned through all your money and friends and can’t easily get any more. Getting off heroin was a lot worse - since it’s replacing the endorphins your body makes to block pain, your body stops making much of them, so when you stop taking heroin, everything hurts until your body decides to start up again. And tobacco? He said his wife was ok with him quitting one vice at a time, so he was still smoking, but that trying to kick tobacco was harder than heroin.

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It’s not pharmaceutical grade crack, it’s crack made from pharmaceutical grade cocaine. Cocaine is a drug that does have valid medical uses, and it is still legally produced.

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i like drugs and sex. i would like to be adopted by a rat family in that park is what i’m saying. i feel like lilly’s monkey experiments would be prudent at this juncture.

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am i the only one that’s on drugs here? you worship Science, i get it. do some drugs.

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Just a guess, but you are most likely the only one who is willing to say so online.

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I understand that cutting is extremely unpleasant for people who don’t understand where that urge could come from, but having a superficial cut on your arm is actually less harmful than having a drink (nearly all of us have had both and know this). Drugs, self-harm, emotional eating, talking with friends: all are ways that people come up with to help them deal with their emotions. All of them can be done in a way that isn’t really that harmful to yourself in the long term and all can be done in a way that is very harmful.

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I can’t buy that; the risk inherent in a single purposeful self-incision is not even remotely comparable to the risk inherent in drinking a single beer. I’ve seen three people hospitalized with cellulitis in the last year - two nearly died - from cuts smaller than a cat-scratch.

But your earlier remarks about Rat Park are very pertinent here - most of us mammals need a healthy environment to be reasonably healthy, and from what I’ve seen personally, cutters are usually entrenched in an environment that is psychologically harming them far more than a few cuts will harm them physically. I think it’s worst when the harmful environmental factor is something that should be healing to the human psyche, things we are naturally drawn to like love, work or play. It seems to me that a psychologically destructive love interest can be far worse than no lovers at all.

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That sounds like a cluster of unlikely events, given that cellulitis has an incidence between about 2 and 25 per 1,000 person years (found a few sources with conflicting numbers). Cuts are only one of many risk factors for cellulitis, you can acquire it from scrapes too small to detect with the eye, from inflammation, from rashes, and any other break in the skin. It is much more common in middle aged and elderly people, unlike self harm which is most prevalent in teenagers.

Aspirational pneumonia, which accounts for about 15% of cases of pneumonia, has about the same incidence as cellulitis. Since resources on cellulitis I’ve found don’t ever mention self-harm as a common cause, we could imagine that it is a very small portion of cellulitis cases. On the other hand, aspirational pneumonia is almost always caused by drinking!

I realize that cuts can get infected, but bringing up conditions that a sizeable portion of the population will suffer from and recover from in their life time doesn’t really add much to the argument. Honestly, what do you do when you get a cut on your skin? Wash it and slap a bandage on, or call the doctor? People who cut themselves are more likely to die of a serious infection (and pretty much every other cause, it turns out) but that is because they are far more likely to be socially isolated and generally don’t want to come forward for treatment for fear of having to explain scars.

Of course you are probably right. Do cutters mostly sterilize their blades? Do they wash the area beforehand and after? These sorts of sensible precautions probably don’t get a lot of play (of course, again, that’s because we stigmatize it - can’t tell people how to do things safely or we are encouraging them; like condoms and sex).

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Isn’t needed. Atheists can be members. After all ‘a power greater than yourself’ can be most anything, even in a purely practical sense. If you don’t have any arms, a doornob can be a power greater than yourself.

Thing with this article is, first and foremost, research ethics! Speed I understand, as adderall is just methamphetamine, so it’s available as a prescription drug. However, that doesn’t explain delivering it to street addicts simply because they are addicts. And cocaine? Not lawful under any current circumstances.

And then, the issue of human experiementation? Nuh-uh. Noooo workie. And even if the experiment itself were both legally and ethically plausible, it wouldn’t explain recidivism rates of well into the high 90s, percent-wise for cocaine. I hardly think it’s possible to discourage punishing addicts on the basis of a researcher who has been willing to actually give drugs TO addicts. And worse yet, somebody who doesn’t seen to have any real grasp of what addiction is or does to its victims. His thinking reminds me of people who tried to pay their sons to get haircuts back in the day.

I’l agree absolutely that the DEA needs to die in a fire, and that punishment is no way to deal with a sick addict - but this is no way to go about it! Instead, it’s going to be a battle by inches.

I only wish it could go fast enough to stop these pinhead professors who’ve been campaigning the FDA to severely limit opiate prescriptions. If you listened to them, nearly nobody suffers from chronic pain except for cancer patients, and restricting a physician’s ability to prescribe is the only way to save those who overdose. And then, the hearings go on with nearly no effective notice to the public for commentary.

The same was done to adderall prescriptions on the basis of claims that students and others abuse the stuff. The DEA was given control of ingredients, and caused a shortage that put many, many patients in jeopardy. And likewise, the DEA holds control of medical licensing for prescribing, puts everybody in databases each time they fill a scrip, and literally counts the pills any given physician prescribes, so that they can target physicians as well as patients. So, at this point, that strategy of allowing the DEA to threaten and control has extended FAR past addicts on the street, and right into medical offices and the lives of legitimate medical patients. You really think they care about this kind of ‘research’?

That is just…right up there with PRISM, in terms of invasion of privacy and negation of civil rights.
On one end, pharmaceutical terrorism, and on the other 1st Amendment terrorism by the government. We’re gonna have to do WAY better than this kind of ‘research’ bs to have any hope of combatting it all!

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I wondered if the doorknob would show up.

Great doorknob! Testify, sister!

But I think they are just tools of the insurance industry. Coventry insurance is apparently quite fond of denying pain medications, for example. They just told me that sumatriptan succinate is “not medically necessary” for crippling migraines. The 99% are supposed to suffer, and their insurance payments are needed to buy fresh minks for the 1%.

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I wonder at what point that becomes practicing medicine without a license?

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I hear ya! I know there’s an appeals process - but they’d probably rather you didn’t know - or won’t try. And a formulary…which they’re often perfectly happy to ‘forget’ to give you. (Wish I believed Obamacare was going to fix this kind of stuff, but it happens with Medicare, too. …Damned realities!)

Here’s hoping you get to a win on this one! Migraines suck honeybadger droppings.

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What you say means just about jack in terms of purity. The very act of cracking cocaine is done specifically in order to remove the fillers it was cut with, and turn it back into pharmaceutical grade so you get a clean burn and inhale nothing but coke.

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Um. No. Because A) people who purposely cut themselves are at a high risk of even worse things, like suicide and other substance abuse. It’s not a thing that happens just because a person is in a psychologically unhealthy environment. For example, people with Borderline Personality Disorder. No one knows whether it is genetic or environmental at its roots. But you can put a person with the disorder in an environment other humans would find perfectly fine, and they will still undergo incredible emotional stress - still often cut themselves, and still be at a tremendously high risk chemical dependency and suicide. So in that case, a small self-inflicted cut carries risks far beyond infection OR drinking, OR abuse of various drugs.

Problem is, you can’t solve riddles or arguments of this kind with linear thinking, let alone with Wikipedia (or God help us all, consumer pap like Medline). It’s like that truism about ‘the dose makes the poison’. Well, no. No, it doesn’t. The subject determines the dose. And often, the poison itself. And what about that human determines both the dose and the poison is usually multi-faceted…like…humans are. Simplistic what-if’s just don’t compare very well.

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