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Old 03-30-2018, 11:19 AM   #208 (permalink)
StevenSlate
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Join Date: Mar 2018
Posts: 36
I do not believe physical dependence constitutes "addiction", and even NIDA agrees with me on this point. There is ample evidence that physical dependence does not force people to continue using - it forces them to endure physical withdrawal symptoms when they to stop using. There is a difference. Countless millions of people have gone through opioid withdrawal without seeking more opioids, including many deemed "addicts." I myself fully withdrew more times without detoxification treatment than with it. Many heroin "addicts" have had that experience. So, I don't think that paints me into a corner.

Regarding whether it's dangerous to tell people that "loss of control" doesn't exists, and that there is plenty of research demonstrating that former "addicts and alcoholics" are capable of moderate use, let me offer this counterpoint: even when people attend treatment programs where they are told in no uncertain terms that moderation is impossible, and that if they ever touch an iota of drugs or alcohol it'll be a disaster - about 2/3 of people "relapse" after receiving that message. I could just as well say that telling people they can't moderate is dangerous. After all, plenty of people die while trying to remain abstinent and failing to do so. I hope we can just agree to disagree on this.

Many observers seem to think that in TFM we're giving people "permission" to moderate. We're not and we can't give permission or forbid anything to anyone. When it comes to illegal drugs, people are already forbidden from possessing and thus using these substances - they already do it without permission. They already go back to using after treatment programs that tell them they can't. Permission is irrelevant.

None of this is to press the point that people should moderate - again, I'm not in the business of recommending moderation. But TFM method is to give people the facts, and let them choose. You really can know that moderation is possible, and also know that you'd rather be abstinent. There is evidence that people are more successful and more committed when they choose their own substance use goals amongst the options of both moderation and abstinence. I respect JeffreyAK's point that you can be at peace with knowing you can't do something too, even though I disagree on whether "addicts" can or can't moderate. I think that frame makes more people feel deprived though, and again, I hope we can just agree to disagree on that.

I won't discuss moderation any further as it seems unwelcome. I just hope I stop being prompted to respond to points about moderation.

TFM is designed to help people find the options that they're happiest with, to feel good about the changes they make, and empowered to improve their lives.
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