Everything you think you know about addiction is wrong
 

Wow - outstanding Ted talk! ♡

https://www.ted.com/talks/johann_har...ge=en#t-860422

(thanks to fionamccarthy for referring to this in an earlier thread)

They do have some pretty strange programs for addiction out there. The example he referenced with the women and the shaming T-shirt’s they had to wear reminds me of this program in the 90s, not sure if it’s still around, but it was this “tear you down to build you up” type of thing , where they would basically destroy someone only to “build them back up”. A more recent one I saw was some of these “work” rehabs where they basically are using people as free labor:

https://www.google.com/amp/s/www.rev...en-plants/amp/

I don’t really agree with him regarding his take on the actual physiological effects of addictive substances (or lack thereof, as he’s implying)though. I do believe that plays a role, and has been an issue since as far back as recorded his story shows:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202501/

Not sure where in the world people are located, but I’m in the States, and it makes me cringe when people take what’s going on in a small, homogeneous country, like Portugal, and try to apply it to a place like the United States. I remember there was so much buzz going around about how the Mexican /South American drug cartels were going to lessen/ disappear once pot became legal in the US. With something like 80% of their countries income coming from the drug trade, all it did to the cartels with certain states legalizing it so far, was create a shift in their business model. Now they are pushing more crystal meth and heroin/ fentanyl (our pushing of / and not adequately educating the public on, how quickly a person can become addicted to such things, prescribed by a doctor or not, factors in too, as well as various other cultural influences), and selling to minors and in areas where pot shops were voted down instead (where it was legalized). One of those things where you pull a weed and think it’s going to take care of a problem, but 5 others weeds grown back in its place.

I don’t know, it seems to me that so much is profit driven, including Rehabs. You can grow up in the best environment on the planet, but the truth is, there is money to be made, and anyone can be a potential customer. If you grew up in poverty or abuse, or some other dysfunctional environment, the cards are even more stacked against you. And as much as I agree that there is no one size fits all approach that works for everyone struggling with addiction, I do believe all kinds substances (street drugs, prescription, alcohol..) have the potential for addiction, that piece of it is really important. Other factors come into play too, but I’m not sure if it’s helpful to gloss over or minimize that piece of it?

Whenever I hear that "we're big and complex and it can't possibly work here" I always think why not? What is specifically about the US that would stand in the way of replicating the solution in a smaller country like Portugal? It's not like there's anything scaleable about the solution of changing the emphasis from prohibition and policing to decriminalization and treating it solely as a health issue? The cost of policing and housing drug criminals is astronomical already. And he is absolutely correct that once you give someone a felony conviction, it's nearly impossible to find employment in the corporate sector at any level other than entry level.

I don't think that the speaker was saying that physical dependence isn't a part of addiction. My own experience was that withdrawal was a barrier to stopping, but medical intervention handled that part of the problem pretty handily. It's just that keeping people from being exposed to addictive substances as a means of prevention simply doesn't work to solve the problem.

I don't believe that our 12 Step centric rehabilitation is a solution for everyone either, but it's so entrenched in our rehab systems and criminal justice system that often it's the only game in town. I have no issues with 12 Step as a continued sobriety method, it works for many people, but it also DOESN'T work for many people, myself included. The per-profit motive isn't inherently a problem, but what I think IS a problem is the lack of standards and accepted protocol to open and operate a rehabilitation and/or sober living center.

^They still have policing, and drugs are still illegal in Portugal, they just decriminalized possession if it’s a under a certain amount. Traffickers, dealers, and growers are still dealt with from a criminal standpoint. I don’t agree with dealing with petty drug crimes as a criminal issue here in the states, either...

...However, we don’t have a strong foundation of socialized public healthcare like Portugal does, though. Not just the healthcare system, but our government is different, we have a much larger population, and also our culture and underground criminal scene is different. Not sure how it would play out in real life if we tried apply here, what they are doing there?

I think too many look for one single answer or strategy to many issues & problems. Addictions and recovery would be no different.

But until the addict or alcoholic actually wants to change I don't see much working well enough to be 'the' solution. I'd say that be a factor that must be present regardless of approach.