Rapid Detox
December 7, 2001 7:09 AM   Subscribe

Rapid Detox "In the world of addiction medicine, no technique for treating heroin users has ever been more controversial" According to the article, in the US, 980,000 use heroin, 175,000 are enrolled in government programs receiving daily dose of methadone, and only 1,000 rapid detox procedures are done a year. "Patients want it" Dr. Gevirtz says, "because it gives them a compassionate and comfortable way to get clean." Shouldn't they get it?
posted by Voyageman (19 comments total)
 
See this thread. I have mixed feelings about the quick detox route. NA is the most sucessful method of staying clean. (I would elaborate but I am studying for law school exams!)
posted by anathema at 7:47 AM on December 7, 2001


Shouldn't they get it?

Did you not read your own article?

"Many doctors say that until more research is done, rapid detox, which costs from $3,500 to $8,000 and is usually not covered by insurance, is too risky. And, they say, unless strong measures are taken to keep patients from returning to heroin use, rapid detox, even if it is safe, may not be worthwhile."

Or were you suggesting that the medical establishment wants people addicted to heroin to stay that way?
posted by techgnollogic at 7:51 AM on December 7, 2001


Do they really need it? Addiction: The Analgesic Experience

Addiction is not a chemical reaction. Addiction is an experience — one which grows out of an individual's routinized subjective response to something that has special meaning for him — something, anything, that he finds so safe and reassuring that he cannot be without it.

—Stanton Peele & Archie Brodsky, Love and Addiction

Peele did the study for the US Army on heroin users in the military during the Viet Nam War--one of the more interesting things he found out was that type and severity of withdrawal symptoms varied not only by individul but by unit--implying that withdrawal, like addiction, involves expectations and learned behavior.

Is this a costly waste of time and medical resouces? How much are they charging for this comfort and compassion?
posted by y2karl at 8:05 AM on December 7, 2001


Several years ago, a professor of mine told me about taking part in a marijuana study conducted at Harvard back in the 1960s. The subjects were divided into users and non-users. What the scientists discovered was that those who had never used marijuana before could not, in fact, get high (or stoned, I suppose) on it; those who already had the habit could. They concluded that, at least in the case of marijuana, users had to learn to respond to the drug.
posted by thomas j wise at 8:20 AM on December 7, 2001


Why is the article laid out like that? That's the most obnoxious thing that I've ever seen.
posted by Harry Hopkins' Hat at 8:28 AM on December 7, 2001


This is a comprehensive site collecting scientific data on addiction. I think that there is some learned behavior involved, but I believe that addiction is a disease. Science is certainly telling us the same.
posted by anathema at 8:32 AM on December 7, 2001


Science is certainly telling us the same.

Science
is telling us no such thing.

Opinions differ, let us say--Your beliefs are not facts. There is a great deal of debate among the experts. I'm being lazy, citing only Peele here but he's cogent and coherent and I have an appointment.
posted by y2karl at 8:52 AM on December 7, 2001


Ummm, I'm sure researchers have attempted to deal with this rather obvious issue, but why would anyone want to make it easier to kick heroin addiction?
Isn't the prime deterrance to trying heroin that its very easy to become addicted and very dificult to become unaddicted??
posted by BentPenguin at 10:43 AM on December 7, 2001


Isn't the prime deterrance to trying heroin that its very easy to become addicted and very dificult to become unaddicted??

I'm sure that is a deterrent, but it doesn't seem to stop a lot of people.
posted by kindall at 10:54 AM on December 7, 2001


It's no more easy to get addicted to heroin than it is to cigarettes. The first several times you use either of these drugs, the body rebels. You get sick. You may puke. There is very little positive reinforcement in the physical sense. You have to work to accustom your body to these drugs. You have to struggle against your own body to become habituated. Once you've got the habit, you have to want to break it. Once again, it's work. No one can do it for you. There's no magic bullet to make it go away. The sooner you stop whining and stop taking the drug, the sooner you'll get it behind you. Addiction is not a disease. It's something you do. And it's something you can stop doing. Now. If you want.
posted by Faze at 11:26 AM on December 7, 2001


From what I've been told, some wretch horribly the first time or two, but even then, the high is terribly seductive.

Its like having your spinal column wrapped in soft cotton balls -Kieth Richards

And while the speed of addiction might be the same between cigs and H, the costs are very different. Smoke a butt, go back to work. Sniff or spike, and you're out of commission for hours...
posted by BentPenguin at 11:57 AM on December 7, 2001


They have a similar program for coffee. You can have my Sumatra when you pry it from my cold, dead fingers.
posted by adampsyche at 12:18 PM on December 7, 2001


From the coffee detox program: When our love for caffeine is greater than taste, we may yield to the dark side of cheap gut-wrenching coffee to get our fix.

Just one of many, many hilarious sentences you'll find in that piece. The worst part about caffeine addiction is not that you need to consume more and more to get a buzz; oh, no, the worst part is that you might be tempted to consume inferior-quality coffee! The horror!

I'm addicted to caffeine myself, albeit in the form of soft drinks (I drink coffee like once a month), and need to give it up soon. Probably do the cold turkey thing over the holiday. I'm going to be one cranky bastard for a few days, or crankier than usual, anyhow.
posted by kindall at 1:08 PM on December 7, 2001


Coffe drinkers's methadone pills. They work.
posted by Voyageman at 1:26 PM on December 7, 2001


The sooner you stop whining and stop taking the drug, the sooner you'll get it behind you. Addiction is not a disease. It's something you do. And it's something you can stop doing. Now. If you want.

Well, you are projecting a fairly no-nonsense attitude towards heroin addiction and it's effect on those who take it. I'm not sure I see the point. I feel pretty sorry for the nightmare that some people are in when they are addicted to heroin. My pity won't help them, but neither, I believe, will your "if you really want to, you can get off it" slap in the face approach. A lot of people keep using heroin initially because It makes them feel good about themselves. Blaming them, will often just make them recede further into their addiction.

Everyone is different. I have heard stories about people who can stop taking heroin fairly easily "a friend of mine did it over a weekend" kind of story. But obviously, the thing about these stories, is that they stay in your memory because they are unusual. Like the "my Grandpa smoked all his life and lived to be 98" story. What do they tell us really except that there are exceptions to any rule.

I expect that for the most part, being addicted to heroin is pleasant at first, then devolves into being something that you do just to try and feel "normal" That it is indeed a very difficult "habit" to kick.

Perhaps Rapid Detox does work but that's not the whole story. We need to know what percentage of users backslide into using again. Also, on a societal level, we need to change some of our attitudes towards drugs. The best way to "fight" them, may well be to consider making them legal, at least for those who already have a habit and to legalise injecting rooms.

I certainly don't agree with this point of view-

"We don't need this approach. We have several good approaches, and this one is a waste of money."

I don't think that this should be about money, but about results.
posted by lucien at 2:53 PM on December 7, 2001


I expect that for the most part, being addicted to heroin is pleasant at first, then devolves into being something that you do just to try and feel "normal".

Isn't that pretty much the way all addictions work, and therefore why it's so difficult to break an addiction?

I certainly don't agree with this point of view-

"We don't need this approach. We have several good approaches, and this one is a waste of money."

I don't think that this should be about money, but about results.


Well put. What may work for one may not work for another. To be serious about helping people out of addictions, I think it would make sense to consider all possible avenues.
posted by mr_crash_davis at 3:42 PM on December 7, 2001


Isn't the prime deterrance to trying heroin that its very easy to become addicted and very dificult to become unaddicted??Well, no: The main deterrance is that it's against the law. Just like weed and a few other substaces/lifestyle choices, it's against the law, therefore it's bad, blah blah yada yada. It's the tax revenue and political donations that keep tobacco and booze legal, not that they are less destructive. My best friend is ex Horse addict, his wife ex Crack gal and they kicked successfully, but get this: They can not quit smoking tobacco!
posted by Mack Twain at 5:58 PM on December 7, 2001


Detox doesn't suddenly break the psychological addiction or cure the addictive personality. Its simply the reaction of no longer getting a drug. What matters is after detox. Detox is not getting "clean."

Of course addicts would prefer to slide to methadone, the addictive mechanism is still there and the psychological need to take a drug that makes you low gets fulfilled.
posted by skallas at 6:18 PM on December 7, 2001


y2karl-I am certainly not opposed to the "learned behavior" argument. But, I do think research is leaning in another direction. It also bothers me that Peele cites himself so often. I'm going to try to find more sources to support what you are saying.
posted by anathema at 7:06 PM on December 8, 2001


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