Violence

[de_budding]

My thanks are for the above post, it just looked far more amusing on the above, above post; you speak for me .

Well I realise now that earlier in the thread how eager I was to define a social-badness causing pressure and therefore violence/unhappiness. But that same pressure- perhaps the same one that doesn't allow our heroin junkie love, is also wrongly subject to the good/bad dichotomy. It's not good now, I'm not that slow, it is just 'more positive'.

Dan.

[Didymos Thomas]

Until you can master your immature contempt for all things rational, the access to the acquisition of understanding will escape you.

Cute. In response to my reasoning you say I have contempt for reason. Oh, if you could only make sense for a few minutes. Your diction is no substitute for thought, and does not confuse anyone. You've made a fool of yourself chopping medical definitions for your own purpose - I really shouldn't be surprised that you have no interest in an evaluation of your claims. Hollow claims that they are.

Drugs tend to make the user peaceful; cocaine, marijuana, opiates, amphetamines all promote states of being that tend not to incur violent acts.

I agree with your point that it is not the drugs but the person who is responsible, but come on! Amphetamines promote non-violent behavior? Cocaine? This is divorced from reality. These drugs tend to elicit violent tendencies, and are terrible drugs for it.

[Doobah47]

My only reference was myself and my own experiences.

In fact the drug I've taken that induces the worsrt of violent emotions is heroin, crack cocaine leaves the user slightly beligerent and a bit short tempered but heroin actually induces real violence (although the user probably cant stand up to hit anyone, if they could I think you'd see what I mean).

The worst drug vis a vis violence is (imo) alcohol.

Of course now I've taken to the straight and narrow, and enjoy not much more than strong cigarettes and apple juice; so I do recognize that an addiction to drugs is certainly detrimental in some ways, but I also recognize that all the hype about cocaine and heroin being difficult to give up is nonsense - the real difficulty is extracating oneself from a social circle that deals with such drugs. Giving up drugs is all about a simple cognitive development, extending a receptor or neural pathway to bypass the addiction to drugs, it's straightforward stuff - but then my addiction to 'hard' drugs (for about 1-2 years) was an endeavor centered and engaged in being by my self, if all I did was smoke crack and talk to street scum, then take heroin with prostitutes in squats I may well have found quitting a bit more difficult.

[Didymos Thomas]

My only reference was myself and my own experiences.

In fact the drug I've taken that induces the worsrt of violent emotions is heroin, crack cocaine leaves the user slightly beligerent and a bit short tempered but heroin actually induces real violence (although the user probably cant stand up to hit anyone, if they could I think you'd see what I mean).

It's all circumstantial. Addiction and withdrawal seem to be a particularly significant factors. I believe you about heroin, though.

The worst drug vis a vis violence is (imo) alcohol.

And I would bet the statistics show it to be the most related to violence.

Of course now I've taken to the straight and narrow, and enjoy not much more than strong cigarettes and apple juice; so I do recognize that an addiction to drugs is certainly detrimental in some ways, but I also recognize that all the hype about cocaine and heroin being difficult to give up is nonsense - the real difficulty is extracating oneself from a social circle that deals with such drugs. Giving up drugs is all about a simple cognitive development, extending a receptor or neural pathway to bypass the addiction to drugs, it's straightforward stuff - but then my addiction to 'hard' drugs (for about 1-2 years) was an endeavor centered and engaged in being by my self, if all I did was smoke crack and talk to street scum, then take heroin with prostitutes in squats I may well have found quitting a bit more difficult.

Hey, I've met people who have gone through all sorts of terrible addictions, never giving up marijuana years and years after their earlier battles. Different drugs influence people differently. But again I agree with you. The chronic use of drugs is much more than some hold the drug has over you. The real problems are social, and other more deeply rooted psychological problems, the ones that probably make people more likely to use drugs in a chronic and destructive way in the first place.

[Doobah47]

To me it seems that there are two fields of drug user -

1. Somebody who wants something akin to a comfort blanket, perhaps using the drugs as a form of escape, maybe has a routine drug ritual where they listen to music/draw/cry/dance in order to aleviate their ills.

eg - painkillers

2. Somebody who wants to enhance their performance, or feel stronger or maybe after 10 years on heroin feel 'normal'.

eg - anabolic steroids

I'd say that most drug users belong more distinctly to a specific category, but they do jump the fence or maybe transfer from one to the other (like boredom -> dependency).

We can also take this rather obtuse dichotomy and by analogy use it with violence - the escaping reactionary instinct versus the improving status/influence/etc relative to the status quo. I think if we were to talk in psychological terms we could say that the first would respond to medication, the second to counsel or a change of doctrine. Of course the pair are not alien to each other; often people are in a position of feeling peer pressure to engage in violence yet they still react with instinct when situations arise - although we can say that had they not have felt the peer pressure they might well have not reacted in a violent way.

So my feeling is that instinct should probably not be medicated (we don't know what evolutionary course might occur if we do medicate primal instincts), but doctrines and peer pressure should be counseled in order to change by societal values the reactions people make.

[Aedes]

Originally Posted by Doobah47

To me it seems that there are two fields of drug user

There's a lot more than that. Think about 'dual diagnosis' people, who have both substance problems AND a primary psychiatric disorder. I'm not sure statistically how it breaks down, but a HUGE proportion of habitual users of drugs (whether street drugs or inappropriately used / prescribed medical drugs) are NOT normal at baseline. They have schizophrenia, depression, bipolar, PTSD, whatever.

Originally Posted by Didymos Thomas

And I would bet the statistics show [alcohol] to be the most related to violence.

I believe you are correct, though of course there is quantitatively much greater alcohol use than cocaine. But I've seen clinically what cocaine can do to people, and it isn't pretty (and that includes but is not limited to violence).

The chronic use of drugs is much more than some hold the drug has over you.

With tobacco being the case in point. It's EXTREMELY physically addictive, but often the habitual use is harder to break than the chemical addiction.

The real problems are social, and other more deeply rooted psychological problems, the ones that probably make people more likely to use drugs in a chronic and destructive way in the first place.

Absolutely correct.

[Doobah47]

Originally Posted by Aedes

There's a lot more than that. Think about 'dual diagnosis' people, who have both substance problems AND a primary psychiatric disorder. I'm not sure statistically how it breaks down, but a HUGE proportion of habitual users of drugs (whether street drugs or inappropriately used / prescribed medical drugs) are NOT normal at baseline. They have schizophrenia, depression, bipolar, PTSD, whatever.

What I said is grounded in fact, and I did make clear that people jump the fence.

My addiction to cocaine was grounded in the desire to do something, so I took cocaine and used the computer to play games/philosophy/music, but I also enjoyed the after-effects as a kind of comfort.

I have a 'psychiatric disorder' (psychosis/manic depression) and I find that both fields are applicable to me, one after the other or both at once.

Take it as an example of the uselessness of dichotomy...

Although I would say that my dichotomy is stupidious, at least it demonstrates two primary causes of drug addiction, which are grounded in experience, epistemology and language. The dichotomy is not grounded in what people say about their drug addictions, it is grounded in what they can't say - the ineffable. We don't have words to describe depression or schizophrenia beyond mere identification of obvious symptoms, perhaps we should or perhaps we shouldn't, I don't care either way; but what I do care about is the uselessness of a dichotomy.

The real problems are social, and other more deeply rooted psychological problems, the ones that probably make people more likely to use drugs in a chronic and destructive way in the first place.

That is a point I entirely agree with, however there are many cases of people using drugs and curing societal/psychological ills; take alcohol for example, a person is incapable of talking to the person they love about real serious problems yet when drunk they can express wilfully everything that is wrong, or tell the person about their love for them etc. Apparently (so I've been told) Ketamine is a worthy cure for depression, or cocaine is a way to adjust oneself to be less susceptible to being led astray (through beligerence and self-interest combined to cause a notion of oneself and one's own style of life - knowing thyself as it were), or like I said before alcohol as a cure for shying away from expression. So I think that a major problem for the discussion of drugs/violence/psychology is the innate dichotomy found in many languages - who could determine whether a psychosis is destructive, sure there is structure in the madness but I believe that neither con- nor de- really explain the situation.

[Aedes]

Originally Posted by Doobah47

Take it as an example of the uselessness of dichotomy...

It's not useless clinically, because different diseases can require different treatments. Alcoholism has a life-threatening withdrawal syndrome (delirium tremens), for instance, so there MUST be a detox in heavy alcoholics -- and this is different than the therapy for say biopolar disorder (which involves both medications and cognitive-behavioral therapy in the ideal scenario). So a patient with alcoholism AND bipolar disorder needs to have both diagnoses established so that they can be treated appropriately.

On the other hand, you're correct that being a 'splitter' and not a 'lumper' forces people into diagnostic categories and can sometimes prevent them from being treated holistically. And this is why dual-diagnosis psych/substance programs are so valuable, because they treat the psychiatric diseases, the substance use, and the patient's life circumstances all with one another in mind. And the outcomes are better that way.

We don't have words to describe depression or schizophrenia beyond mere identification of obvious symptoms, perhaps we should or perhaps we shouldn't, I don't care either way; but what I do care about is the uselessness of a dichotomy.

Well, it's a practical problem, not a semantic one. I can diagnose someone with HIV with a blood test that has a certain positive and negative predictive value. But for schizophrenia or depression we need to use diagnostic criteria based on observing and interviewing the patient to make a 'syndromic' diagnosis. This can lead to overlapping and somewhat artificial categories.

On the other hand, this practice is necessary. It's the only way we can actually study psychiatric disorders in order that we can develop or offer treatments for them. And it's ok anyway since medical therapy for psych disorders is symptomatic and not causal. So irrespective of diagnosis, we know that anxiolytics are effective for anxiety symptoms and antipsychotics are effective for paranoia and auditory hallucinations -- so eliciting these symptoms IS useful.

[Doobah47]

Fair enough one can identify dichotomies in the negative/positive outcome of an HIV test, although of course there is possibility for a mutation that is identical in practice but under the theory of a test is not identical.

But I see a problem in the dichotomy for example that drugs are either destructive or constructive, or the same for a psychosis, and other things - the inference that my example incites is that 1 is detrimental to progress and 2 is beneficial - like you said the dichotomy is unsatisfactory, yet if this is so then why should there ever be a dichotomy in such queries? We can have fairly clear distinctions in objective circumstance (there either is x or there isn't x), yet in moral/subjective circumstance we cannot have a satisfactory useful dichotomy (although there might be a use for dichotomy in counseling issues, it is not really satisfactory).

This boils down to the issue of legality of drugs/violence. The question being is drugs/violence an objective or subjective issue... the answer being that a dichotomy is unsatisfactory. A paradox.

Another question would be do you see any similarities between the swings of depression, the swings of bi-polar disorders, the swings of psychosis and the swings of an 'aggressive' person? The inference of the question is whether there is such an illness as 'aggression', or whether it is some kind of 'human condition' that does not exactly qualify as a 'disorder' as such.

[Aedes]

Originally Posted by Doobah47

Fair enough one can identify dichotomies in the negative/positive outcome of an HIV test, although of course there is possibility for a mutation that is identical in practice but under the theory of a test is not identical.

In principle any new diagnostic test is mathematically evaluated for four basic parameters: sensitivity (ability to exclude false negatives), specificity (ability to exclude false positives), positive predictive value (ability to capture true positives), and negative predictive value (ability to capture true negatives). There are other statistics as well that need to be run, but the point is that NO test is perfect -- but we always need to know a test's limitations and evaluate that against our suspicion.

But I see a problem in the dichotomy for example that drugs are either destructive or constructive

But public health policies always have the possibility of excluding individual benefit. Demerol (a narcotic painkiller) has been taken off the formulary at many hospitals because it has terrible side effects -- but it STILL works well for some people. It's just that we'd rather have alternatives like morphine or hydromorphone used instead 'cause they're safer. And while cocaine might be very useful for controlling nosebleeds and, and while methamphetamine may be useful for helping a tired truck driver stay awake, the public health implications of a free-for-all unregulated policy towards these drugs are such that the individual benefit is outweighed by the individual risk and the societal risk.

Another question would be do you see any similarities between the swings of depression, the swings of bi-polar disorders, the swings of psychosis and the swings of an 'aggressive' person?

I'm not a psychiatrist, so I can only answer this so well. But there are such things as schizophrenia with manic features, bipolar type schizoaffective disorder, and bipolar disorder with psychotic features. And something like 25% of people with major depression actually have undiagnosed bipolar disorder (don't quote me on that percent, but it rings a bell). A psychiatrist would have to tease them out, of course. But I think someone who stays up all night writing philosophical treatises or doing math equations and is restless and energetic and grandiose has pretty typical manic features; whereas someone who is doing all this stuff but the newspaper is talking to him or who is paranoid or who hears voices has psychotic features. It's not as simple as 'aggression' -- because you need to put it in the right context. But hey, there are schizophrenics on mood stabilizers and there are bipolar patients on antipsychotics -- it just depends which features predominate.

The inference of the question is whether there is such an illness as 'aggression', or whether it is some kind of 'human condition' that does not exactly qualify as a 'disorder' as such.

Well, also remember that something isn't a psychiatric disorder until it interferes with normal functioning in life (loosely defined though that may be). We ALL get depressed or bereaved from time to time, but we DON'T all have major depressive disorder. Humans can be aggressive in sports, war, arguments, whatever. But normal human behavior restricts aggression to a reasonable context. So excessive aggression that interferes with life may indeed be the result of an underlying psych disorder, or substance-induced disinhibition, or whatever, rather than being simply a variant of normal.

There's a point at which normal transitions to eccentric and at which eccentric transitions to disordered. It's not always clear, but our object is to help people, so we make diagnostic categories that are most likely to capture the right people.