drbanimahd

1.I am a categorical fan of Gabor Mate and pretty much in line with his approach and paradigm.

2/3. Flaw of character is a tragic deeply American approached fueld by many social and cultural roots. Talking points and data and succesful approaches? Please see the Portugal model, amongst others. I believe that addiction can be couched in a social context and the root of it is existential angst stemming from human isolation caused mainly from a capitalistic corporate approach to our lives.

Yes, I believe so. I believe we all have "the potential for addiction" and many of us manifest that propensity in different avenues. Much of it is hidden. I believe the root of it is an unhealthy community and social structure that we occupy.

Existential Angst: Where do I begin? Some short years ago I was proud to have gotten one of my young patients, BW age 21, to a reasonably safe place. He had been in over 30 programs and in meth psychosis when he got to us. 2 years later he was a different young man. The last year with us his insurance had even cut off. But he was now ready to go. Now what? How do I guide him towards continued recovery? What society was I to send him back into? What healthy society that I did not believe in was I supposed to advise him to adjust into? What tools did he have after 8 years of meth, heroin, benzos, and ETOH and more importantly, tools for what? Go get a job at 7-11 for 12 dollars an hour and be a good corporate citizen? You will barely sustain. No health insurance. Share an apartment with 3 others barely surviving with no end in sight! You will have no retirement, no hope for a better future for your children, and impending environmental catastrophe for icing on the cake!
Should I send him back to the broken home he came from? Should I tell him to spend endless mind-numbing hours on social media and continue to mistake this vacuous mind flattening engagement as real human engagement? Should I tell him to mistakenly get a bullshit certificate and call it education and push him into a debt he will never repay? Should he hyper-consume, watch staged reality TV, consume ubiquitous porn that destroys his sense of human connection even worse than social media? Should he watch the endless meaningless streams without a narrative on Twitter, spend hundreds to watch gladiators on UFC, or put his vote in for meaningless caricature candidates that will have no impact on the improvement of his life? Wait, should I send him to the local mega-church that has nothing to do with the Abrahamic tradition but deeply wrapped up with everything I am telling him to run from? Maniacal and false sense of hope, magical thinking, cognitive dissonance, and eventually bigotry and hate?

It looked to me that I was sending him into what I thought caused his addiction in the first place. Addicts: too sensitive for their own good. They smell the bullshit and hopelessness of it all and run into the warm fuzzy embrace that seems to them, the last haven of honesty. They are rebels in protest but chose the wrong tool. Then, they wake up and see this crap was bought and paid for just like the rest of it.

This is existential angst. In short anyway! This is what I am fighting.

Hope this helps.

Yes. Absolutely. In fact, The most basic sugars are the most addicting. Looking at WHO statistics, they cause more mayhem across the planet than almost any other thing. The American corporate structure fueled by greed and the need for profits is a large culprit. Addiction is everywhere.

I usually advise patients to taper. Also, just the fact that I engage with them regarding quantity and the health consequences seems to have a therapeutic effect. Not very different than some of what I do with the classical substances of abuse.

Dr. B's assistant here.

We originally made posts on various subreddits to just announce the AMA and increase awareness but people started asking questions and Dr. B decided to respond to them anyway. Then we started getting more questions until we decided it prudent to make this thread early to consolidate and not have 10+ posts of questions.

Our sincere apologies for creating this post early and Dr. B being unavailable to answer, but I promise we will get to all your questions first thing in the AM (PST)!