Withdrawal from opiates is a pretty trivial condition

Screen Shot 2014-06-22 at 12.38.48— certainly by comparison

with illnesses which most of us have experienced, or by comparison with withdrawal from other drugs.

Research has shown, says Dalrymple, that

medical treatment is not necessary for heroin addicts to abandon their habit, and many thousands do so without any medical intervention whatsoever.

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  • Richard Celine  On February 27, 2018 at 03:55

    Seemingly arguing from a position of fundamental ignorance, Theodore wholly misconstrues the physiological effects of opiate addiction and doesn’t understand the true impact withdrawal can have on an individual’s health and wellbeing. It’s a tragedy that this lack of understanding underpins this political point scoring which hinders the adoption of the best social and health policies.
    It’s true that acute opiate withdrawal, whilst very unpleasant, very rarely is fatal (in stark contrast with alcohol withdrawal). But, focusing solely on the acute phase of withdrawal misses the key features of opiate withdrawal and their significance to health and wellbeing.
    A long term opiate addict is likely to suffer chronic and debilitating physical and psychological effects that can persist for years, following a period of brief acute withdrawal symptoms. Chief amongst these ill effects is a condition called Anhedonia, which describes the physical and psychological inability to feel to derive pleasure or achieve any sense of satisfaction / fulfilment from all social and physical activity including basic acts of biological necessity such as nourishment and sleep. To realise the profound significance of this condition it’s necessary to understand the central role hormones and endorphins play in managing human physiology: the pain and reward cues we receive in response to external stimulus are of crucial and unique importance to living a healthy life. Long term opiate use at first dampens and then ‘switches off’ natural endorphin production; when an opiate addict goes into withdrawal their pain and discomfort is primarily caused by the absence of dopamine and serotonin. Long term opiate addiction, involving increased tolerance, will likely result in a chronic inability to biologically produce endorphins.
    Sure, as Dalrmple argues, acute heroin withdrawal is not fatal and although painful and uncomfortable can be overcome with perserverance – most people can tolerate 7-12 days of discomfort and anxiety if they know the experience won’t go on forever.
    But this isn’t the crucial point,… the important aspect of opiate withdrawal concerns chronic (in some cases lasting several years) depression, insomnia and Anhedonia: psychological issues with direct biological / physical causes which result from the physiological effects of long term opiate use. It’s well documented that people with mental health issues have a markedly lower life expectancy and can expect to suffer many years living in ill health.
    Heroin abuse and withdrawal may not be seen as the primary cause of death; but indirectly it is the most significant factor in the poor health and early deaths of addicts and ex long term addicts.
    The relationship between mental health and substance misuse is complex and involves a variety of interrelated social and biological issues, the relationship of which provokes much controversy and debate. Dalrmple in casting addiction as purely a moral and spiritual failure, is guilty of throwing the baby out with the bath water by ignoring all biological and physiological factors.
    The strength of the link between mental illness and addiction is widely accepted having been the subject of substantial research over the past 70 years.
    By ignoring this research Dalrymple is being willfully ignorant; his argument is purposefully disingenuous to make a political point.

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