You hear about the failures.

The recovery industry is dominated by 12 step programs. These have yet to be proven effective. The nature of these programs like AA and their cousins make it difficult to design a scientific study of the effecacy.

but the 12 Step, faith based approach dominates the rehab industry . It does nothing to address underlying mental health issues like major depression, bipolar disorder, schizophrenia, borderline personality disorder, etc. When people have mental illness AND substance abuse, it's called "dual diagnosis" and it's hard as hell to treat.

There is a system called SMART Recovery that's based on Cognitive Behavioral Therapy techniques. You can go to groups and there are apps you can use, but 12 Step has a stranglehold on residential rehab.

could be quantified. So many people who are addicted have underlying mental issues they have been self-medicating for years. The meds for mental illnesses make them feel worse and the illegal drugs make them feel better.

Maybe if there was treatment for mental illnesses caught early, before people turn to illegal drugs, there would me more success.

One of my brothers was addicted to heroin about 20 years ago, he went to a rehab center and has been clean since he completed the program.

Kicking is a walk through hell. Best wishes on his continued recovery.

He takes his clean and sober day by day.

Anecdotally, my long-time barber was a junkie stripper. She went to rehab when she got knocked up 25+ years ago and has been clean since.

She's still a weirdo.

Has been proven to make you permanently insane, bipolar or schizophrenia, even if clean
I deal with many addicts users and ex
The ex addicts can be hard to manage

The potency of a drug is often related to how fast it is cleared from the body and how quickly it can reach its target organs. Methamphetamine is more able to get to the brain than amphetamine salts, and is eliminated from the body more rapidly.

One dose of a stimulant, or hallucinogen, or deliriant, is not going to "make you permanently insane". It may cause a stress response than exacerbates an already existing and otherwise controlled mental health issue.

I haven't heard anything about "super meth" and if it is an amphetamine or just a name for a drug that induces similar effects. It is really unlikely that one drug would cause "insanity" as there are so many flavors of it.

With regard mental illnesses like bipolar disorder or schizophrenia - they share delusional elements that may implicate the dopamine system (and therefore be directly activated by amphetamine), but schizophrenia is strongly genetic and usually exists prior to any drug use.

Them look it up!
P2 Super Meth
They banned ephedrine and started making it with a different chemical , P2. It can permanently alter brain chemistry

Phenyl-2-propanone methamphetamine. Looking at the structure, it does look like it'd be a good deal more active than amphetamine salts.

I'm going to read more about this - thanks for the tip.

I'm going to stand by my claim that single doses can permanently alter brain chemistry directly. It is more of a straw that breaks the camel's brain situation.

I remember drinking ephedrine iced tea during my early morning organic chemistry as an undergrad. Definitely got me to the gym after. I was very sad when they removed it.

I forget the titles He studied the crap out of it, and well written
That’s where I first read about it

And to the point of this thread he does describe effective treatment for drug addiction, specifically the synthetic opiates

If you're looking for science, look elsewhere than the 12 Steps. It works, if you work it, but it's not for everyone, like most things in life. Its record of treating a chronic, progressive, incurable disease isn't so bad relative to some other killers and their treatments. It's a social based cure, a fellowship if you will, and simply studying the books and journaling or wall-flowering meetings doesn't usually cut it for very long. However, I do get that for some folks that sort of thing is just incompatible with their nature.

When I was in middle school they brought in a former heroin addict to talk to us about using drugs. It really scared the shit out of me. I don't know if I ever would have used drugs, but his presentation really affected me. I do remember somebody asking him "how did you finally quit?" and he answered "by the grace of God".

I didn't take that to mean that he was necessarily religious but that its a very hard road if you take it.

AA worked for me 42 years ago and still going strong.....

Recovery never "just ends". It's a lifelong process.


There's several well-known people who will always be in recovery. Just right off the top of my head: Hunter Biden, Elton John, Eminem, Robert Downey Jr., Jamie Lee Curtis, Cherie Currie, Nikki Sixx, Marilyn Manson, Drew Barrymore, and John Goodman.


No one is immune from substance abuse or alcohol abuse. It can happen to anyone.


My understanding is that drugs like heroine can change chemicals inside the brain, both short and long term.


I hope this information helps.

as well as alcohol, cocaine, and methamphetamines can change reward circuitry in your brain, This is insidious because you are your brain, and what you think 'is the right thing to do' is an internal decision. When you screw with these systems, it becomes a lifelong battle to resist what amounts to self harm. Self harm is, kind of definitionally, an irrational behavior. But in an irrational mind, it becomes essential.

As a kid, I'd have a smoke sometimes outside of bars or whatever. 'Social smoking'. It was never enjoyable, I never got a buzz or relaxed feeling. It was subjectively a neutral to mildly unpleasant experience the dozens of times I did it.

To this day, I crave something I do not want. I know exactly what I feel like after I smoke, I know it'll make me feel gross, and yet there is this undying kernel of 'Damn, I could smoke now!'

It is a completely bizarre thing my brain is doing.

The weed and xanax? Those are because of Trump.

Can’t remember where I found it, but I heard an interview with Nick Reiner where he stated that he would dutifully go to rehab and get clean (presumably at the insistence of his parents), knowing that he would return to drugs again once he was released. Obviously, rehab won’t work if you aren’t committed to at least trying to make it work.

I guess Nick never hit rock bottom, until now. Now he has no choice in the matter. He’ll have to live with knowing he killed his parents without the drugs to help him escape that reality. It’s just so sad all around.

Some people can "flip a switch"- they were addicted out of boredom -it was something to do or was an interesting vibe at the time, and they've since found something more fulfilling or satisfying.

Some people replace one addiction with another. They're living for the dopamine hit or the adrenaline rush, no matter what. Also, they tend to be the "it's not my fault, it's the drug, or alcohol, or whatever".

Some people are addicted because they're self-medicating. Those people are often harder to reach, because not only has their brain chemistry betrayed them, they realize it and are living with shame and uncertainty of their condition.
Because seeking mental health is considered a moral failing in Western societies, especially in the US, and the way we treat mental illness has a lot of force the patient to take more responsibility for their quirks or failings than one would the average functioning person.
The drugs and treatments are supposed to make you normal, however, because you're on treatment, you're not supposed to have a bad day, or mess up. A patient in treatment is under more compliance stress than someone who self-medicates.

And many times, that stress to comply ("you're better now, why can't you just...." ) - or the casual way insurance or pharmaceutical companies treat psychotropics, randomly denying existing approval or just decide a shortage is okay for profits or whatever, will cause relapses. Which leads to the downward spiral back into addiction.

IIRC, the average is something like 8 times in treatment, either inpatient or outpatient, before the person with addiction is able to remain in recovery.

But there are miracles, or people who seek treatment early, and don’t have any co-morbidity that complicates their recovery, who stay sober.

It takes a bio-psycho-social-spiritual approach, including addressing mental health issues, trauma, lifestyle, friends, activities.

Metastatic cancer isn't something that goes away. You manage it and live your life with it, but it is always with you. You tame it with treatments, nuke the hell out of it with cobalt-60, and get immune therapies to better fight it yourself. It might even seem to go away, but a doctor would never say you've been completed cured because all it takes is one cell, somewhere, hidden away to return.

Physical addiction is a neurological and psychological illness. You fight it every day, and everyone's fight is different. People manage it, I guess, sometimes and become high performing addicts (I must submit that I might be one).

I suspect that very few people that go rehab are ever "cured" because I don't know if you can cure true physical addiction. It equips people with tools.

Many of these tools are cult-ish and psychological displacement. They replace one addiction (drugs) with another (church). But the underlying pathology remains.

To answer your question -- sometimes it works, sometimes it doesn't. When it doesn't work, we talk about it. When it does work, only a few people find out.

There are thousands and thousands and thousands of us. Maybe millions. People quit drugs every day and never go back.

But we’re not celebrities who overdosed. So we’re not in the papers.

and several relapses are often part of the process

Facilities can only assist people who truly want to change.

The person has to accept that they can't do drugs in moderation. It's all or nothing.

Also, because of the nature of the illness, I think it really does require a bigger mission or purpose that motivates the individual to stay on track (family, fulfilling a dream or leaning on a "higher power" ). A person who doesn't see the value in his/her own life won't necessarily be motivated to change.

My brother was an alcoholic. He was a part of AA for a long time. He couldn’t go 100% because…well he was Jake. He was sober for the last 20 years of his like.

It’s up to the individual and their expectations. Their expectations. From there it’s practice. Time. Repetition, even it’s NOT doing something.

It's not a "one size fits all" issue. There can be differences in insurance coverage's time a person can be in. I'm sure things have changed over the years since I worked at the mental health clinic, including with the MICA population. But it was cut from 90 days to 30 then, and a month isn't enough for many people.

In patient programs, including coordinating with family and/or community services, will differ. Every staff member is an individual with a specific skill level. Every person being admitted for care is likewise an individual, with a level of insight unique to themselves, with different goals, and different support systems upon release. Hence, outcomes range from recovery to utter failure. And even in recovery, a person with addiction is at risk of relapse -- for addiction is a disease with a significant relapse feature.

Many people benefit from participating in community support groups. Others do not. And there are those who quit without rehab, support groups, or legal problems. In my opinion -- whatever it may be worth -- the current list of drugs available to abuse or even use exactly as prescribed complicates the issue even more. Certain drugs alter the brain's functioning long-term, not limited to periods of use/abuse. For example, I worked with people who never carried a diagnosis before, who then have significant periods of cocaine abuse, correctly be termed bi-polar in recovery. Others do just as much, quit, and are fine.

While it is an individual thing, there are certain risk factors. These range from the age when one started "partying" to extended family patterns.

Great question! It brings focus to very real issues that confront our society.