http://blogcritics.org/ A sinister cabal of superior bloggers on music, books, film, popular culture, politics, and technology - updated continuously. en Copyright 2002-2006 by the authors Sat, 11 Oct 2003 19:27:28 EDT http://backend.userland.com/rss Blogcritics.org custom software http://blogcritics.org/archives/2003/10/11/154138.php#comment-22917 The Dutch have a system by which opiate addicts -- chiefly heroin -- are given, potentially perpetually, maintenance doses of their drug. They are able to manage family and social lives; and in most cases work in some capacity. Addiction isn't usually about cost/benefit analyses: it's about missing the last turnoff before the interstate. Once you're there the pain of quitting often outweighs the reality of declining health. Cost/benefit analyses are the sort of calculations recreational users make. If I go out Thursday night, I'll have a great time; but I'll have to work all day with a monster hangover. That being said, addiction medicine today is a joke. Most contemporary inpatient programs are loosely based on the Hazelden model, which required a minimum 30 day stay. Now insurance puts you out after 5 day medical detox; 3 if they can get you fully ambulatory in that time. And substance abuse patients are housed and treated on the same wards on the same schedules as psychiatric patients. Thirty years ago most rehab patients were doomed before they checked in; now it's almost all of them. ]]> 22917@blogcritics.org Sat, 11 Oct 2003 19:27:28 EDT http://blogcritics.org/archives/2003/10/11/154138.php#comment-22904 Thanks MD - excellent, clearheaded, and somewhat troubling look at the situation. I think most addicts/users are too self-deceptive to even consider the rather stark nature of the cost/benefit analysis going on inside their heads. ]]> 22904@blogcritics.org Sat, 11 Oct 2003 17:18:17 EDT