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I don't think it would be nice nor kind for drug addicts if we seriously started discussing drug addiction as a disease. Today we think diseases are treatable, but that is because the usual meaning of the word covers diseases caused by pathogens and relatively similar set of causes which the Western science can treat. Viruses that previously killed multitudes have been eradicated with vaccinations. Many of cancers can be fought and occasionally dealt with with surgery, radiation and chemotherapy (made possible because of the antibiotics). Even HIV can be managed with antiretrovirals. Common thread to all: sick individual receives treatment and is treated to effect they he or she is cured, gets better and regains functionality.
As evidenced by the growth of the problem of drug addiction, there is no equivalent of penicillin for addiction. If addiction is a disease, the medical science of addiction is at the level of the medicine of biological diseases in the 18th century or early 19th century: doctors often can recognize the disease you have, there is a scientific name for it, there are procedures to manage it, but professionals are in dispute how they work and which treatment works better than other, because none of them obviously and easily cures the patient or prevents its spread (the way antibiotics cure and vaccinations prevent). The methods that sometimes work often are radical, crude, painful, and often focus on preventing spread of the disease because the individual very rarely can be cured.
You get a wound that that is likely to become infected and septic? The treatment is amputation; there is a profession that is very skilled at removing your limbs quickly and efficiently, but it will be a painful operation and limit your functionality permanently. You catch leprosy (or a skin disease that looks like one)? There is no treatment, the public health officials will do their best to ship you to to a remote colony isolated from rest of the society, for life. Tuberculosis? You are encouraged to be shipped to a remote sanatorium isolated from the rest of the society, which can be a rather nice place if you are rich, but the treatments are no cures and you will eventually die there. Later revolutionary treatments include exposure sunlight and nutrition (which helps vitamin D intake, which may marginally help) and collapsing affected lung (possibly limiting spread of disease to other organs). Public health officials are concerned with sanitation to prevent spread of the disease.
There are reports that Ozempic allows people to unhook to other stuff that they are hooked to - not only food. Like gambling. Chances are that probably we are somewhere in the neighborhood for penicillin for compulsive behavior.
It is left to the reader to decide whether this is good or bad thing and in what kind of jolly anti-utopia we will put ourselves into.
Scott offered a teaser for a forthcoming post about GLP-1 receptor agonists as a treatment for addiction. I very much look forward to reading that when it drops.
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I have also seen these reports and man, I have trouble thinking that this stuff isn't fundamentally hollowing out people's humanity in some meaningful way. I can see that being a good tradeoff for people that are destroying their lives with food, booze, or gambling, but eliminating cravings seems almost synonymous with dampening drive and joy.
As someone who used ozempic for aesthetic weight loss... It's pretty insane. Cured my nicotine habit and brought my borderline alcoholism to maybe one-drink-a-week.
It also killed my libido. I've not heard much about that as a side effect, but a model where it works by just shutting down pleasure circuits seems to be consistent with it as a side effect.
Also helped my anxiety and spouts with depression, though. I expect it'll be really hard to disentangle all these effects.
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Cravings suck. Satisfying the craving provides a dopamine hit, but plenty of other things provide similar hits without having the escalatory cycle of requiring more to be satisfied. Indulging in the addiction loop is absolving individual agency to seek prosocial alternatives, and further incentivizes a nonacretive utility function.
If Ozempic means people ge their dopamine hits from more effective sources, then that is a net benefit. If people get less addicted to retweets and updoots for personal validation and find value in touching grass then we will have a much better existence than what we suffer now.
What makes you think Ozempic won't also eliminate any satisfaction from "touching grass" as well?
Possible. I have only my own personal experience with addictions to go on, and my personal conclusion is that the diminishing returns of autonomic biochemical release from satiating addiction was specifically pleasurable due to the novelty of youth, and minor psychological reprogramming allowed my personal utility calculation to value steak, lagavulin and VR porn equally to nicotine and cocaine.
Of course that could be due to physiological incapability limiting me from continuing to achieve the same upper highs of nicotine and cocaine use that sparked the initial addiction cycle, but post-hoc quantification of 'personal utility' is so useless that I might as well make up whatever historical valence I had assigned to the different contributory factors.
I am personally suspicious of modern 'research' into therapy and addiction, particularly the suspiciously high incidence of journals concluding moral expatiation for asocial behaviors. He had addiction/genetic trauma/ptsd/a bad day so of course he had no choice but to be an asshole. In this space of 'addiction cannot be managed' the criticisms of Ozempic as some form of permanent pleasure-depriving limbic path zombiefication drug seems more like concern trolling to encourage continual indulgence in bad behaviors rather than handwringing about motivation death. If ozempic causes the tweaker to rot in a lazyboy watching SpongeBob and chugging doritos instead of seeking means to score meth for that sweet sweet dragon, then bring on the apathetic skinnification of antisocial losers.
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It doesn't eliminate them (after all, it's not like ozempic users drop to a bmi of 20), it merely lessens them.
Going the other way, do you think that people with more cravings for food, etc are more joyous and driven than normal people? To me it seems unlikely. I suspect that the thought patterns that drive addiction are different than those that drive joy, and inhibiting the first doesn't lessen the second.
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