I think that's the point, really, that the activity has ceased to be entirely voluntary and has instead become a hard-wired learning disorder. What I'm not sure of is whether the electrical...
I think that's the point, really, that the activity has ceased to be entirely voluntary and has instead become a hard-wired learning disorder. What I'm not sure of is whether the electrical stimulus helps reestablish the ability to learn, or just replaces the reward of alcohol.
Messing with the brain's reward system has its own addictive potential, and the question would be whether Dr. Plummer will still function if his batteries die.
As part of a larger argument, Scott Alexander recently wrote about goals versus urges. While still somewhat fuzzy, maybe that's a helpful way of thinking about it?
As part of a larger argument, Scott Alexander recently wrote about goals versus urges. While still somewhat fuzzy, maybe that's a helpful way of thinking about it?
I generally agree with Scott Alexander's model of dopamine bias, based on my own experience with depression and nicotine addiction, and the behavior of a parent with OCD. Personally, I bin most...
I generally agree with Scott Alexander's model of dopamine bias, based on my own experience with depression and nicotine addiction, and the behavior of a parent with OCD. Personally, I bin most drug addictions as learning disorders, with the drug as the biasing reward/punishment system that fixes the pattern of learned behavior. For any given drug, the majority of users don't sustain enough consistent reward/punishment to continue the learned behavior, in the presence of more complete patterns of reward/punishment from daily life.
For about 10% (that proportion is weirdly consistent across addictive substances!), the learned behavior is essentially permanent. Addiction is a disease of good learners, or people who are functionally or materially deprived of other reliable behavioral biases.
Edit: Scott Alexander's essay here nicely sums up the case for treating addiction as a disease if effective treatments are available, rather than just sitting back and tut-tutting about the moral incapacity of the sufferer.
EDIT: I'm going to leave this up in case anyone else finds it useful, but I severely misread @MimicSquid's message. It was an expression of woe that I actually strongly identify with. This reads...
EDIT: I'm going to leave this up in case anyone else finds it useful, but I severely misread @MimicSquid's message. It was an expression of woe that I actually strongly identify with.
This reads to me as a criticism of character, so please correct me if it's not. But if it is, then.. yes. That's exactly what alcohol use disorder is. If he could simply stop because the bad effects outweighed the good, he wouldn't be suffering from alcohol use disorder. This goes beyond almost anyone's conscious ability to simply try harder. Aside from the fact that cold turkey alcohol withdrawal is potentially lethal, and can cause hallucinations and seizures as early as 12-24 hours since last consumption, someone suffering from alcohol use disorder has a brain that thinks it needs (and, if you consider the symptoms of withdrawal, really does need) alcohol to the same extent that your brain thinks it needs water. I think most likely people would talk a different game if they thought about the last time they tried to just "get through" water withdrawal symptoms.
I don't blame most people for harboring unfair opinions of what it means to suffer from a substance use disorder. Society at large, as well as certain specific organizations like Alcoholics Anonymous, have been pushing messaging for hundreds of years that paints these medical conditions as somehow different from other mental or physical disorders and illnesses, as if they're indications of character and not, like almost everything else, a largely unknown combination of nature, nurture, chance, and choices. For anyone interested, there is an excellent Atlantic essay on Alcoholics Anonymous, and how their practice really works in America, and what it has meant for the people who suffer from these disorders. I think it's worth reading with an open mind to how we as a society have been primed to view these conditions.
It's very much not, though I should have considered my words more carefully. Both of my parents are alcoholics, and I spent more than a few hours as a kid playing with toys or reading in the...
It's very much not, though I should have considered my words more carefully. Both of my parents are alcoholics, and I spent more than a few hours as a kid playing with toys or reading in the corner while they were at AA meetings, though the one of them who still goes to meetings attends Narcotics Anonymous instead of AA. I'm really clear that this is a disease, and did not mean my statement as a moral condemnation of Dr. Plummer or anyone else who is suffering from addiction.
It's just that everything seems to have been done right, and it still wasn't enough to actually cure this. Even the extreme of brain surgery and direct brain stimulation didn't cure his alcoholism, only provided a little extra help. It's disheartening.
Ah, I'm so sorry for misunderstanding. This I can absolutely empathize with. My little brother was at one point going to AA, NA, and CA meetings. The fact that we still have so little...
Ah, I'm so sorry for misunderstanding.
It's disheartening.
This I can absolutely empathize with. My little brother was at one point going to AA, NA, and CA meetings. The fact that we still have so little understanding of how to treat these disorders just wrecks me if I think about it too hard. This article does give me a little hope, that I hope I can pass on to you: the fact that direct brain stimulation, as invasive and extreme as it is, did something at all is a good thing. This is the "we must be on the right track" kind of experimentation and feedback that leads to "we've figured it out". It's likely that that second step won't happen for a little while longer... but it makes me feel just a little better that really smart people are taking this really seriously, and seem to actually be getting closer to the kind of treatment that we need.
Hmm...I know the article states he's failed many other treatment attempts, but I wonder if he gave the Sinclair Method a go. It's supposedly highly effective and isn't as drastic as surgery.
Hmm...I know the article states he's failed many other treatment attempts, but I wonder if he gave the Sinclair Method a go. It's supposedly highly effective and isn't as drastic as surgery.
And after liver failure, trauma to his relationships and brain surgery, he still drinks.
I think that's the point, really, that the activity has ceased to be entirely voluntary and has instead become a hard-wired learning disorder. What I'm not sure of is whether the electrical stimulus helps reestablish the ability to learn, or just replaces the reward of alcohol.
Messing with the brain's reward system has its own addictive potential, and the question would be whether Dr. Plummer will still function if his batteries die.
As part of a larger argument, Scott Alexander recently wrote about goals versus urges. While still somewhat fuzzy, maybe that's a helpful way of thinking about it?
I generally agree with Scott Alexander's model of dopamine bias, based on my own experience with depression and nicotine addiction, and the behavior of a parent with OCD. Personally, I bin most drug addictions as learning disorders, with the drug as the biasing reward/punishment system that fixes the pattern of learned behavior. For any given drug, the majority of users don't sustain enough consistent reward/punishment to continue the learned behavior, in the presence of more complete patterns of reward/punishment from daily life.
For about 10% (that proportion is weirdly consistent across addictive substances!), the learned behavior is essentially permanent. Addiction is a disease of good learners, or people who are functionally or materially deprived of other reliable behavioral biases.
Edit: Scott Alexander's essay here nicely sums up the case for treating addiction as a disease if effective treatments are available, rather than just sitting back and tut-tutting about the moral incapacity of the sufferer.
EDIT: I'm going to leave this up in case anyone else finds it useful, but I severely misread @MimicSquid's message. It was an expression of woe that I actually strongly identify with.
This reads to me as a criticism of character, so please correct me if it's not. But if it is, then.. yes. That's exactly what alcohol use disorder is. If he could simply stop because the bad effects outweighed the good, he wouldn't be suffering from alcohol use disorder. This goes beyond almost anyone's conscious ability to simply try harder. Aside from the fact that cold turkey alcohol withdrawal is potentially lethal, and can cause hallucinations and seizures as early as 12-24 hours since last consumption, someone suffering from alcohol use disorder has a brain that thinks it needs (and, if you consider the symptoms of withdrawal, really does need) alcohol to the same extent that your brain thinks it needs water. I think most likely people would talk a different game if they thought about the last time they tried to just "get through" water withdrawal symptoms.
I don't blame most people for harboring unfair opinions of what it means to suffer from a substance use disorder. Society at large, as well as certain specific organizations like Alcoholics Anonymous, have been pushing messaging for hundreds of years that paints these medical conditions as somehow different from other mental or physical disorders and illnesses, as if they're indications of character and not, like almost everything else, a largely unknown combination of nature, nurture, chance, and choices. For anyone interested, there is an excellent Atlantic essay on Alcoholics Anonymous, and how their practice really works in America, and what it has meant for the people who suffer from these disorders. I think it's worth reading with an open mind to how we as a society have been primed to view these conditions.
It's very much not, though I should have considered my words more carefully. Both of my parents are alcoholics, and I spent more than a few hours as a kid playing with toys or reading in the corner while they were at AA meetings, though the one of them who still goes to meetings attends Narcotics Anonymous instead of AA. I'm really clear that this is a disease, and did not mean my statement as a moral condemnation of Dr. Plummer or anyone else who is suffering from addiction.
It's just that everything seems to have been done right, and it still wasn't enough to actually cure this. Even the extreme of brain surgery and direct brain stimulation didn't cure his alcoholism, only provided a little extra help. It's disheartening.
Ah, I'm so sorry for misunderstanding.
This I can absolutely empathize with. My little brother was at one point going to AA, NA, and CA meetings. The fact that we still have so little understanding of how to treat these disorders just wrecks me if I think about it too hard. This article does give me a little hope, that I hope I can pass on to you: the fact that direct brain stimulation, as invasive and extreme as it is, did something at all is a good thing. This is the "we must be on the right track" kind of experimentation and feedback that leads to "we've figured it out". It's likely that that second step won't happen for a little while longer... but it makes me feel just a little better that really smart people are taking this really seriously, and seem to actually be getting closer to the kind of treatment that we need.
Hmm...I know the article states he's failed many other treatment attempts, but I wonder if he gave the Sinclair Method a go. It's supposedly highly effective and isn't as drastic as surgery.