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Comment by bostonsre | Hacker News Reader

The assertions that the are made in the article seem like something that should be backed up with studies and not anecdotal evidence from one person (even if he is well respected).

It is an incredibly slippery slope for people to walk out on. It would be incredibly hard for someone to say whether or not they will spiral out of control if they try it and the consequences of becoming heavily addicted are life destroying. It seems like playing Russian roulette and I'm not sure it's a good thing to raise the idea that one can potentially manage it. Also, the person being interviewed could be one of the people that can't control it and will spiral out of control or him saying he manages it well and it's possible to do so could be a facade and he could be trying to do whatever possible to keep his habit alive, but we just don't know. Many people manage it fine for years without anyone knowing until they start their sharp decline towards bottom.

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>The assertions that the are made in the article seem like something that should be backed up with studies and not anecdotal evidence from one person (even if he is well respected).

Wherw do you think he got these assertions? There have already been studies about how often heroin users are addicts or what the addiction rate of prescription opioids are.

From the interview, it sounds a lot like he got them from his personal experience. He mentions percentages, but I see no references to any sources. It matters what those sources are (e.g. if they are from Purdue pharma or the sacklers, it's probably BS).

Then buy his book, how is he supposed to cite his sources in an interview?

He could mention an institution and professors that ran the studies like other people I've seen interviewed. It is an incredibly dangerous assertion he is making, it seems like the readers shouldn't be the ones that need to investigate and you certainly shouldn't need to buy his book to investigate it. Denial is an incredibly huge problem with addiction, stuff like this could be used by those with bad addictions to stay in denial and maintain their addiction.

One thing I am curious about with this research is how they would get reliable numbers for high functioning opiate addicts. Addiction is really a spectrum from "no dependence on the drug and no negative life consequences" to "high dependence on the drug and many negative life consequences". I'm sure that many people fall in the middle where they continue to responsibly live their lives while still being dependent on a drug that they may wish to quit, but can't because the withdrawal is too much. I also would not be surprised if many of these people did not seek out help and tried to hide their problem from others due to the major stigma associated with being addicted to opiates, not to mention those who are dependent on opiates but in denial about their dependence.

> is how they would get reliable numbers for high functioning opiate addicts.

He's very clearly advising against getting addicted, something most opiate users accomplish.

So the article states that Carl Hart makes a claim that 70% of drug users don't meet the criteria for being a drug addict. I'm wondering how you could even get a reliable number for this for a drug like heroin, given the stigma attached to this drug and the fact that users themselves may be in denial that they are dependent on the drug. Someone can be meeting all their obligations in life and still be struggling with a drug addiction. If asked, I would imagine a lot of high functioning addicts would say they can stop whenever they want to, they just don't want to. Anyway, I may just have to give his book a read, it sounds interesting.

An easy way to improve that accuracy is to survey people based on their past use as well. There's less reason to be in denial about something you've already dealt with.

Yea, I would be very interested in the methodology they used to come up with that 70% and I am wondering if that is a snapshot in time or is that over someone's entire life. Addiction almost always starts out in a more controlled manner until its not. So if 50% of those 70% of drug users become full blown addicts, then its a BS number. I'm also really curious how they found those high functioning drug users, because I can't imagine anyone that is successfully hiding their use from the world would divulge it to anyone they don't know or trust ("hey, are you a high functioning drug user?" sounds like something a cop might say).

Both the "snapshot" studies and the lifetime studies find similar rates of addiction, I went and found part of what he's referencing.

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

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