To wonder if addiction is a choice

[BarbaraAnnee]

I am sorry if this sounds insensitive to some people but I just wondered what people thought of this. A relative of mine is an alcoholic and due to her being unfit, her parents have had to permanently look after her DD. I feel so bad for her and just wondered if she really loved her DD she would just stop drinking?

I realised after a while the only person who'd help me was me

Seriously? Are you honestly saying that nobody wanted or tried to help you?
What help should you have been able to expect from whom?
Did you ever deny you had problem or reject help?
How do you square that with the official advice of “you have to let them hit rock bottom”?

Complele misinterpretation there of what I said! I'm also not willing to explain myself to you thanks very much

Everybody knows the dangers of Cocaine, this is not an accident, it was a choice.

I don't believe for a second that anybody chooses to be an addict but I do think that some people don't make a choice to care enough not to be one - and then when it happens, it's always that they didn't choose that. Yes. Yes you did. Everybody chooses.

No. Nobody knowingly takes steps towards addiction. Part of the insidious nature of addiction is that the addict doesn't realise until it's too late.

This.

Cocaine is so readily available. It's not a - I don't know - a rich person's choice of drug now.

Well done @An2020 thats great to hear.

Of course you are right, nobody makes the decision to be an addict.

Well done again.

But most people taking cocaine aren't doing it thinking I will take cocaine so that I can be addicted, that's such a great idea! That would be choosing to be addicted.
Of the people that I know who have taken cocaine (I have never touched it personally) it was for fun on a night out no one thought of possible addiction or the implications. I do know of one person who has developed an addiction, they had a lot of childhood trauma and underlying mental health issues (anxiety), cocaine made them feel 'normal'. They then used cocaine to feel normal, manage stress and unfortunately developed an addiction as they felt they needed it daily, this was while at uni. They often relapse when super stressed and it's a long hard battle which they absolutely hate.

Cocaine unfortunately seems to be incredibly easy to come by, especially in bigger cities. I know of a lot of people who take it on nights out. None of them appear to be addicts. They are massive assholes obviously, but not addicts. So I don't agree that people who take cocaine "know what they're getting in to".

I've been turned away from A&E twice with severe withdrawals. They give you an IV of fluid and vitamins and then tell you to go home and drink alcohol. It's entirely true.
It took my four years to get an at home detox despite engaging with everything that the local NHS service was able to offer me (which was very sporadic group meetings, frequently cancelled, changing key worker every few months and two meetings with a nurse).

'I've been turned away from A&E twice with severe withdrawals.'

Really? How odd because while A&E of course isn't the place for withdrawal management they can't presume by looking at you what the problem is even if you're a regular.

Next time rung 111 they'll direct you to more appropriate care.

I didn't say they didn't check me over, and I did say they gave an IV. My point is that they don't detox or admit to hospital.

@JanglingJack thank you. It's an expensive habit but certainly not the rich man's drug it used to be.

'My point is that they don't detox or admit to hospital'

No they don't but I'm surprised anyone would think A&E did detox. Anyway well done on kicking the habit now. 111 if there's a next time fingers crossed there isn't.

'it's an expensive habit but certainly not the rich man's drug it used to be'

I've lived on towns, cities and rurally, plus a stint abroad. I've never once been offered or seen anyone take cocaine. So whilst I don't doubt it is readily available I think you still need to know who to ask and actually make a point of sourcing it. Not like you just happen across a line in the pub's toilets and feel powerless to resist.

@Janiie A&E can be necessary should you be withdrawing as it can be lethal. 111 wouldn't be able to determine this.

@BarbaraAnnee you don't seem to have listened to the posters who have responded with the medical determination of alcoholism being determined as a disease, nor the ones explaining that it slowly rewires your brain dopamine delivery system so it is no longer a choice to drink.

Course they would. They ask questions, you answer them they then direct you to out of hours care as appropriate. That is what they do.

Yes, to A&E mostly. The other option is telling you to keep drinking and make a GP appointment where they tell you to keep drinking 🤦🏻‍♀️. Not an excuse for not getting sober, just explaining how it is for the alcoholic.

I’ve had to call ambulances when DM was withdrawing and having seizures and choking on her tongue. Should I have call 111 or taken her to the walk-in? (Actually neither of those services existed back then but my point stands).

'nor the ones explaining that it slowly rewires your brain dopamine delivery system so it is no longer a choice to drink.'

Brain chemistry fluctuates all the time. Adrenaline rush when nervous/excited? Endorphins buzz post exercise? Booze does not alter brain chemistry permanently.

It is always a choice. A bad choice yes. I feel a bit stressed now, I have an important appointment looming I could just fancy a couple of massive vodkas to calm my jets but you know what, i won't because I'll no doubt feel sluggish and shit tomorrow morning so I'll choose not to.

I would have put her on her side to keep her airway clear (do that next time) and yes rang 999 in that situation. We weren't talking about collapsed people choking though we were talking about walk in detoxes, which nope A&E don't offer.

But back before the NHS was destroyed, people would be admitted to a psychiatric ward for a dry-out once they’d been stabilised in A&E. As I said earlier, DTs have a 37% mortality rate without medical intervention. You won’t get that in the out of hours from a nurse prescriber. A&E is literally the only place for it that treatment. The difference is that nowadays they’ll stabilise you then send you home and tell you to carry on drinking until you can be treated elsewhere.

"In contrast to other stimuli, alcohol-related stimuli maintain their motivational significance even after repeated alcohol administration, which may contribute to the craving for alcohol observed in alcoholics."
"Psychological dependence on alcohol develops because alcohol-related stimuli acquire excessive motivational properties that induce an intense desire to consume alcohol-containing beverages (i.e., craving). As a result of this intense craving, conventional reinforcers (e.g., food, sex, family, job, or hobbies) lose their significance and have only a reduced impact on the drinker’s behavior."
This is what we mean when we say how hard it is to quit:
"enhanced dopamine release in the NAc shell induced by conventional reinforcers (e.g., food) rapidly induces habituation, and repeated presentation of related stimuli no longer induces dopamine release. In contrast, no habituation occurs after repeated alcohol consumption. As a result of the persistent dopamine release in the NAc shell in response to alcohol, alcohol-associated stimuli acquire an abnormal emotional and motivational significance that results in excessive control over the drinker’s behavior. This excessive control constitutes the essence of addiction."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826820/

https://www.researchgate.net/figure/Diagram-depicting-the-difference-in-the-quantities-of-dopamine-receptors-in-the-brain-of_fig1_262675156

Dopamine shown in brain scans.

This is rather to the point:
"because the way the brain’s reward system has been altered means that the substance allows them to simply feel more normal."
And then says "it does change one’s biology"

Plus:
"which causes individuals with substance use disorders to often have difficulties with impulse control related their substance use."
"However, dopamine is also released into the nucleus accumbens when using substances like nicotine, alcohol, and heroin. In addition, addictive drugs can release significantly more dopamine that non-drug-related rewards do, and they do it more quickly and with more regularity. This means that addictive drugs can create a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine."
https://www.recoveryanswers.org/recovery-101/brain-in-recovery/

'This means that addictive drugs can create a shortcut to the brain’s reward system by flooding the nucleus accumbens with dopamine."

Yes we know all about the brains reward system. The point is one still chooses to take whatever it is in the first place to get all the dopamine etc etc zzz responses.

Your links are very longwided and again, medicalise what is in fact a choice to take something in excess then get stuck when it actually makes you feel shit and expect blue lighting to A&E. Choose life as a film intro once advised.