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In rural America, religious norms reduce compassion for people who use opioids

#1
C C Offline
https://www.asc.upenn.edu/news-events/ne...se-opioids

RELEASE: Estimates suggest that 1.7 million people in the United States suffer from opioid-related substance abuse disorders and approximately 50,000 people die each year from an opioid-related overdose. The opioid epidemic is a widespread crisis, but rural areas — particularly those in Appalachian and Midwestern states — have been the hardest hit. However, many individuals in those same states do not support policies scientifically proven to help, like medically aided treatment and syringe exchanges.

A new study from the Social Action Lab at the University of Pennsylvania’s Annenberg School for Communication found that individuals in rural areas of Appalachia and the Midwest who regularly attend religious services were more likely to support punitive drug policies and less likely to support policies that aid people who use drugs. They were also more likely to support the same policies as those they perceived their religious leaders supported, whether punitive or supportive. The findings suggest that religious leaders, if persuaded of the benefits of policies that aid people with a substance use disorder, could influence the general population’s opinion toward those measures.

“Many religious communities have either disapproved of or overtly repudiated protective drug policies, like medication–assisted treatment, retail access to syringes, or syringe exchange programs,” says Dolores Albarracín, Alexandra Heyman Nash University Professor and Director of the Social Action Lab. “This is largely because they interpret substance use as a moral failure rather than a disease and see these kinds of programs as enabling drug use. Our study supports this hypothesis, but it also indicates that religious leaders could be mobilized to support protective and efficacious drug policy to curb the opioid epidemic.”

Albarracín and her co-authors surveyed over 3,000 people from 14 states, including Alabama, Georgia, Illinois, Indiana, Kansas, Kentucky, Michigan, Missouri, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia. Participants were asked questions about their own alcohol and drug use; their attitudes toward alcohol and drug use, social support, public policy, and mental health; and attitudes and resources within their communities. They were also asked about their religious affiliation, their religious-service attendance, and their religious leaders’ attitudes about drug use and public policy.

The researchers found that while religious affiliation had no impact on either protective or punitive policy attitudes, a respondent’s likelihood to support punishment and incarceration for people who use drugs increased with the frequency with which they attended religious services. However, if an individual’s religious leaders supported protective policies, they were more likely to also support protective policies.

“Ending the opioid epidemic requires finding ways to help religious communities become more open to protective policies that are scientifically shown to be more effective at supporting people using drugs,” says Albarracín. “Our study suggests that incorporating religious leaders into those efforts and developing an agenda that incorporates religious values in a way that increases compassion may go a long way in reducing the harm of drug use in rural areas in the United States.”

The study, entitled “The Associations of Religious Affiliation, Religious Service Attendance, and Religious Leader Norm with Support for Protective versus Punitive Drug Policies: A Look at the States Affected by the Rural Opioid Epidemic in the United States,” was published today in the Journal of Rural Mental Health. In addition to Albarracín, authors include Marta Durantini, a senior investigator at the Annenberg Public Policy Center; and the Grid for the Reduction of Vulnerability, a consortium of agencies from counties in the affected areas.
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#2
Magical Realist Offline
Moralizing addiction only has the effect of exacerbating the addiction as a source of shame and guilt and low self-esteem. What addicts need to see is that their addiction is an illness and should be treated as one with appropriate therapies. Religion has no place in this process, as this study makes abundantly clear.
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#3
Syne Offline
(Aug 4, 2021 08:38 PM)Magical Realist Wrote: Moralizing addiction only has the effect of exacerbating the addiction as a source of shame and guilt and low self-esteem. What addicts need to see is that their addiction is an illness and should be treated as one with appropriate therapies. Religion has no place in this process, as this study makes abundantly clear.

That's actual backwards, as low self-esteem is the single biggest factor in substance abuse. You can't exacerbate the primary cause. Seeing addiction as an illness means you are powerless to do anything about it without medical or professional intervention. That alone will keep people abusing drugs, as it is a form of learned helplessness.
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#4
Magical Realist Offline
(Aug 4, 2021 08:48 PM)Syne Wrote:
(Aug 4, 2021 08:38 PM)Magical Realist Wrote: Moralizing addiction only has the effect of exacerbating the addiction as a source of shame and guilt and low self-esteem. What addicts need to see is that their addiction is an illness and should be treated as one with appropriate therapies. Religion has no place in this process, as this study makes abundantly clear.

That's actual backwards, as low self-esteem is the single biggest factor in substance abuse. You can't exacerbate the primary cause. Seeing addiction as an illness means you are powerless to do anything about it without medical or professional intervention. That alone will keep people abusing drugs, as it is a form of learned helplessness.

https://healthblog.uofmhealth.org/brain-...al-failing

"Addiction is a serious issue: The U.S. is currently facing an opioid epidemic, and excessive use of alcohol continues to be one of the leading preventable causes of death, according to the Centers for Disease Control and Prevention.

In a November 2016 report, former Surgeon General Vivek Murthy, M.D., publicly confirmed what researchers have known for years: Addiction is a chronic illness accompanied by significant changes in the brain.

Addiction does not occur because of moral weakness, a lack of willpower or an unwillingness to stop. This finding stems from decades of work investigating the effects of substance use on the brain.

The first time individuals drink or take drugs, they do so voluntarily, and they believe they can control their use. With time, more and more alcohol or drugs are needed to achieve the same level of pleasure and satisfaction as when they first started. Seeking out and taking the substance becomes a near-constant activity, causing significant problems for them and their family and friends. At the same time, progressive changes in the brain drive the compulsive, uncontrollable drug use known as addiction.

When this happens, individuals can no longer voluntarily choose to not use drugs or alcohol, even if it means losing everything they once valued.

The brain on addiction

Research has identified a number of areas in the brain key to the development and persistence of addiction. In particular, pathways containing dopamine are where many drugs exert their effects. Dopamine is a small chemical in the brain important for carrying signals from one brain cell to the next, similar to how a train carries cargo between stations. Pathways where dopamine is present are involved in many different functions, one of which is reward-motivated behavior.

In the healthy brain, dopamine is released in response to natural rewards, such as food or exercise, as a way of saying, “that was good.” But drugs hijack dopamine pathways, teaching the brain that drugs are good, too. For example, some drugs have a structure similar to other chemical messengers in the brain, allowing them to bind to brain cells and release dopamine. Therefore, taking a drug produces a euphoric feeling, which in turn strongly reinforces drug-using behavior.

Drugs release two to 10 times the amount of dopamine that natural rewards release. How much is released depends on the type of drug; amphetamines, for example, release more dopamine than cocaine. As a result, the increased and sometimes constant influx of dopamine means feelings of reward, motivation or pleasure are also increased.

But if substance use continues, the brain produces less dopamine and/or reduces the number of brain structures that receive dopamine. Thus, dopamine’s impact on the reward network diminishes, along with the individual’s ability to experience pleasure.

This explains why individuals who chronically abuse drugs or alcohol begin to appear lethargic, unmotivated and depressed, and report a lack of pleasure in things that were once pleasurable. To counter this, they increase their substance use in an attempt to feel the same pleasure they used to. This only exacerbates the problem, creating a vicious cycle of needing to take the drug in order to regain dopamine levels, then later needing to increase the dose, and so on, an effect known as tolerance.

While short-term use may only produce small, transient effects in the brain, prolonged substance use changes the brain in fundamental ways that reinforce continued use, such as the strengthening of memory circuits associated with drug taking. Cues that are social (such as being around substance-using friends), geographic (former favorite bars), and physical (experiencing stress) in nature become strongly associated with the drug. These have a powerful impact on the brain — no matter if that person has been abstinent for 15 days or 15 years — and can trigger a relapse.

Brain changes from chronic drug or alcohol use can persist years after a person quits. This is why individuals risk relapse even after long periods of abstinence, and despite a relapse’s potentially devastating effects. More importantly, this is why treatment depends on the type of drug and the individual characteristics of the patient.

Understanding the brain’s role in addiction can help reduce negative perceptions and attitudes of those struggling with substance use disorders. Because addiction is typically a chronic disorder characterized by intermittent relapses, a short-term, one-time treatment is generally not sufficient. However, research shows that addiction can be managed successfully. Individuals who enter and remain in treatment can manage their addiction and improve their quality of life.

If you or a loved one is dealing with an addiction, the University of Michigan Addiction Treatment Services (UMATS) offers assessment, diagnosis and treatment personalized for individuals and their families. UMATS accepts a variety of private insurance plans and is here to help. Please call 1-800-525-5188 to schedule an appointment, or visit the Addiction Center online to schedule an appointment."
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#5
Syne Offline
Like all claims of brain changes, they've never managed to determine causality. They can only correlate changes in the brain to behavior, but we also have significant research and evidence that behavior causes changes in the brain.

Plenty of people with a supposed "genetic predisposition", childhood trauma, peer pressure, etc. do not become addicts. Plenty of people also quit substances without any medical/therapy intervention.

The exact same dopamine response leads to obesity too. Pathologizing all that is just an excuse for those of little to no willpower to use as crutch.
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#6
C C Offline
(Aug 4, 2021 08:38 PM)Magical Realist Wrote: Moralizing addiction only has the effect of exacerbating the addiction as a source of shame and guilt and low self-esteem. What addicts need to see is that their addiction is an illness and should be treated as one with appropriate therapies. Religion has no place in this process, as this study makes abundantly clear.

There are ironies. I recollect a preacher's wife who got addicted via the pharmaceutical contribution to the epidemic, which is why it's gobbling up people who don't even fit into the "poverty, unemployment, thrill-seeking behavior, family history of abuse, etc" trailer park category.

Following the "snakepit hysteria", in the late '50s and '60s we had idiots in the psychological expertise area recommending that state hospitals be closed down, which incrementally led to a flood of the mentally ill being released upon the streets to help swell the rising homeless situation of later decades.

Over the last quarter century the honor for this particular fiasco goes to the educated halfwits in the employ of a different industry, along with facilitating doctors seduced by poor judgement.

- - - - - -

What is the U.S. Opioid Epidemic?
https://www.hhs.gov/opioids/about-the-ep...index.html

• In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to opioid pain relievers and healthcare providers began to prescribe them at greater rates.

• Increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed be highly addictive.

• In 2017 HHS declared a public health emergency and announced a 5-Point Strategy To Combat the Opioid Crisis

https://www.mayoclinic.org/diseases-cond...t-20360372

"In addition, women have a unique set of risk factors for opioid addiction. Women are more likely than men to have chronic pain. Compared with men, women are also more likely to be prescribed opioid medications, to be given higher doses and to use opioids for longer periods of time. Women may also have biological tendencies to become dependent on prescription pain relievers more quickly than are men.

"Opioids are safest when used for three or fewer days to manage acute pain, such as pain that follows surgery or a bone fracture. If you need opioids for acute pain, work with your doctor to take the lowest dose possible, for the shortest time needed, exactly as prescribed.

If you're living with chronic pain, opioids are not likely to be a safe and effective long-term treatment option. Many other treatments are available, including less-addictive pain medications and nonpharmacological therapies."
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