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kottke.org posts about addiction

Is Ozempic an Anti-Addiction Drug?

Writing for The Atlantic, Sarah Zhang details how some people taking Ozempic for weight loss are reporting that the drug has also curbed their addictive impulses (to drink, to shop, to smoke).

Earlier this year, she began taking semaglutide, also known as Wegovy, after being prescribed the drug for weight loss. (Colloquially, it is often referred to as Ozempic, though that is technically just the brand name for semaglutide that is marketed for diabetes treatment.) Her food thoughts quieted down. She lost weight. But most surprisingly, she walked out of Target one day and realized her cart contained only the four things she came to buy. “I’ve never done that before,” she said. The desire to shop had slipped away. The desire to drink, extinguished once, did not rush in as a replacement either. For the first time — perhaps the first time in her whole life — all of her cravings and impulses were gone. It was like a switch had flipped in her brain.

Not everyone experiences these effects, but there’s enough anecdotal evidence at this point that scientists are interested and investigating.


How to Kick Your Phone Addiction Using Stop-Smoking Techniques

I don’t know if you’ve been listening lately, but yesterday’s episode of Kottke Ride Home was a particularly good one.

I was amused by the jetpack story (as well as Casey Niestat’s denial) and the idea that there’s a 50/50 chance we’re all living in a simulation is right up my alley. But I was most interested in the segment on how we can curtail our phone usage using proven techniques learned from people who have successfully quit smoking (aka the thing that people did with their hands when they had free moment before phones came along).

From the article by McKinley Valentine that Jackson highlighted:

I tried turning notifications off on every app. I just got anxious and opened the apps more often.

I tried deleting the apps that caused problems-social media, news, messages-from my phone. I ended up just accessing them in the browser.

I tried using apps like Stay Focused to block my access. I’d just disable them.

I tried just not checking my phone — the cold turkey method — and folks, it didn’t go great. All it did was add a layer of guilt to my bad habit and sour mood.

I thought: I have to get smarter about this. Who knows about addiction? What addiction has been studied in-depth, for decades, with an absolutely massive group of experiment subjects, to establish the best-practice methods? Cigarettes!

Valentine tried three main methods to kick her phone addiction habit: substitution, urge-surfing, and following the techniques in Allen Carr’s Easy Way to Stop Smoking. Carr’s advice was the most effective:

Carr notes that there is a huge disconnect between what we want and what we actually enjoy. They’re different neurological processes. That’s why you can desperately crave, for example, an entire blueberry cheesecake, but when you actually eat it, it’s only OK. Or why you often don’t feel like going out with your friends at all — it seems like kind of a hassle — but when you actually see them, you have an amazing time.

So Carr recommends working to really notice and internalise that disconnect. He tells smokers to pay attention to their next cigarette. It’s like mindfulness but for noticing the unpleasantness. How does it taste? Not, “how did you imagine it would taste when you were craving it,” but how does it actually taste? Does it smell nice? Do your hands smell nice? How do you feel — do you actually feel more relaxed, or do you feel worse?

Wow, “a huge disconnect between what we want and what we actually enjoy”…boy, have I observed that in my life many times. Gonna totally use this on some of my less constructive pandemic coping habits… (via kottke ride home)


How Iceland Has Dramatically Lowered Rates of Teen Substance Abuse Over the Past 20 Years

There are certain links I’ve posted here that I think about more often than others. One that I think a lot about — weekly at least — is Emma Young’s story for Mosaic about Iceland’s very successful program that’s steered the nation’s teens away from drug and alcohol abuse. At the center of the Icelandic strategy is an insight by psychologist Harvey Milkman about a strategy of replacing substance and other unhealthy addictions with healthier natural highs:

At Metropolitan State College of Denver, Milkman was instrumental in developing the idea that people were getting addicted to changes in brain chemistry. Kids who were “active confronters” were after a rush — they’d get it by stealing hubcaps and radios and later cars, or through stimulant drugs. Alcohol also alters brain chemistry, of course. It’s a sedative but it sedates the brain’s control first, which can remove inhibitions and, in limited doses, reduce anxiety.

“People can get addicted to drink, cars, money, sex, calories, cocaine — whatever,” says Milkman. “The idea of behavioural addiction became our trademark.”

This idea spawned another: “Why not orchestrate a social movement around natural highs: around people getting high on their own brain chemistry — because it seems obvious to me that people want to change their consciousness — without the deleterious effects of drugs?”

BTW, this is a somewhat controversial view but it has always made sense to me for those with mild addictions or depression. Speaking strictly for myself, I’ve found that when healthier alternatives are available to me (spending time with family & friends, exercise, exploring, reading a good book), I spend a lot less time mindlessly doing things that give me the same sort of brain buzz but which I don’t consider positive or worthwhile (drinking alcohol, watching TV, eating poorly, and especially reloading Instagram over and over again like a lab rat slapping that lever to get more cocaine).

But back to Iceland. By giving teens access to more healthy activities, getting parents more involved in their children’s lives, implementing curfews, and administering annual surveys, the country has made great strides over the past two decades:

Today, Iceland tops the European table for the cleanest-living teens. The percentage of 15- and 16-year-olds who had been drunk in the previous month plummeted from 42 per cent in 1998 to 5 per cent in 2016. The percentage who have ever used cannabis is down from 17 per cent to 7 per cent. Those smoking cigarettes every day fell from 23 per cent to just 3 per cent.

The way the country has achieved this turnaround has been both radical and evidence-based, but it has relied a lot on what might be termed enforced common sense. “This is the most remarkably intense and profound study of stress in the lives of teenagers that I have ever seen,” says Milkman. “I’m just so impressed by how well it is working.”

Young did a follow-up last year about the expansion of the program into other areas of the world.


A chemical cure for chemical dependence?

For an episode called The Fix, Radiolab explores what anti-addiction drugs are available and why they aren’t more widely known and used to treat alcoholism and drug addiction.

Reporter Amy O’Leary was fed up with her ex-boyfriend’s hard-drinking, when she discovered a French doctor’s memoir titled The End of My Addiction. The fix that he proposed seemed too good to be true. But her phone call with the doctor left her, and us, even more intrigued. Could this malady — so often seen as moral and spiritual — really be beaten back with a pill?

We talk to addiction researcher Dr. Anna Rose Childress, addiction psychologist Dr. Mark Willenbring, journalist Gabrielle Glaser, The National Institute of Health’s Dr. Nora Volkow, and scores of people dealing with substance abuse as we try to figure out whether we’re in the midst of a sea change in how we think about addiction.


Good and hopeless at the same time

Benoit Denizet-Lewis is a recovering sex addict. As part of his rehab process, he wrote a note from the addict inside of his head:

I will make Benoit lie and manipulate and chase sex every hour of every day, until he can’t feel anything anymore, until everything good and decent about him is removed. He needs me. His life is boring when I’m not in charge. I control him. I keep him numb so he can function. I make him feel good, and I make him feel worthless. The minute he steps out of this stupid rehab, I’ll start whispering in his ear. That’s all it takes — whispers. I win. I ALWAYS win.


It starts simply enough. At some point

It starts simply enough. At some point you decide you like cheeseburgers better than hamburgers. No big deal. Then one day you try your cheeseburger with bacon. And then after a while you think, you know what would be really good on this? Jalapeños. Jalapeños would be really good on this. And then you’re stuck. Hooked on Jalapeño Bacon Cheeseburgers, and you realize you can never go back.

Update: Speaking of cheeseburgers, feel free to blast these to bits. (thx, jeff & swissmiss)

Update: Aaron points me to the Luther Burger: “a hamburger, specifically a bacon cheeseburger, which employs a glazed donut in place of each bun.”