People who have been diagnosed with something, and then pursue alternative lines of therapy, usually manage to use those alternative therapies responsibly, because they are actually thinking of them using the mental framing of "treatment for condition" rather than "fun recreational substance I seem to enjoy even more than other people."
A lot of recreational drugs are fine if approached in a medical context. Amphetamines, nicotine, MDMA, whatever—given appropriately-controlled dosing and a desire to achieve a therapeutic effect rather than a "high", one can consume these substances in a long-term fashion without addiction, and remain "healthy" or even "healthier".
It's the undiagnosed who are the problem. Since they don't think they have a problem (except perhaps a problem common to all human experience, or a problem with their environment—anything but an uncommon neuroendocrine ailment) they don't even realize that there's any other point than the "high" to begin with. They pursue these drugs because they seem really, really good: they get the recreational effects and they help with their problems! And then they get addicted, because they associate a recreational dosing schedule (rather than a therapeutic one) with their life getting better.
> People who have been diagnosed with something, and then pursue alternative lines of therapy, usually manage to use those alternative therapies responsibly, because they are actually thinking of them using the mental framing of "treatment for condition" rather than "fun recreational substance I seem to enjoy even more than other people."
Are you sure? Prescription drug abuse is rampant. And in my experience, most of these people do legitimately need the drugs they're abusing - but they also see them as "fun recreational substances." I've noticed this seems to be especially true for anti-anxiety medications and painkillers. People take them to treat their conditions and to enjoy the way the abuse of it makes them feel. I think the fact it's a legitimate prescription makes it "okay" since in their minds they need it and there's no harm in taking extra because of that.
Of course, then they run out of their prescription before they can refill it and then there's some miserable days (or shady transactions) ahead.
I'm speaking from extensive experience in Mississippi. Maybe it's different in wealthier places. I do get the sense those are are better off tend to adhere more to the correct dosing schedule, but I have no idea how to begin untangling cause-and-effect there.
As noted, some drugs do create genuine chemical dependence, even when you're trying to be responsible with them. Heroin is the default example, and is now mostly considered a recreational drug because of this (i.e. it is no longer considered safe to prescribe at any dose), but that recreational "market" grew out of what was originally prescription drug abuse.
The benzodiazepine class of drugs also has a chemical dependence problem, and serves as a good example of the medical establishment's reaction to prescription drug abuse. When prescribing a benzo-class drug nowadays, your doctor will work with you to create a dosing schedule that includes its own "taper-off" period (and perhaps secondary therapies to counter withdrawal effects) to avoid addictive potential. They will also try to find a drug which not only fits the effect profile they want, but which you can safely afford out-of-pocket, or they will attempt to get you on a manufacturer's discount plan, and so forth, to ensure you never encounter the "I can't get my dose this month, but I'm at the height of treatment and addicted so I have to do something else" problem.
In the modern day, just prescribing the drug instead of the treatment program as a whole is medically irresponsible.
> In the modern day, just prescribing the drug instead of the treatment program as a whole is medically irresponsible.
In that case, there are a lot of medically irresponsible doctors. I have never seen nor heard of a doctor that does that. And the problem is truly rampant from what I see here. Maybe people are doctor-shopping, I don't know. I do know that most of my non-professional acquaintances have prescriptions for something and nearly all of them abuse it. And to clarify, I don't mean "oh, I'm going to take an extra one because I'm feeling really anxious/in pain today", I mean "I'm gonna take six and get fucked up."
> to ensure you never encounter the "I can't get my dose this month, but I'm at the height of treatment and addicted so I have to do something else" problem.
FWIW, I pretty much never see this. They always find a way to afford their dose that month[1]...the problem is they run through it in 1-2 weeks. Then they either suffer, ask their friends for help, or more rarely find something more extreme.
[1] Fortunately there seems to be cheap generics available for most of them. I know a month's worth of kolonopin runs about $15-20; my ex was on it and she didn't have insurance.
