The E.R. and Society

I was talking recently to someone who works in an emergency room as a nurse, and she told me about all the non-emergencies at the E.R. – among them, people seeking drugs, people sleeping off drunkenness, people with untreated mental illness.

What she described reminded me of this excerpt from a short story, “Emergency Room Notebook, 1977,” by Lucia Berlin (published in an anthology, A Manual for Cleaning Women):

“Fear, poverty, alcoholism, loneliness are terminal illnesses. Emergencies, in fact.”

Synaptic Sunday #3

This Sunday, some links on addiction and control:

1) The Fallacy of the Hijacked Brain

An op-ed from the NY Times:

A little logic is helpful here, since the “choice or disease” question rests on a false dilemma. This fallacy posits that only two options exist. Since there are only two options, they must be mutually exclusive. If we think, however, of addiction as involving both choice and disease, our outlook is likely to become more nuanced. For instance, the progression of many medical diseases is affected by the choices that individuals make.

2) Disease and Choice

One blogger’s response to the above op-ed.

The hijacked brain metaphor may be flawed, but it’s attempting to communicate that the addiction uses the addict’s own self-preservation instincts, desires and will to maintain addiction.

3) Addicts’ Brains May Be Wired At Birth For Less Self-Control

A study in Science finds that cocaine addicts have abnormalities in areas of the brain involved in self-control. And these abnormalities appear to predate any drug abuse.

Cocaine addicted people were studied alongside siblings who didn’t have a drug abuse history. What’s interesting is that the siblings also showed poorer self-control during the study’s task, and had atypical brain scan findings as well. So what led to one sibling abusing drugs, while the other didn’t? How do personal choices and environment come into play? Having a brain that might be more susceptible to poor impulse control or addictive behaviors doesn’t doom you to drug addiction. And, as in other studies, were there individuals whose results differed from the group as a whole? (e.g. a cocaine-addicted person who didn’t have the pre-existing abnormalities in the brain).