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Published: 06 December 2022

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Timmen L. Cermak MD December 2, 2022
KEY POINTS

• Motivation is a subjective experience and therefore extremely difficult to measure objectively.
• Motivational syndrome has long been seen as a sign of cannabis addiction, but has only recently been measured.
• Liking and wanting are two different forces. Drug use changes the brain in ways that stimulate wanting the drug.

Until recently, I ignored the idea of a cannabis-induced amotivational syndrome. Of course, I was familiar with the stereotypical view of potheads couch-locked into immobility, but this could have a variety of causes other than amotivational syndrome. Besides, I could not imagine how motivation could be measured objectively.
Then Meghan Martz[1], at the University of Michigan, published research that changed my mind. Martz used a delayed monetary reward protocol, which means people were given a simple computer task that promised cash rewards at the end of the test—a low monetary reward for poor performance and a higher reward for better performance. While watching the computer screen and pressing a button whenever a stimulus appeared, and before any money was received, Martz used functional magnetic imaging (fMRI) to measure activity in a small part of the brain called the nucleus accumbens, the reward center. She tested individuals three times, at ages 20, 22, and 24. She also recorded their report of marijuana use at each age.
Her data showed that, while everyone at age 20 had the same level of reward center activation in anticipation of the cash reward, those who most increased their cannabis use over the next four years showed progressively less activation at ages 22 and 24. Cannabis users no longer viewed cash with as much anticipation of the reward. Martz concluded that the effects of long-term cannabis use results in a general blunting of reward response. While it could be argued cannabis produces enlightenment and freedom from materialistic desires, a deeper look at nucleus accumbens functioning points in other directions.

For complete article 

For Metz Research

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Published: 29 November 2022

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After nine years as a homeless drug addict in Los Angeles, Jared Klickstein finally checked himself into a drug treatment center. Unlike the program he had gone to six years before, which had hot tubs, acupuncture, and trips to the beach, this one, in North Hollywood, was deadly serious about personal responsibility. Clients kept a strict schedule. They did chores. They scrubbed toilets. “No hot tubs,” Klickstein said.
Most important, they couldn’t use drugs. “If you use, they kick you out,” he said. “There’s consequences.”
It took him two attempts, but Klickstein, now 33, finally got clean. Four and a half years later, he’s independent, employed, and emotionally stable. “I was a person that you would see on one of these videos, screaming with blood and shit all over them,” he said. “And now I’m not.”
Klickstein attributes his success to the North Hollywood program’s emphasis on sobriety and accountability. “Without sobriety, there is no mental or emotional stability for me and most other drug addicts, meaning homelessness was inevitable,” he said. “Half measures and coddling do not work. Period.”
But tough-love centers like the one that turned Klickstein’s life around are becoming harder to come by. The idea that you have to quit drugs to recover from addiction has become old-fashioned, and treatment centers that insist on abstinence are disappearing. In California, changes in state law have made it virtually impossible for any program that accepts public funds to push clients to quit using.
... and before he got himself cleaned up. “Half measures and coddling do not work," Klickstein says. "Period.”
“You cannot intervene or even speak to someone regarding their alcohol and drug use,” said Reverend Andy Bales, who has worked in drug recovery in Los Angeles for decades. As a result, most homeless services and housing providers in the city allow, in his words, “a free flow of alcohol and hard drugs.” This permissive approach, Bales believes, is why California has more people living on the street than any other state in the country.
The repudiation of abstinence-based treatment in California and many other states represents the broad embrace of an approach called “harm reduction.” Instead of seeing addiction as a serious illness whose treatment ultimately requires addicts to stop using drugs, it casts addiction as a risky health condition to be managed, and insists that different people benefit from different management strategies, not all of which require abstinence.
But as the addiction crisis has deepened across the country, with the highly toxic and addictive opioid fentanyl killing addicts at record rates, homelessness exploding in California and throughout the West Coast, and drug cartels operating in the open in cities like San Francisco, the ascendance of a particularly dogmatic form of harm reduction may be exacerbating the crisis instead of mitigating it. By normalizing drug use, eschewing intervention, and shutting down abstinence-based treatment programs, critics of this radical harm reduction philosophy believe it’s keeping people trapped in addiction.
“It’s just going to end up with more death,” said Klickstein.

For complete story

Also see
The inevitable outcome of ever permissive drug policy interpretations and
The Disastrous Californian Cannabis Legalization Experiment – More than promises ‘Up in Smoke’!

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Published: 15 November 2022

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Published: 09 November 2022

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This brief expose’ below is the inevitable outcome of ever permissive drug policy interpretations. This is happening in several States in the U.S. and it is literally a nightmare, not only for the hapless substance user, but all those around them.  The A.C.T. in Australia have just stepped into this space and the proponents of this toxic experiment will work tirelessly to sanitize the outcomes.

However, if drug addiction is a ‘disease’ then fundamental aetiology of disease management is being utterly ignored. The two fundamentals are to reduce both exposure and susceptibility to said ‘disease’. Increased permission for drug use is antithetical to best practice disease management – it only increases exposure and susceptibility to the potential for drug use disorders and addiction. This is shocking bad #publichealth policy: 

NIGHTMARE CITY: How Portland’s Decriminalization Of Hard Drugs Destroyed The City

 
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also see 

‘Loving People to Death’ Seattle 

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