Your last paragraph is the most telling of all.

The rise in dopamine is the key. I learned early on that sweet foods did it for me. They do nothing for my husband. I can drink wine and not have any rise in dopamine or desire for more. Why?

Avoiding sugar and overeating in general are just about impossible to overcome long-term if you learned early in life to self medicate in that way. I was so sensitive to hurt feelings and rejection as a child that I had to find a way to alleviate that deep pain. Desserts were readily available and tasted really good.

A number of times I have controlled overeating sweets for significant periods, but eventually the need for overeating sugar becomes unbearable, and bingeing returns with a vengeance. It is ultimately my way to cope with life, good and bad. It makes happy times happier, hard times better, and daily life manageable.

I'm convinced that psychological addiction is more difficult to overcome in the long term than physical addiction. It's a heavy cross to bear.

Thanks for writing about this difficult issue.

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This was beautifully written and so true. My sister in law died of a heroin/fentanyl overdose in 2016. She'd been prescribed some painkillers following on from a back injury in a car accident. I was so young and naive and into holistic medicine that I was always suggesting this or that instead to get her off of the pills. I thought it was like a magic switch that could make it go away. I still remember her telling me one day "I just wish you could step inside my body for one minute so you could understand how much pain I'm in." My first husband likewise struggled with pain and most commonly self medicated with alcohol for it. Keeping on the move with a constant change of environment seemed to work best for him. It's in all of us and I'm forever in gratitude for my good health, but I see how lacking in empathy I was at the time. We always judge harshly the bad habits we don't have...

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My youngest son, of six, died in July of 2019, at 38 years of age.

He had a heart surgery, with a mitral valve replacement the year before, because of drug use.

Many don't understand what these drugs do to all your body parts.

He kept trying to be clean, but the Heroin just wouldn't let him go.

He had such a wonderful personality and loved people and people loved him.

I was always glad that I told him that his addiction was not what defined him or who he was.

He knew that his father and I loved him no matter what; and he told us he knew that.

We are blessed that he had a sweet wife and a daughter, who is now 7 years of age.

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An important and beautifully human message -- thank you.

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You're such an excellent writer and thinker, Brad, and have so much compassion. This made me think, of course, of the Rat Park Experiments. Pre-Substack, I did a YT on Gabor Mate that also led to Bruce Alexander. It's called the Epiphany Jumpstart and I think you might like it: https://youtu.be/erwJwvid4o4.

But I also did one asking Are Opioids the New Opium War? where I recount my Appalachian handyman's experience, remarkably similar to yours. As a HS senior he was wrestling on some new mats that they hadn't taped, in preparation for a match. His friend flipped him and landed on him--with his foot still stuck. While in a cast, the bone got infected. He was scheduled for amputation the next day when he happened to meet a man with one leg and a crutch, who said he had too much phantom pain to wear a prosthetic. He walks now, on two legs, with a boot but, as you can imagine, they pumped him full of oxy in the process. What he says is that he'd rather go through the pain of the experience again rather than the pain of withdrawal. Here it is: https://youtu.be/S_Ub1MDJ16g.

I hear stories like that a lot in Appalachia. It's not thrill-seeking, it's an intentional infliction of a highly addictive pharmaceutical poison. I don't know if you know Mark Kulacz, who does Housatonics? He lost his son to addiction and has a video where he walks through a DC annual shared memorial with photos, first names, and descriptions. I made it through almost four before sobbing.

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Aug 30, 2023Liked by Brad

This is a really difficult and important topic. I would guess that very few families have not dealt with the trauma of a family member’s addiction.

Along with studying the best ways to help those already afflicted, I hope we also study how to build a society where addiction is rare and not rampant. It seems the best way to alleviate suffering is to make sure very few become addicted in the first place.

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After fifty-nine years of heavy smoking I quit cold-turkey. To stay "sober" I had to give up both coffee and alcohol. Of all of it, I miss coffee the most. I often awaken and can feel a cigarette being held between two fingers of my right hand.

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