That is a rather significant complication in itself. The reason for the variation is because these figures come from a number of studies that I have actually seen and which were less flawed than would actually call the results into serious question. The problem is that there are several different ways to simply define addiction/substance use disorders. Then there are different ways to qualify the addicts.

With the exception of a relatively small number of extremely important studies, most addiction stats are taken from people who are or have recently been incarcerated. Many of them use folks who were arrested for illicit substances. This is extremely problematic, because there are a lot of people who are thus classified as being addicts, who most certainly are not – at least by any reasonable metric.

One study in particular, focused on people who were incarcerated. They were trying to determine what percentage of inmates had a substance use disorder. The problem was, if you were convicted of a drug crime, you qualified.

Although your numbers don’t add up (AtoN and NtoN must = 100%) my gut feeling is that the magnitude is right.

There is a lot of ambiguity at the fringes. Is extreme codependency an addiction? Is someone who gets high every day, pretty much all day, but who has a decent quality of life an addict? Is someone who works eighteen hours a day and who never sees their family an addict? There is enough that is questionable to really make it hard to come up with a clean breaking point.

My point was that for every N to A you stop, you stop a series of A to A’s later, for a long time, because A to N is rare. And, stopping N to A may be easier than stopping A to A.

The problem is that it really isn’t easier. There are so many variables and potential variables involved in the A to N equation, that it becomes nigh on impossible to deal with. Especially because in many cases, the behaviours involved aren’t necessarily considered entirely negative and may well be considered positive. At the very least, they aren’t behaviours that would seem particularly obvious or even noticeable.

I will address your last para later, when I have more time.

Although your numbers don’t add up (AtoN and NtoN must = 100%) my gut feeling is that the magnitude is right.

My point was that for every N to A you stop, you stop a series of A to A’s later, for a long time, because A to N is rare. And, stopping N to A may be easier than stopping A to A. A huge effort to sterilize A’s may sterilize only a few, half those resources spent on avoiding N to A may be more effective.

But yes, I agree with all your points about the difficulties of defining all of this. I just want to point out that since Reagan was president, systematically facilitating regular drug use by some subsets of the population has been policy. That makes it hard to deal with any drug related issues.

I do have some estimates, with the addicts as starting point being rather more accurate. There is much more solid data from that dimension, because it can be taken from actual addicts as parents, in the system.

N –> A = abt six or seven percent
A –> A = between sixty seven and eighty percent
N –> N = ninety odd percent
A –> N = between seventeen and thirty percent

This assumes there are a significant number of people who cannot be pegged as clearly N or A. And yes, somewhere in there A’s came from N’s somewhere along the line. Given what we actually do understand about addiction however, that line isn’t necessarily clear or clearcut. Someone who is extremely codependent isn’t generally identified as an addict – yet that person engages in exceedingly addictive behavior. And that is just one example of how that line might start. Not so much as a clean non-addict to addict, but as a progression of generational transmission of certain behaviors that eventually manifest in overt addiction somewhere along the line.

There are a whole hell of a lot of other factors involved in this. The comorbidity of other mental illness with addiction is high enough that I would argue it is unlikely that addiction exists very often in a mental health vacuum.*

I really don’t like coerced sterilization, but I think it is important to do what we can to discourage addicts from reproducing. But while there have been attempts to discourage addicts from reproducing – attempts that have even managed to convince individuals they should not and don’t want to reproduce, they have been failures. In some cases it is just general irresponsibility, in others it is a phenom similar to that of persons with a medicated mental illness who decide they no longer need their meds.

There may be better ways to deal with this even now. I am certain their will be in the future and if all goes well, I will play some small role in developing those ideas.

By and by, I worded my comment about a lot of others shouldn’t be reproducing. Though I do believe there are certainly people and even some groups who probably really shouldn’t – some even less than addicts, I was really considering general overpopulation when I said that. I am a big believer in politically making a case for people within our society making the choice to be fixed and help avoid overpopulation – in general, not within a specific population.

Getting fucking doctors and in some places lawmakers to quit restricting vasectomies to those who are above a certain age or who already have kids, would be a start. I am still very angry about being denied a vasectomy when I was nineteen and again when I was twenty. While it would have denied me my beautiful kids, who likely saved my life, it is disgusting and demeaning to be denied that bit of autonomy – and in my case would have prevented the suffering of two little boys.

* We don’t include overt dependence without other manifestations of addiction, addiction. There are some psychologists who would argue that we must, but that would mean that anyone who ever experienced a major trauma and developed a dependence to pain killers is an addict. This is, of course, bullshit. Just like someone who was dealing with some emotional trauma who went on a bender with coke or heroin and became dependent – then got clean and never wanted to touch it again, isn’t an addict.

I don’t think that is a valid flip side. Addicts could be said to have damaged free will. Imagine handing out a social welfare benefit to war-wounded who could win a certain foot race or schizophrenics who could pass a certain cognitive coherency test. This is handing out a social benefit (in reverse) to addicts who are … not demonstrating addictive behavior.

This is a complicated issue and the answers aren’t always obvious. We really need to get past moralising addiction, before we can truly begin to deal with addiction and substance use disorders.

Absolutely. I just think that sterilizing people is a strong moral statement!

What I am talking about, is reducing a huge fucking risk factor. More importantly, I am talking about preventing children from a great deal of suffering before they ever have the opportunity to become drug addicts.

That is very true, and the current system routinely removes kids from addict (or otherwise fucked up) parents. And, having those kids not be born to begin with is a very attractive idea, and it would absolutely certainly work.

Have you ever actually spent time around the children of substance abusers?

I have indeed been around the block a few times.

We aren’t talking about some monolithic entity that can be functionally fixed with any singular solution.

DuWayne, it isn’t helpful to keep telling me that I don’t understand the complexities, or have not experienced or observed the misery. I do, I have, and it should not matter that much anyway.

Indeed, sterilization is a rather one-dimensional fix (pardon the pun) to a very complex problem. And, if you read my comments above (way back) you’ll see that I’m asking other commenters to try to understand that the situation is more complex than it is being treated as.

We can agree to disagree, but I’m going to vote “no” on any policy of coercive (implied or explicit) sterilization, and vote against any candidate who supports such a thing. Not all solutions, even “good” solutions, are acceptable. And there are some slopes, and sometimes they are slippery.

You are also ignoring the fact that, while it is true as you say that “In all honesty, there are a hell of a lot of people who shouldn’t reproduce. ” (this can be applied to everyone if quantified … no one should have more than one or two kids) major demographic shifs do in fact happen, and yes, education and other factors tend to reduce fertility.

Maybe in time we can figure out the problem of republicans too.

Well, they should just be sterilized.

Here’s a question for you, seriously (I figure you’ll have these data or the ability to estimate it): What are the Markovian factors here? In other words, what numbers (probabilities) would go into this chart:

Non Addict –> Addict offsprign
Addict …> Addict offspring
Non Addict –> NonAddict Offspring
Addict —> Non Addict Offspring

If A -> A is high, which it probably is, that’s bad, but is it the case that the first A in a series always comes from N? And, isn’t that a very effective route to reduce the total proportion across all A fields?

I think you fail to really comprehend the nature (or more accurately, natures) of addiction Greg. We aren’t talking about some monolithic entity that can be functionally fixed with any singular solution. While there’s no question that we don’t do nearly what we can, there is also only so much we can do at this point.

When it comes to kids and addict parents, there are jurisdictions that bend over backwards to help. The ex and I took a parenting class while we were in Portland, for example. More than half the class were people who have substance abuse problems. Only one other couple besides us, was there without a court order. It really doesn’t make much of a difference though. Not because the culture in Portland doesn’t want to help, not even because most of the parents don’t want to be better parents.

The problem is that we just don’t know how to make it better. In part because in a room of twenty odd substance abusers, you have twenty odd substance abuse problems that require twenty odd different solutions. And even should they manage to get better, we still don’t understand how these peripheral problems work – such as why their children are still so very likely to become substance abusers. It’s no wonder that we don’t either, because we’re still dealing with very different substance abusers.

Beyond what we don’t know, one of the things that we do know is that a lot of “clean” addicts are still dysfunctional parents. An unfortunate side effect of twelve step recovery programs is that they overtly encourage continued dependence – just on something other than the original substance of abuse. The addict still engages in the addictive behaviours, they just don’t happen to translate that to actual substance use. This is fine for getting clean, but doesn’t change the fundamentally selfish nature.

As for your argument about emotion and society – bullshit. We make laws and develop political positions based on emotion all the time. Sometimes good positions, sometimes bad. While you have very good arguments for your position on guns, you really can’t argue that it isn’t based on emotions. I am also making a very reasonable argument for why addicts really shouldn’t reproduce, that also happens to have a strong emotional context. That many other people should also not reproduce is irrelevant. This is a discussion about people who, having specific characteristics should not be reproducing.

In all honesty, there are a hell of a lot of people who shouldn’t reproduce. I would love to see massive campaigns to encourage people (through educated, reasoned arguments – not pay) to ensure no accidents are made by getting fixed. But just as I would prefer that people with certain other extreme mental illnesses not reproduce, I don’t think it is necessarily an inherently bad idea to provide more motivation to addicts to get fixed.

I hope that someday we will have better solutions, but we don’t. Maybe in time we can figure out the problem of republicans too. Until we do however, it is important for us to find ways to mitigate the damage. In the case of republicans, we need to find political balls. In the case of addicts, discouraging reproduction is a viable option for reducing suffering.

This is a complicated issue and the answers aren’t always obvious. We really need to get past moralising addiction, before we can truly begin to deal with addiction and substance use disorders. All we really tend to do is talk about substance use disorders as a consummate evil and because of that we can’t do a fucking thing about it.

When I am talking about the problem of children of addicts becoming addicts, I am not talking about something we need to weed out through eugenics. That isn’t going to happen. I am a perfect example of just how big a fail that is, because my parents aren’t substance abusers and never have been. What I am talking about, is reducing a huge fucking risk factor. More importantly, I am talking about preventing children from a great deal of suffering before they ever have the opportunity to become drug addicts.

Have you ever actually spent time around the children of substance abusers? I’ve spent time around a whole hell of a lot of them. With very few exceptions, there lives are shit. There is some variation in just how shit they are, but being the child of an addict almost always sucks disease infested donkey balls. I understand that a lot of parents are shit and their children have shitty lives – I get that. The difference here is that these children are virtually guaranteed a shit life.

And even those who manage to rise above it and have not so shitty lives, struggle against it to get there.

I would love to fix the problems of addiction. That would be why I am all about focusing my career on trying to do just that. I would be fantastically happy if we just managed to get rid of this obnoxious fucking moralising problem. But I would also love to see less kids suffering because their parents are irresponsible, drug addled gits.

And for the record, I am not the least bit oblivious to the connotations. I actually happen to be rather thoughtful and, as I mentioned, have spent a lot of time on this one. I have mixed feelings about coercive sterilisation, but in this context really don’t have a better solution. Whether encouraging them with money or merely convincing them it is best, I would love to see fewer addicts reproducing.

One is a personal feeling, desire, reaction, the other is how I want civilization to work. If we based our desires for how civilization should work on our desire, feeling, reaction … that wouldn’t be civilization.

I also don’t think that everyone is automatically a good parent just because they figure out how to have sex and manage to not kill the fetus along the way with their dumbosity or other problems. There is no mommy instinct or daddy instinct. Yet, a very large number of parents are very very bad at it, and only some of them are addicts. If sterilization should be offered somewhat agressively to addicts because they may be bad parents, shouldn’t it also be offered to anyone who might be poorly educated or poorly socialized or, I dunno, maybe foreigners or people with po-lice records or whatever?

Regarding the parent-offspring link. Please back up and look at what you are saying. There are numerous things that have familial links, and yes, addition is one of them (no, I’m not hearing this from you for the first time). If the assumption in the program that we are talking about, or among some who support the idea, is that addiction is genetic so we should weed the population of those genes, than this very clearly and certainly IS a eugenics program. And that makes me very uncomfortable. If the assumption is that there are behavioral routes that can link the behavior of the parent with the behavior of the offspring but NOT genetically, then the argument falls apart for that reason, going back to what I said at the beginning of this comment: Our society has dropped the ball on this and the fact that we have failed due to our own inadequacy is not a reason to bunt.

Most of the problems of this world, you know, are caused by people of means who are mainly of European ancestry (plus a few guys from Japan). If we want to solve the problems of the world for the next generation, sterilize the wealth hoarders and redistribute their money. Funny thing, though … this suggestion will be assumed by all to be tongue in cheek, and no rich white guys are going to have their tubes cut. But the proposal to trade money for sterilization to people desperate enough, due to their addiction, to take the deal is being made quite seriously and there have already been a fair number of people who’s reproductive systems have been mutilated because elements in our society have decided that society has done enough and can do no more.

Policy FAIL. Humanity FAIL. Public health FAIL. Compassion FAIL.

Godwin’s Law: “As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches 1.”

Laden’s corollary: “As the Nazi’s regress into the murky past of history, normal thoughtful people forget to not be Nazi’s”

(Note that both are meant to be humorous. Not that this is all that funny, but whatever.)

I am opposed to the sterilization of people based on their behavior.

While my own children are wonderful, brilliant kids, they are also dealing with way more shit than small children should. Eldest has severe emotional problems, despite them being relatively privileged as far as the kids of addicts go. And tomorrow they are going to be losing their mother. At least for two years, possibly permanently.

As much as I love them, am glad to have them in my life and will do absofuckinglutly everything I can to mitigate the damage, their mom and I screwed them over. We screwed them over by having them. They are at risk in several ways and not to some small degree. Had I actually been sterilized when I fucking tried to years ago, to small boys wouldn’t have been through hell and about to go through more.

And yes, the problems are largely due to the addictive behaviours of their parents – as well as our other mental issues.

Unless, of course, there is a presumption that an addict will beget an addict. Is that on the table here as well?

Absolutely there is. There has been study after study that have indicated that the odds are exceptionally high, that the children of addicts will become addicts themselves. The range runs from about sixty odd percent to as high as eighty seven percent of the children of addicts will become addicts themselves. Of risk factors for drug abuse and addiction, having parents who are addicts tops the list.

This is not just in the case of parents who are addicts while raising their child either. Even those who clean up before the child is born – before conception, still have an at risk child. There are several theories for why that is the case, a couple of which are very likely true. First, many of the neurological problems that tend to have high comorbidity rates with addiction, are suspected to be heritable – whether through genetics or environment. Second, behaviours that might have some link to addictive behaviours might still be exhibited by the addict, long after they get clean – kids pick up said behaviours to the extent that they develop neural pathways around them.

Whatever the reason, there is overwhelming evidence to suggest that the children of addicts are extremely likely to be addicts themselves. It is substantially more likely they will become addicts, than not. This is one of the most important reasons for my interest in addiction and addiction research. It is also largely why I want to explore addiction from a cross cultural perspective.

Look, I am cognisant of the history of coerced sterilisation. This isn’t something that I take lightly or am making an off the cuff response to. Considering how much time I have spent thinking about this in the context of my own life, I assure you that I have considered it in great detail. I don’t like coerced sterilisation. I just happen to like what happens to most of the children of addicts even less. And yes, I am including the upheaval of my own children’s lives in that statement.

If they get their shit together and believe they can be and want to be a competent parent later, there is no shortage of children needing adoption.

It is like eugenics but it is not really eugenics because we do not believe that we are avoiding another generation of addict by making sure today’s addict is sterilized. Rather, we’d be avoiding the public welfare costs of caring for the offspring of an addict. Or, to paraphrase from the person who cooked up this idea, we are avoiding paying the cost of the addict breading like a rabbit, having one child every year.

Unless, of course, there is a presumption that an addict will beget an addict. Is that on the table here as well?