So even if it's not true for everyone that's a practically useless observation because how are you going to find out it's not true for you without risking becoming instantly addicted?

I don't have the reference at hand, but the rates of problematic use in the population seem to mirror alcohol. A small single digit percent of people will absolutely have a horrible problem, 8-10% will engage in disordered use, ~10% will over use in some way, and 80% will never develop a problem at all.

Excuse the snark, but any chance it was funded by the Sacklers?

No. There's a large body of research.

Here's one showing only 5% of people filling opioid scripts go on to long term use.[1]

Another older study citing 2% of US adults regularly using opioids, while a further 29% use them infrequently. Other more recent studies I seen hold this pretty constant. [2]

Here [3] only 13% of elective surgery patients fill opioid scripts beyond 90 days, and "mental health disorders, and tobacco dependence or abuse were associated with prolonged opioid use". It's well known that people with one substance abuse issue tend to be at higher risk for developing others.

You could go on and on finding studies that show that relatively few people with high risk medical/mental health history go on to develop opioid addiction after using these substances. There doesn't seem to be any support for the idea that the average person can take these drugs once and become "hooked".

All that said, they are dangerous and have strong addictive potential so caution is warranted.

[1] https://link.springer.com/article/10.1007/s11606-016-3810-3?...

[2]https://www.sciencedirect.com/science/article/abs/pii/S03043...

[3] https://www.sciencedirect.com/science/article/abs/pii/S03635...

That you cannot imagine an approach doesn't mean an approach doesn't exist. It may be possible to form a generalized understanding of an individuals predisposition based on testing with other substances, just as one example.

You’re still taking a substantial risk when forming that generalized understanding, and then another substantial risk when you start making conclusions from that general understanding.

And for what?

My point is only that you strongly implied a fallacious argument, which damages your ability to reason on a topic.

Ok, so basically, since we haven’t proven the opposite, we can’t be sure, regardless of how the situation appears. I think that’s a weak argument in a general sense, but point taken.

No, I'm not arguing that proof is necessary for certainty. I'm pointing out that the implied reasoning is akin to argument from ignorance. We don't have to take a position on a topic if we are ignorant, but we often do so when doing so can be used to justify existing biases.

The assertions that the are made in the article seem like something that should be backed up with studies and not anecdotal evidence from one person (even if he is well respected).

It is an incredibly slippery slope for people to walk out on. It would be incredibly hard for someone to say whether or not they will spiral out of control if they try it and the consequences of becoming heavily addicted are life destroying. It seems like playing Russian roulette and I'm not sure it's a good thing to raise the idea that one can potentially manage it. Also, the person being interviewed could be one of the people that can't control it and will spiral out of control or him saying he manages it well and it's possible to do so could be a facade and he could be trying to do whatever possible to keep his habit alive, but we just don't know. Many people manage it fine for years without anyone knowing until they start their sharp decline towards bottom.

>The assertions that the are made in the article seem like something that should be backed up with studies and not anecdotal evidence from one person (even if he is well respected).

Wherw do you think he got these assertions? There have already been studies about how often heroin users are addicts or what the addiction rate of prescription opioids are.

One thing I am curious about with this research is how they would get reliable numbers for high functioning opiate addicts. Addiction is really a spectrum from "no dependence on the drug and no negative life consequences" to "high dependence on the drug and many negative life consequences". I'm sure that many people fall in the middle where they continue to responsibly live their lives while still being dependent on a drug that they may wish to quit, but can't because the withdrawal is too much. I also would not be surprised if many of these people did not seek out help and tried to hide their problem from others due to the major stigma associated with being addicted to opiates, not to mention those who are dependent on opiates but in denial about their dependence.

> is how they would get reliable numbers for high functioning opiate addicts.

He's very clearly advising against getting addicted, something most opiate users accomplish.

So the article states that Carl Hart makes a claim that 70% of drug users don't meet the criteria for being a drug addict. I'm wondering how you could even get a reliable number for this for a drug like heroin, given the stigma attached to this drug and the fact that users themselves may be in denial that they are dependent on the drug. Someone can be meeting all their obligations in life and still be struggling with a drug addiction. If asked, I would imagine a lot of high functioning addicts would say they can stop whenever they want to, they just don't want to. Anyway, I may just have to give his book a read, it sounds interesting.

Yea, I would be very interested in the methodology they used to come up with that 70% and I am wondering if that is a snapshot in time or is that over someone's entire life. Addiction almost always starts out in a more controlled manner until its not. So if 50% of those 70% of drug users become full blown addicts, then its a BS number. I'm also really curious how they found those high functioning drug users, because I can't imagine anyone that is successfully hiding their use from the world would divulge it to anyone they don't know or trust ("hey, are you a high functioning drug user?" sounds like something a cop might say).

Both the "snapshot" studies and the lifetime studies find similar rates of addiction, I went and found part of what he's referencing.

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

An easy way to improve that accuracy is to survey people based on their past use as well. There's less reason to be in denial about something you've already dealt with.

From the interview, it sounds a lot like he got them from his personal experience. He mentions percentages, but I see no references to any sources. It matters what those sources are (e.g. if they are from Purdue pharma or the sacklers, it's probably BS).

Then buy his book, how is he supposed to cite his sources in an interview?

He could mention an institution and professors that ran the studies like other people I've seen interviewed. It is an incredibly dangerous assertion he is making, it seems like the readers shouldn't be the ones that need to investigate and you certainly shouldn't need to buy his book to investigate it. Denial is an incredibly huge problem with addiction, stuff like this could be used by those with bad addictions to stay in denial and maintain their addiction.

A gun is always loaded. Even if it has no bullets.

I think you're trying to argue GP's point, but you've only confirmed it, because you're misrepresenting both the facts and the traditional advice.

"Treat every gun as if it were loaded" is the traditional advice, and is a wonderful attitude to have about firearms. But if it's not loaded, it's not loaded, those are the facts.

Perhaps the same with opiods: treat them as if they are highly addictive, in a rapid manner. But if (for you) they aren't, they aren't.

Two things I don't like FUD around: My Linux and my heroin.