thoughts of an indigenous nursing student

This page has more information and recommendations for some basic exercises:

Wanting something requires dopamine signaling, but liking something doesn’t.

If you have a mental illness/disorder that affects dopamine, you might feel that you don’t want to do the things that you like. You do still like them. You will appreciate having done them.

Let your likes guide you.

(If you want to read more, here’s one experimental paper about it. https://pmc.ncbi.nlm.nih.gov/articles/PMC5171207/ This theory called the incentive-sensitization theory was originally created to explain behaviors in addiction but can be applied elsewhere as well)

so here's a super long post about strokes in general, and mine in particular/what I went through.

The substance I was addicted to was heroin. While I was actively addicted, it absolutely came before everything else. My life shrank around it. I kept using despite very real, very obvious negative consequences. If you’re looking for something that fits the “compulsion + harm + loss of control” model, that was it.

But what’s always sat strangely with me is what happened when that context changed.

Once my abusive relationship ended and I was no longer in an environment where it was readily available, it was shockingly easy to stop. I’m not saying it was physically comfortable. My body was pretty pissed off for a while. But psychologically, it just didn’t have the same hold anymore. I wasn’t spending my days white-knuckling cravings or constantly thinking about it. It dropped out of my life in a way that, according to the 12-step model, is not really supposed to happen.

And that’s where my issue with that framework starts.

Because 12-step ideology tends to assume that if you have ever had that kind of relationship with one substance, it reveals something fundamental and permanent about you. That you now have a generalized “addictive nature” that will attach itself to other substances or behaviors if you’re not constantly managing it. That you are, in some essential way, always on the verge of transferring that pattern onto something else.

And that just hasn’t been true for me.

I was a near-daily cannabis user for years. When it started consistently making me feel physically uncomfortable instead of good, I stopped. No drawn-out battle, no existential crisis, just “this isn’t giving me what I liked about it anymore” and I moved on.

I drink occasionally, in social or celebratory contexts, and I genuinely find alcohol kind of boring outside of that. It doesn’t have much pull for me.

I tried gambling once, got annoyed at how tedious and overstimulating it felt, and left the casino in under an hour. I have not felt remotely compelled to revisit that experience.

I use the internet a lot, and I play a handful of video games, but I can also go on a camping trip with no signal and be completely fine, unless you want to try and find something pathological about nature photography, in which case you can blow it out your ass. If anything, I generally enjoy the change of pace. There’s no sense of panic or withdrawal or “I need to get back to my computer/consoles immediately.”

So when I hear the idea that addiction is this broad, transferable trait that will latch onto anything with quick reward or low friction, I just don’t see it reflected in my own life.

What does make sense, looking back, is context.

When I was using heroin, I was in an abusive relationship. My environment was unstable, stressful, and honestly pretty bleak. The substance didn’t just exist in a vacuum. It fit into a specific set of conditions where it functioned as relief, escape, and regulation.

When those conditions changed, the behavior changed with them.

That doesn’t mean there was no dependency. There obviously was. It doesn’t mean there were no consequences. There very much were. My grades suffered. I dropped out of college. I lost my apartment because staying out of withdrawal and numbing out from the abuse felt more important than paying rent.

But it does suggest that what we call “addiction” might not always be this permanent, identity-level trait that needs to be managed forever. Sometimes it looks a lot more like a relationship between a person, a substance, and a specific environment.

When that’s the case, then a framework that assumes universality - “if this happened once, it will always be waiting to happen again, with anything” - is going to miss a lot of variation.

I’m not saying 12-step programs can’t help people. Clearly they can, or they likely wouldn’t exist in the way they do. But I do think they’re often treated as the model of addiction rather than a model that fits some people and not others, and when your experience doesn’t match that model, many people who swear by them will assume that you are misunderstanding yourself, in denial, or “not taking it seriously enough.” This paternalistic attitude only serves to make me even more skeptical of the framework.

For me, what mattered wasn’t declaring myself permanently “addictive” or treating every pleasurable behavior as a potential threat.

What mattered was getting out of the environment where that pattern made sense in the first place.

A man came up to the girl and said, "You'll never save all of them. What you're doing is pointless. It doesn't matter."

The girl threw another starfish into the water. "It mattered to that one."

The man snorted and walked away.

The girl kept throwing starfish, one after another.

To throw one starfish back into the ocean takes a trivial amount of effort, but to throw ten, or fifty, is much less so. The girl had not learned much of biomechanics, but she began to feel the strain in her back. Her skin had softened from the seawater, and the starfish themselves were abrasive. Her fingers had pruned. Her shoulder hurt. She was cut, twice, on her fingers, as the same storm that had stranded the starfish had also brought up broken shells and crab carapaces. The skin of a starfish was like sandpaper.

She tried switching hands, and could throw the starfish less well, and it wasn't long before she had mirrored all her injuries. She was bleeding, though the blood wept rather than flowing, briefly staining the starfish pink before they were tossed into the ocean.

It seemed as though there were just as many dying starfish as when she'd started.

After three hours, the girl was sunburnt. A passing man had told her that she should stop what she was doing, and had offered her some water, which she took, but he hadn't helped to throw the starfish back.

The girl's hands were cracked, scraped, and raw. Saltwater found the wounds, but she'd gone numb, and her motions became more mechanical.

"It mattered to that one," she thought to herself, "It mattered to that one," over and over, like a mantra. Her muscles ached, but the ache became familiar. When she'd started, her throws had been beautiful things, guided by purpose, but now they were sloppy and threatened to pull her off balance.

She did fall, more than once, landing on sand that was filled with jagged debris, and sometimes she was slow to get up. But she did get up, because there were more starfish to save, tens of thousands of them.

Night fell, and it was harder to see the starfish, but they were still in need of help. She was tired, and the cuts on her fingers had multiplied. The skin had been wet for too long, and in one place, on her palm, where she had gripped a thousand starfish to throw them, a piece of white skin had come off.

Still, she kept throwing starfish.

Her mother didn't find her until after midnight.

"Hi mom," said the girl. Her voice croaked. She had been saying, "It mattered to that one" under her breath for long enough that her vocal cords had strained. She threw another starfish into the ocean.

"You need to come home," her mother said.

"These starfish will die without me," said the girl.

"I know," said her mother. "But you need to come home, because if you keep doing this, you'll collapse on the beach, and like a starfish, you'll need to be rescued too."

The girl stooped down, back aching, and picked up another starfish. Many of them had died by this point, but there were still uncountably many that lived. The rough skin of the starfish grated at her tender skin, but she rose and threw it, arm protesting, and watched it fall down into the water.

Her mother grabbed her gently by the shoulders. "I'm bringing you home," she said. "It would be better if I didn't have to carry you, but I will if I have to."

"I don't want to be the sort of person who leaves starfish to die," said the girl, shrugging off her mother. But a part of her did want to be carried, because she'd walked for miles along this beach, one stooping step at a time.

"I know," said her mother. "But to survive, you have to be. Save as many as you can, but take breaks, get good sleep, eat well. Then go back and save more."

The girl swayed where she was. She was close to passing out, though maybe it was because her rhythm had been interrupted.

Her mother held out a hand, so they could walk together, like they'd done when she was smaller.

And it was then that she noticed the scars on her mother's hands, the calluses and rough spots, the places where cuts had healed. She had seen her mother's hands many times before, but had never asked why they were that way.

what. I know it must be comfortable and nice to assume police are always on your side but a) no and b) even if they are they are not trained to interrogate children (i would argue they are not trained to interrogate anyone at all) and c) this child still has rights??? and also needs support ?? even if questioning went "well" in that police got info they needed, the kiddo needs support before, during, and after that was clearly not provided