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The Disease Model of Addiction · Why We Do What We Do

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You're listening to Why we do what we do? Welcome to Why we do
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what we do. I am your dependent but not disease Toast Abraham, and
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I'm your curious seeking host Shane Ooh. We're Psychology podcast. We talk about
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all the things that people in animals do. We talk about like mathematical models
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and diagnoses and currently, and over the last couple of weeks and for the
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next few future weeks, we are talking about the very complex discussion that is
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addiction in various formats. Yes, and so we have a suite of topics
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that we're going to cover. We're going to try to unpack them and give
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them all the space they deserve. And today we are talking about this idea
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that many people talk about, which is that addiction is a disease, and
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we're going to talk about kind of what that means, what that looks like,
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and maybe unpack a little bit of that and kind of talk about why
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that might not be the most useful way to have a discussion about this.
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Yeah, I think this is going to be one of the maybe surprising ways
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that people have because I think a lot of people have more or less accepted
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and built into their discussions their advocacy even of addiction by talking about it using
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the sort of disease model framework. And there's a reason for that. There's
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a reason that these people who are advocates for supporting people with addiction and dependency
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by using the disease model framework. And we're going to do our best to
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sort of talk through why the implications for that, and why we think there
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might be an alternative way that would be even more effective to conceptualize how dependency
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works and what we can do about it. Sure, absolutely, but before
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we do that, we've got some stuff to do, right, We've got
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some things to celebrate. Indeed, Yes, So this episode publishes on April
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tenth, and April tenth has Day is a day, and therefore it is
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a day of holidays. Yes, yes, yes, we do holidays on
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days. So today is ASPCA Day. So if you like Sarah McLaughlin,
2:06
it's a really great day to celebrate. I love that encourage a young writer
2:10
day, fantastic, get out there and write. I love that it's global
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work from home day, which you know, I like that every day.
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Is that a that might be only a few years old, I'm guessing I
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think so. Yeah, I'm surprised it's not in March, but sure.
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There's also the International Day of Pink maybe also called Barbie Day, Yeah,
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Barbie Stoke. It's also International Safety Pin Day, so all those punks in
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high school that decide to pierce their ears with safety pins, you're welcome.
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Sure, National Cinnamon Crescent Day, ym sounds delicious. It's National Farm Animals
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Day, so but not like Animal farm Day, Like that's a different one.
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That's you know, that's an allegory for communism and all the real dictatorship
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and stuff like that. Maybe not that one, but farm animals in general.
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We like animals. I love farm animals. I've always wanted to,
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like, be friends with a pig. I really like pigs. They're so
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wonderful. I think you could have one now, Yeah, I think you're
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probably right. I would like an emotional support pig. But speaking of farm
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animals, it is also National Hug your Dog Day, which is I mean
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you could conceptualize as a farm animal in one way or another. Yeah.
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Absolutely. Also, speaking of farm animals, it's National Sibling Day, So
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my brother is definitely some kind of farm animal. I'm not quite sure what
3:20
would be a goose? A silly goose if that, If you will,
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it is apropos of this suite of topics, and particularly as we get into
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some of the later topics that we will be having. So not directly related
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to today, but anyway. It is National Youth HIV and AIDS Awareness Day.
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It would be very important, yes, very important. Now as far
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as weeks go, it is Bat Appreciation Week. Sweet right, that's not
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in October. It's also be kind of Spider's Week, also not in October.
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I think I might have pulled the wrong date. No, it's a
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great week for goths. It's also eat al Faturday. So to our friends
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who celebrate, I want to make sure I get this right. They say
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eat Mubarak, so just to celebrate and break the fast. Ah, I
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see, it does kind of sound like eat a fritter, so I could
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see breaking the fast with a fritter. It is Explore your Career Options Week,
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yes, and it's also to go with Exploring your Career Options Week.
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It's hate Week and the National Library Week. Some people hate the library.
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I guess that's the thing. Yeah, well, yeah, there's a lot
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of people who just like you know, people in Florida tend to hate libraries
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because there's bad It is true, and people hate books. That's that's Florida
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Week. Is the library a week? Yeah, they just combined those two
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weeks. It's great, it's very cool. We do talk about holidays mostly
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just you know, for fun and to sort of say, this is a
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piece of trivia you can now share with people around you. If you're listening
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to this right bright and early in the morning, well good on you for
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staying so on top of your episodes. But now you can tell people that
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it's International Safety Pin Day or whichever of those holidays stood out to you.
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Apparently safety pins for me. But we're actually not talking about those holidays as
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our private discussion. As we said, our primary focus for this discussion is
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going to be talking about the sort of philosophical approach to thinking about and conceptualizing
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addiction by looking at and using the diseased model of sort of looking at addiction
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specifically as a disease and why that sort of model exists and what we think
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about that. To kind of give a little bit of insight on this,
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you're going to find in any sort of space where there's treatment or trying to
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conceptualize some type of you know phenomenon, you're going to find people that kind
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of have different viewpoints and perspectives. I mean, we've kind of talked about
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this on the show before, where we tend to take a behavior's bent in
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the world of psychology, but there are people that take more of a Freudian
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bent or a Jungian belt or what you know, whatever. Like, there's
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there's a lot of different ways to kind of like look at a thing,
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and so it's important to kind of understand walking into this. That's kind of
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where this comes from. But the disease model is actually kind of a medical
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approach to understanding the idea of addiction. And so when you apply a disease
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model in general, the disease model, what it does is it looks at
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the idea that we focus on what is wrong with a person in an effort
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to fix that issue. Not necessarily that person themselves is wrong or broken ory
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and like that, what we tend to look at is that there is something
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going wrong with that person in whatever homeostasis, whatever environment they're looking at.
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Basically they have a disease. Yeah, and because there is a disease,
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we have an opportunity to fix that disease, not the person themselves. Yeah,
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they have a pathology, you know, they have a let's just say
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some kind of flu or some illness that we know about. We administer cure.
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We inject them with some medication penicillin or whatever it's going to help with
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whatever disease they are, and disease goes away. And so they like,
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well, let's just apply this to addiction, Like, they have a pathology,
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let's inject them with cure, disease goes away. And so in different
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terms, part of I think the motivation for this approach is to extract blame.
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We say, the organism is not to blame. We don't blame someone
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for catching a flu. We don't blame someone for like getting cancer. We
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don't blame them, right, Rather, they got sick and they must be
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treated to address that sickness. And I think there's we can understand the ethos
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and the compassion and the desire to try and see this as an issue that
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requires attention. And a model that has been successful at helping support people when
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they have these situations is been in the medical model by calling you by it
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with disease, right, And so I think that you know you're going to
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find that this approach is going to have more of a moral and social type
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of like implication to it, whereas like the medical piece doesn't really happen.
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You'll see what I mean when we get into I'll leave that discussion for later.
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So what the disease model of addiction does is it focuses on addiction as
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a disease, meaning that it's effectively an ailment that the organism obtains, like
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they come into it. It is not necessarily something that and we'll kind of
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talk about different ways this comes up to, but it's not something that they
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have chosen per se. Usually people who oppose this model tend to say people
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chose to get into addiction, and that's there's its own problems inside of that
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too, right, But this is kind of saying that the person did not
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choose. They have kind of come into this ailment and they are dealing with
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that as is. Yeah, and we've I think unpacked choice to some extent
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in past discussions and why I think that that's not a particularly helpful framework for
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understanding how behavior unfolds in the first place anyway, because I think it very
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incorrectly assigns the locus of control. A choice also is a locus of control
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inside of the organism, and that's why I think this one tries to extract
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that. It tries to pull back from this to saying like this, you're
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at fault because you wouldn't be at fault for like getting you know, you
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know, some other disease that people get, And it almost doesn't matter even
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if you are at fault because we're going to treat it anyway, which I
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think is a whole nother discussion. But right, you know, we just
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recently talked about alcoholics anonymous, and this idea of addiction as a disease really
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developed from that, and it was specifically an effort to help shift the perspective
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on like, these are people who need support. We like, they need
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help, they need some kind of system to support them through this, to
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get them on the other side of things, and so we don't blame the
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person, we blame the illness. Like that. That's sort of the general
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ethos there, right, which I you know, we can get on board
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with. I agree with that general sentiment at least. Yeah, yeah,
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I love that idea, right, And so you know, as we get
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into this later, I am sure that we'll talk about a circumstances view.
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Yeah, you know, we're going to have to at some point time.
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But I think also worth unpacking inside of this is that addiction is often categorized
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within the world of brain diseases. So this is kind of an interesting thing.
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Some of the conversations I've seen around this is that addiction is a brain
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disease, and sometimes brain diseases are also called neurodegenerative diseases, and they refer
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to diseases that cause brain and nerves to deteriorate over times. So you know,
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if you look at over use of a substance, then yes, it
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will cause damage to parts of the body, including the brain. And brain
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diseases are often things like stroke, multiple sclerosis, epilepsy, TBI acquired and
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organic brain injuries. So you start to kind of see that those diseases are
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something that are a little bit different categorically compared to addiction. Addiction tends to
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be a behavioral thing that leads to other things, whereas the like, you
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know, somebody can't control that they've got a stroke. But we'll, like
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I said, we'll talk about a lot of this inside of that, and
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I think it's just worth knowing that brain diseases are categorized as diseases underneath this
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medical model as well well, and arguably because you just interestingly use the words
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they can't control, and I think arguably when we talk about addiction, it
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is characterized in this lack of control, and that was a part of the
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Alcoholics anonymous sort of thing, right, is like, you don't have control,
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but you need like and you can't have control, right, you need
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to just give control over and then you will be helped give control over to
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God or higher power or whatever doorknobs, as we discussed that episode. But
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what that means is I think full of other implications that that are maybe not
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as straightforward as they kind of even sound, like what does control mean?
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But anyway, let's go ahead and get into the characteristics of a disease model,
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specifically in relation to a disease model of addiction. There are some core
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assumptions that I think when people are talking about it, we have to make
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a note of because this is kind of where people lean on this. First
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is that addiction is a discrete, diagnosable medical condition with very specific symptoms that
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include withdraw symptoms and different physical things that come along with this, but that
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is one of the primary assumptions of addiction as part of a disease model.
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There's also an observed pathology related to the disease, and with addictions specifically,
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the primary pathology is this loss of control idea. This essentially you're sort of
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being driven, guided, and pulled along by the behaviors associated and surrounding this
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dependency. Absolutely, and then the third assumption that they talk about inside of
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this is that addiction requires specialized treatment, which you know, when you think
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of other diseases like cancer or you know, epilepsy, those also require specialized
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treatment. So these again are assumptions of the disease model that say, addiction
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is diagnosible, it's discrete, it comes with symptoms, it's a specific there's
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a specific pathology related to it, and it requires special treatment. So far,
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all that being said, I'm good with that. That all makes sense
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so far. Yeah, you can see those parallels like they overlap pretty availably,
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Like you can see exactly how that happens, right, And there are
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variations inside the disease model too that are worth discussing. There's the exposure model,
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which argues that disease is acquired due to prolonged or excessive exposure to said
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disease, right, And then there's a susceptibility model, which is the argument
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that people who have genetic previous positions may already have the disease without exposure or
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they are particularly vulnerable. So and I think both of these are important to
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kind of unpack as well. But before we do that, I think we're
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gonna give everybody a little bit of space because we're gonna have a big,
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long discussion about this. So we're gonna do some ADS, we're gonna come
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back, and we're gonna riff real hard on this. You might say that
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the disease of podcasts ADS a nice okay, So we we sweated the fever
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out the fever that was ADS, all right, So let's get into this
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more and sort of I think unpacking the whole disease model and what we've discussed
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so far, and how like we do see parallel Like it's not that we
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don't understand why this came to be or why it had some utility and where
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people could easily sort of look at this is how diseases work, and we
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have a very similar overlap with how addiction works. And I think that is
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more or less understanding that humans are biological organisms, right, and so we
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our behavior is conceptually related to medical things because our behavior exists in the context
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of our biological being. And so when biology breaks down, our behavior changes.
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When biology changes, our behavior changes, and when our behavior changes,
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our biology changes oftentimes because we will do things that affect what our biology does.
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And it's just this really intermeshed something that you cannot dissect. It is
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nonlinear, but is not a direct like this than this thing. It is
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this constant, dynamic interaction of our biological organism and a stimulating environment. And
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that is where we start to see what these things look like. They don't
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play as nicely together, if you will. Like what I mean by these
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things is like illnesses and behaviors start to look a little different when you get
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to considering like how behavior works. Yeah, I think that's actually a really
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great distinction, because you know, an illness is going to require your and
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to me, maybe this is just that this is an ignorant understanding of this,
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but like to me, illness requires your biology to fight it, where
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addiction is so reliant on behavior to continue to access it, right, Like,
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I feel like there's this piece where you know, addiction is perpetuated by
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the fact that somebody is using and using and using or obtaining that substance and
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connecting with that substance. Now, you know, I'm not saying that that's
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like we need to be really clear about those distinctions, but I do think
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that that is a difference between like having a cold and your body, your
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biology fighting off a cold, you know, or your body repairing after a
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stroke. Those are very different processes, I would argue, than the process
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of addiction, which is a lot of those symptoms come from a behavioral outcome,
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right, It's the outcome of some set of behaviors that you engage in,
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at least on some level. Like I said, I have a really
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hard time too, because when we start talking about this as a disease,
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so often in the medical model, you can pinpoint something some causal effect of
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not maybe not of the disease itself, but you know, the symptom that
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somebody has. Like there's a very specific thing, a specific pathology that we
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look at that's like a biological pathology, and addiction has these biological processes,
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but there's not like it doesn't become a biological pathology until well into the throes
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of addiction, when somebody has gained that addictive substance and they have continued to
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do that. So like it almost moves from a choice to a biological model.
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And I feel like that doesn't that's not characteristic of other diseases that they
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talk about in medical and the medical space. Yeah. Absolutely, And I
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think there's so much just sort of unpack here. One of the things I
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like to think about is when we think about, as you are sort of
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alluding to the onset of these things, which is the onset of disease often,
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if not most of the time is kind of unknown to us. We
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don't know, like we couldn't behave with respect to the conditions under which that
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disease was acquired because we don't always know. And like, doing behavior X
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does not mean that you'll get disease, even though you know that it's a
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risk for behavior X that you might get that disease. So let's say,
17:15
for example, that like you're someone who works and hazardous chemicals. You know
17:18
that there is a inherent risk with working with chemicals that you might get cancer,
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So you maybe suit up and protect yourself and you try and get all
17:26
the gear to prevent the likelihood that there's going that the exposure to those chemicals
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is going to have that adverse outcome, But we don't know, Like it's
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like people who never work around those chemicals might get the disease associated with exposure
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to those chemicals. And with addiction, it's pretty clear what the onset is
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like you usually walked head on into it, looking right at it the whole
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time, right right, And it's sort of like thinking about when we get
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disease, As we said, we don't know where it comes from. Sometimes
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it's something we breathe in. Sometimes it's something that touches our skin or penetrates
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our skin. Sometimes it's something that develops inside of us. Sometimes it's something
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that we then potentially let in not knowing that it had that component. But
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you don't like touch a doorknob and get alcoholism just because the person who had
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alcoholism before you, who touched a doorknob, and so like the contagion that
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is characteristic of many diseases, the onset, which is characteristic of many diseases,
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just doesn't have a lot of consistent overlap with the kind of features that
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the substances and behaviors do a round addiction where we pretty much can observe what
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those are right ahead of time, and most of the diseases we can't.
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I think that's a great point too, And I think another thing to unpack
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inside of this is the exposure model versus the susceptibility models that they talk about
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inside of this, I think exposure models make sense from a behavioral standpoint and
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just from a general disease standpoint, right Like, if somebody gets exposed to
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some condition, then they are more likely to catch whatever that condition is.
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You know. By that, I think again when it comes to addiction,
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because so much of it relies on behavior as part of the onset that slips
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towards a more pathological issue, then your exposure model here is not prolonged exposure
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to some virus or bacteria or some type of biological disease. What you start
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finding here is it's more a learned process or exposure by environment or something like
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that. It's a very different type of exposure, you know, or just
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kind of like a slope into leading in addictions, Whereas, like the susceptibility
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model is saying that you're addicted without ever being exposed, or like you have
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such a high risk of being addicted that basically you're addicted without ever having displayed
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any of the pathology of addiction. And I think the susceptibility model is a
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little bit I think that's a little bit of a slippery slope. But I
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think you hear a lot of people talk about that. I think my brother,
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as an example, will never drink, and he will I mean,
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he says it constantly, He'll never drink, will never do drugs because in
19:48
my family, alcoholism has run rampant, and so he's so afraid of that
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that, like, as part of that susceptibility piece, he's afraid that he's
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so susceptible to that that he actively avoids that. But by this model,
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it would say that he is either very at risk or he's already addicted and
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he just doesn't engage with it. So there's I just have some problems with
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the assumptions inside of both of these. Yeah, I think that's absolutely fair,
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is that it doesn't seem to capture. It basically puts a pathology on
20:17
something that's not happening, right right, Like, presumably all of us have
20:22
the potential to get cancer, But treating all of us as if we currently
20:26
have cancer would first of all, completely overwhelm our medical infrastructure. Right,
20:32
like every single person on earth, like all of a sudden has like terminal
20:36
illness. Is definitely a problem that we do not have the facilities to address.
20:40
But second of all, I think it's not helpful because it's dealing with
20:44
a problem that doesn't exist yet. And in a system of triage, we
20:47
often want to start with like where is the place at which we can make
20:51
the most benefit the quickest, And we can't just treat every single thing as
20:56
if they're all the highest priority, Like We've got to sort of tyrate that
20:59
down. So I think it's not very practical to consider that we just treat
21:03
people as having addiction when they're not engaging in those behaviors. Although I think
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you know the preventative strategy of just don't do X. If you can maintain
21:14
that, that's probably your best bet. I mean in this case, because
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it's similar to like smoking, Right, It's like you might get lung cancer
21:21
even though you never smoked, but the chances of you getting lung cancer are
21:23
a way higher if you do smoke, and so let's just not smoke if
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that's something you can choose not to do and decrease the likelihood that you'll ever
21:32
get lung cancer. And it's like it's not a guarantee, right, but
21:34
we're not going to treat you as if you currently have lung cancer, but
21:37
we're going to if you have the prevention strategy in there. And I think
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nicotine actually is an interesting thing to speak about in terms of addiction here too,
21:47
because it's so tightly linked to disease. I can see where there's like
21:49
a lot of overlap with those ideas there. Yeah, absolutely, it's probably
21:53
worth unpacking a little bit. Like I mean, we've kind of said this
21:56
already, but I think we want to get into like the nitty gritty about
21:59
why disease models might be a problem for this particular type of issue. Right,
22:03
So, as a general rule, just to kind of go back,
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I think the disease model can be useful in a medical space, like by
22:08
identifying some type of outside influence, medical treatment can focus on curing the disease.
22:14
And I want to emphasize that that so many times in medical models we
22:17
focus on curing the disease. We're going to come back to that in a
22:19
little bit. Yeah, So, whether the disease is acute or chronic,
22:23
there is the idea somewhere that the disease can be eliminated or at least there's
22:27
hope that it can be eliminated. And that is I think a core kind
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of feature of a general disease model as kind of the way that it's implemented,
22:34
at least in the United States. And by taking a medical approach to
22:38
addiction, we can account for an acute problem an attempt to target that disease
22:44
through you know, again said disease whatever that is, through specific treatment.
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However, as I sort of said, like often we don't necessarily know what
22:52
the onset is for a particular disease, but there is one. And with
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addiction it's so much more complish because it doesn't have a single cause, right,
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It's such a complex, like branching spider web of contextual variables that lead
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to and support and maintain addiction and dependency. The history of use, the
23:17
psychological impacts, all of the cues in our environment, our social supports,
23:23
whatever motivating variables may be contributing to our choice to use in the first place
23:27
or continue to use or return to it at some point in the future.
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Like, it's very, very widely variable, and with disease, it's it's
23:36
usually like a thing, right, Like breathing in a bacteria that gives you
23:41
a bacterial infection is a thing. It's not that like, oh, well,
23:47
this bacteria was hanging out with its right bacteria friends and you just happen
23:49
to be in the sort of the right vulnerable condition and you know it happened.
23:53
I don't know, there's like it's not so complex because we have I
23:56
mean, it's complex in a lot of ways, but in this and this
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sort of onset part of this, we think about like there was a thing
24:04
that happened that caused that disease to develop inside of us. And addiction just
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has a lot of converging routes of variables. And I mean, at any
24:15
given point in our life, there's just like a million overlapping routes of things
24:19
of variables that are going on with us. And some of those might converge
24:22
on addiction for a lot of people. For probably most people they don't,
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but for some people they do absolutely. And I think this brings me to
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kind of the most troubling or concerning part of applying a disease model to addiction
24:36
specifically, because when you are looking at the disease model with the idea that
24:41
there is a cure, that means that for addiction there would be a cure,
24:45
and there are topics of curing addiction. And so by asserting that addiction
24:48
is a disease by definition of the disease model, there is a cure.
24:52
Whether that addiction is chronic or acute, it's still the idea that like,
24:59
ah, here's a secific thing that we can specifically treat and that we can
25:02
specifically get rid of, right right, And that I think is that creates
25:07
some problems. So I kind of want to I want to talk about this
25:08
a little bit because I think, you know, there is this idea that
25:12
somebody who is struggling with substance abuse disorders or somebody who is struggling with addiction
25:18
as a general rule, I think those folks, when they enter a space
25:22
where there is discussions of cures, I think that that creates a level of
25:26
false hope for people to think that the idea of getting cured means they will
25:32
never struggle with this thing again, right right, So you get rid of
25:36
this thing entirely. You can go, you know, excize this from your
25:38
body and then you're done with it. Right, But that's not ever,
25:41
ever, how addiction works. Given the complexities and given the type of psychological
25:47
and emotional processes and social processes that go along with this, I think that
25:52
calling addiction a disease inside of this model might actually be creating more problems for
25:59
folk folks who are entering looking for treatment and looking for a quote unquote cure.
26:04
That's just kind of my general thought on that. And you're thinking this
26:07
because they'll basically think, oh, I've been cured. I'm fine now,
26:12
is that sort of what you're Yeah, I've been cured. I don't need
26:15
to ever worry about this thing again. I see, okay, And you
26:19
know, I think that there again, we can certainly draw parallels to diseases
26:23
that exist, like cancer can go into remission and then come back, right.
26:27
We can see people who get chronic illnesses that never really go away even
26:32
with a lot of maintenance and treatment, and so like I can again,
26:36
we can draw those parallels because, as you said, because it's so complex,
26:40
because we have so many variables that lead to the onset and maintenance and
26:44
development and evolution, if you will, of the behaviors around a dependency,
26:49
then whatever treatment looks like is going to be a very multifaceted comprehensive model as
26:56
well, because it has to address all those different variables, or at least
27:00
most of those variables to get behavior to change course. Right, Because as
27:03
we're sort of talking about, the behaviors themselves involve oftentimes a change to our
27:10
biology anyway, which then changes what our motivations are going to be in those
27:14
different circumstances. And this is largely chemical addictions. I mean, we think
27:18
about other sort of behavioral addictions. Even in those cases, we're still doing
27:22
some like we're practicing a behavior so often that you can make the argument that
27:26
we're changing part of our neurological processes and sort of how we're essentially building a
27:30
high level of fluency, which means a lot of neural connections around particular behavior
27:36
patterns, and so those do also become like a change to our overall biology,
27:41
if you will. Just is sort of similar to like how we introduce
27:45
a bunch of chemicals to our brain, to our lungs, to our livers,
27:47
et cetera. That those also then change how those function, which then
27:51
change how we interact with our world around us. And so those are just
27:55
multifaceted components of dependency type behaviors that you have to con is like, what
28:00
now are our current motivations maybe from what they were before we started using something
28:04
to what they are now after we've started using something, that have altered what
28:08
those are. And as you said, the social components, there are now
28:12
the psychological components, if you will, of often as they're being used for
28:17
some particular variable and we've become as we mentioned before, oftentimes it happens when
28:22
you use is that you go into a state of like the state of using
28:26
a substance becomes baseline, and not using a substance becomes painful, and so
28:30
then it's using just to avoid pain, right and be at baseline, right,
28:36
And so that becomes a whole new thing. Is like, okay,
28:37
so now what can we do to get you to baseline without that substance?
28:41
And that just doesn't that doesn't really reflect a lot of how the other diseases
28:45
sort of work. As you were talking about this, I was thinking about,
28:48
let's say the example of somebody who has a pretty significant cancer diagnosis,
28:53
and they're struggling with with that particular diagnosis and the treatment a right, So
29:00
there are a lot of things that can happen inside of that. Somebody may
29:03
have to have an amputation as a result of that and deal with the fallout
29:07
of that particular procedure, right. So they're struggling with anxiety around that,
29:11
they're struggling with depression around that, whatever whatever other things might be going on.
29:15
But I think that is the thing, and this is where I could
29:18
see people really glimbing onto this idea of addiction as a model as part of
29:25
a disease, because addiction, just like cancer, can lead to all of
29:30
this other fallout. Right. So addiction is here, now this person is
29:33
using. Now they're getting despondent, and now they're experiencing anxiety, or they're
29:38
using because of anxiety, or there's a lot of things that could happen.
29:41
Right. But with cancer, you have the same kind of thing. This
29:44
disease has led to a decrease in some quality of life, which has resulted
29:49
in these other psychological detriments this person, and I could see I could see
29:55
somebody looking at addiction and doing the same thing and going, well, cancer
29:59
I mean to be clear, I'm not saying they're the same thing. I
30:00
don't want anybody coming after us and being like cancer adictionary. That's not what
30:04
I'm saying. What I'm saying is I could see the parallel. You we're
30:07
kind of saying the opposite directly. Yeah, I'm trying to write where the
30:10
idea is, like, I could see somebody going cancer bad leads to bad
30:15
things, drop off in quality of life, addiction bad leads to bad things,
30:18
drop off in quality of life for that person. I could see that
30:22
parallel as part of somebody's discussion or at least mentality around this. I can
30:26
see that, and also adds bad lead to a decrease in quality of podcast.
30:37
All right, let's get to talking about sort of cure versus management and
30:44
talking about addiction and the disease model here. So, as I was kind
30:47
of putting the notes together on this, I was thinking about a lot of
30:49
the discussion around prognosis and treatment outcomes because so much, so many of times,
30:56
and you'll hear doctors that can never promise anything, but they'll say the
31:00
prognosis is good because of X, Y and Z, right, whatever treatment
31:02
conditions are going on. So by calling addiction a disease, though, it
31:06
implies that there is a cure of sorts inside of that, right, or
31:08
some kind of treatment, some kind of treatment at least right, or some
31:11
kind of really positive effect of that treatment. But most of the discussions around
31:15
addiction treatment indicate that addiction never really goes away. It kind of stays with
31:19
that person on some level, or at least the impact or the psychological or
31:23
emotional, you know, kind of impacts of that. And so instead people
31:26
who are struggling with substance often face this challenge indefinitely. So once somebody has
31:33
gained or like gotten to the space where that you know, formally they have
31:36
an addiction, they struggle with that forever. Now there's no cure for the
31:42
cravings or the I mean there may be, there can be on some level,
31:47
but the idea that you have an addiction, you have this thing and
31:49
it can be cured is I feel like a false flag and it produces some
31:55
i think some quality of life issues for folks that are going into treatment wanting
31:59
support thing and they are going to be cured and realizing that it's never going
32:01
to happen. It'd be also a little bit tough to ask people to.
32:06
I think, consider the reason you have this disease, cancer or whatever it
32:10
is, is because something that well it's cancer actually just have some drug parallels
32:15
here. But the reason you have this disease is that something you're doing that
32:19
is really hard for you to not do and I need to just not do
32:22
that thing anymore, right, and that you're sort of responsible for that now.
32:25
But anyway, you know, I think taking a moment to understand between
32:29
the difference between curing a disease and managing a disease. With a cure,
32:31
we have relief it could be an animal, person of the symptoms and often
32:37
underlining pathology of the disease or condition. Versus management, we have the process
32:44
of dealing with or controlling the things or the people just sort of indefinitely.
32:50
And there are diseases that have this characteristic, But as you said, I
32:53
think that's pretty much always. The characteristic of addictive and dependent and addiction behaviors
33:01
is that there's I think pretty much always a risk of relapse. And I
33:06
think the thing is is, I think that risk of relapse is different than
33:08
the risk of relapse for something like cancer, because for something like cancer,
33:14
you might have certain psychological processes where there are certain cues that remind you of
33:19
your treatment or anything like that. Right, there are some things that can
33:22
happen inside of that. But for addiction, there are cues that are like,
33:24
oh, I know where I can score, I know where I can
33:27
get this. This is where I used to drinkle my buddies, this is
33:30
where I used to do this, And those are more readily available things that
33:32
could be choices that somebody can make inside of that environment. But I think
33:37
understanding all of that right, by definition, is addiction ever cured, Not
33:42
at all, okay, because it's not a disease to be cured per se.
33:45
But by definition, addiction is as a disease would likely be classified as
33:49
a chronic disease, which means, you know, if we're kind of playing
33:52
that Devil's Advocate piece, addiction could be classified as a chronic disease in that
33:57
the conditions persist longer than a year. And so somebody who is diagnosed with
34:02
addiction or a substance abuse disorder that lasts for this chronic kind of use,
34:07
that use happens for over a year. It's prolonged, and it means that
34:12
they were kind of constantly struggling with it, similar to chronic diseases like Alzheimer's
34:15
or epilepsy, something that lasts much longer than just an acute treatment condition.
34:21
Yeah. I mean, let's take, for example, the someone gets like
34:24
gang green, and so they get I don't even know what the treatment is
34:28
for gangreen, but you know, they get some kind of medicine antibacterial maybe
34:31
or anti viral medication that I'm exposing my ignorance about the exact pathology or eteology
34:38
of that, but anyway, point being that, like they get that,
34:42
and then they sort of like whatever it was that they did that sort of
34:45
gave them gang green, they just sort of, you know, avoid that
34:50
thing. Yeah, and that's probably fairly easy to do versus something like,
34:53
as you said, someone who was maybe smoking or drinking or using some other
34:59
harder substance cocaine or heroine or something else. The cues for that aren't something
35:04
we can get rid of, you know, we can get rid of the
35:07
thing that caused you know whatever. X. If you had testicular cancer and
35:10
had testicles removed, like, you can't get testicular cancer anymore because you don't
35:15
have any medicals, right, but we can't just go through and just remove
35:19
every psychological cue that has ever impacted you in relation to addictive behaviors. We
35:24
just can't do that, you know, we can't turn the world off.
35:29
I think that's an element of this that I think where you see it doesn't
35:32
quite have the same overlap. Well, and I think too, when we
35:37
start thinking about medical models of diseases, most of those medical models might enlist
35:42
other supports to address other things, right, So, like, for example,
35:47
when you have somebody who has chronic illness, you might be enlisting the
35:51
services of somebody who does specialized palliative care, or you might enlist family counseling
35:55
services as a separate part of the treatment package, not necessarily the direct intervention
36:00
for treating that disease, like you're kind of treating additional fallout and symptoms of
36:04
that too. So I think that there's something interesting in looking at addiction from
36:09
the space of there's not a medical treatment for it that is as prominent as
36:15
the psychological or the emotional or the behavioral treatments that are in place. Right
36:20
So, like with cancer, or you've got radiation treatment, you've got surgery,
36:23
you've got these things that happen. Those don't exist for addiction, so
36:28
they don't even fit in line with what a disease is from the medical model
36:30
and how those medical models are actually actively treat those like it almost always gets
36:37
deferred to unless it's like withdrawal symptoms, it almost always gets deferred to some
36:42
treatment center that usually includes psychological well being practices or something like that. So
36:47
I think, you know, just understanding kind of like how it even gets
36:50
approached from this space doesn't even align with a medical model in that regard,
36:54
like it ends up in a space where it's just management and not curing.
36:58
As we're having this discussion, my thoughts are evolving on this, and I'm
37:01
eager to kind of explore these as we get toward the end and have our
37:06
sort of big summary take home about this whole discussion. But I think let's
37:10
talk about how how the disease model may or may not align with a more
37:19
scientific, i think objective psychological orientation to thinking about addiction more or less.
37:25
Yeah, well, let's unpack that for a second. As I was kind
37:29
of putting these notes together, my first thought is that, you know,
37:31
early in the episode, I was kind of going and I still kind of
37:35
had this thought as like, I don't think that it's fair to call addiction
37:37
a disease, but I do think that kind of the philosophies of this it
37:42
aligns well with kind of the general perspectives of behaviorism. Right. So,
37:45
for example, behavior is not the organism's fault. It's a result of the
37:50
environment. Disease is not the organism's fault. It's a result of the environment.
37:52
Responses occur and addiction occur as definable links to their environments, and behavior
37:58
is reinforced. Addiction related behaviors are reinforced, and they're maintained over time.
38:02
Right, So those things I kind of leaned back on this idea that behavior
38:07
is not the organism's fault, disease is not this organism's fault, And that
38:12
parallel is so strong to me that it's kind of made me start kind of,
38:15
like you said, my thoughts around this have evolved in a different way
38:19
because of that particular perspective. Yeah, where these viewpoints diverge is is a
38:24
couple of places. One important one is the cure perspective. As we've discussed,
38:29
behaviorism doesn't really aim to cure what it's doing, and said is it
38:31
is developing adaptive skills that can support this individual's quality of life. And this
38:37
aligns more with what actually happens with addiction and treatment for addiction anyway, right
38:44
is and when we talk about a lot of in psychology, what we're doing
38:49
is we are looking for the development and fostering of new sort of behaviors and
38:53
skills. Which is it. What you're actually trying to do is you're trying
38:58
to build something new, not remove something bad. And like, there,
39:04
I think is the sort of fundamental change in a pathological view of disease where
39:09
it's like remove the thing that's causing harm. And in this position instead and
39:15
our philosophy, we are like we can't remove that thing. We can't pull
39:19
it out of you, we can't cut it out, we can't inject something
39:22
into it to make it go away. What we can do instead, and
39:25
what we do attempt to do instead, is to help add a new set
39:31
of skills and approaches that will make it so that the thing that you're doing
39:37
is not as powerfully controlling over your behavior. And so it's building new skills
39:43
and it's like adding something rather than taking something away. Yeah, I think
39:46
that's a beautiful way to look at it because I think, you know,
39:49
when you think about treatment, and we're going to spend some more episodes talking
39:52
about kind of different ways that addictions are treated. But when you think about
39:58
it, treatment many many, any times, most of the time, it's
40:00
not just about getting somebody off of a substance. It's also about teaching them
40:05
those adaptive skills to avoid the substance, to cope with not having the substance,
40:09
to cope with whatever they were using the substance for when it comes to
40:13
their own psychological well being. Like I mean, so much of it is,
40:16
like you said, building something new, not necessarily removing something from the
40:21
biology of the person. And I think that that fundamental difference is really what
40:27
solidifies it all for me, that the disease model does not align with what
40:31
even actually happens inside of addiction. I think that there are medical components,
40:36
right, It does arrive in the medical space where somebody is experiencing significant,
40:40
severe withdrawal symptoms and they need medical intervention to stabilize themselves, like that is,
40:45
and that goes back to the kind of the biology side of addiction,
40:49
right, that piece is there, But that's one small part, and I
40:52
don't think that's the active ingredient for treating an addiction, whereas, like with
40:55
something like cancer, the active ingredient is a medical treatment. It is part
41:00
of a medical model to treat a pathology, to remove something from your biology.
41:05
So I think what you just described tied it all up in a nice,
41:07
neat little bow. For me, was like, yes, we are
41:09
building something brand new. We are addressing something that was missing from this person's
41:15
skill set versus removing something to improve that person's quality of life. Well,
41:19
thank you. I think we have some interesting tidbits or tid points as I've
41:22
sometimes called it, love tid points, and then I think time to sort
41:28
of give our final thoughts on this and sort of wrap it up in how
41:34
we want to leave this. So we'll do our final advertisement intervention boo yeah,
41:39
and then we'll come back and wrap this up. Okay, let's go
41:50
ahead and talk about some other sort of interesting pieces here that are worth unpacking.
41:54
So as far as the models of addiction, there were two other ones
41:58
that are talked about often, and my perspective is I imagine that all three
42:02
of these are typically tied together to help address addiction because it's so complex.
42:07
But one of them is the psychological model, and the other is the social
42:09
learning model. The psychological model primarily focuses on psychological and emotional factors that have
42:15
contributed to the development and the sustaining of that addiction. And basically what it
42:20
says is that addiction stems from some unresolved trauma or poor coping mechanisms. And
42:24
so the psychological model tends to kind of look at a causal approach, but
42:28
from a psychological standpoint instead of from like a biological or medical standpoint. And
42:32
then the social learning model is the idea that addiction is influenced by social factors
42:37
and the environment, which it definitely, definitely is. Sure, yeah,
42:43
that also is worth looking at as like a way of unpacking the sort of
42:46
models of an understanding addictive and dependency behaviors. As I was kind of looking
42:52
at this stuff too. You know, the idea of the disease model is
42:55
to not attribute blame to the person who's struggling. But neither of these do
43:00
that either. Sure, so you know, a psychological model doesn't do that.
43:04
It's like, oh, like you're missing skills, it's not your fault.
43:07
Let's teach you skills, or you know, you went through some stuff
43:09
and that sounds really hard, and it makes sense that you would cope this
43:13
way. Let's go ahead and get you some treatment to help you with that,
43:15
because none of that was your fault either. Or you were around some
43:19
people that were really bad and they influenced you, and the environment just set
43:22
you up for not success, but for failure in this space. Not again,
43:24
not your fault. Let's get you some treatment to kind of get you
43:28
out of that. Right. All three of these models absolutely divert blame away
43:31
from the organism and onto some other circumstance, which I think is critically important
43:37
for understanding addiction. Yes, absolutely so, I'm sort of chomping at the
43:42
bit here, eager to to I think summarize this discussion as well as sort
43:45
of my thoughts on this as we've been talking. And I think the first
43:50
is that when you break it all down, you start to realize. I
43:52
think that addiction is just it's more complicated than a disease. And I'm sure
43:57
that like any immunopathology person or person who specializes in diseases is going to scoff
44:04
at me tremendously. But what I mean by it's more complicated is that there
44:07
is a myriad of factors sometimes that we can identify and many times that we
44:13
cannot. There's just dozens or hundreds or thousands of them that all contribute to
44:20
the development of addiction behaviors, right, and most of the sort of disease
44:24
models, like even though there can be a lot of things that cause anyone
44:29
particular disease and we don't know what they all are a lot of the time,
44:32
like it tends to be like there's a thing and just what happens with
44:37
addiction is it has so many variable inputs that establish and maintain and though those
44:44
inputs shift and change and evolves as the organism's learning, that like it's really
44:50
hard to pin down and you're also dealing with the volatility of people's behavior right
44:54
at the same time, So like it is very complicated. It can't be
44:59
cured, and it's influenced by environmental factors and learning skilled deficits with coping,
45:05
access to highly reinforcing and valuable substances, et cetera. And by calling it
45:09
a disease where we sort of imply that they can be cured, we kind
45:14
of when we don't think that a lot of times it really can in the
45:16
way that you might think of a cure for some kind of disease, and
45:20
instead what we're doing is managing the behavioral, psychological, and emotional concerns that
45:24
go with it, often by establishing new sets of skills, new behaviors,
45:30
new approaches to help overcome all the environmental and social factors that are there.
45:35
Absolutely, one of my taking on points on this would be that I think
45:37
it's very easy for a person who does not understand addiction to fall into thinking
45:45
that this model makes sense. It's very easy model that makes sense, right,
45:47
this person's not blamed, there's hope for a cure, and it leaves
45:52
more complicated psychological or emotional processes kind of behind in terms of understanding kind of
45:58
the mechanisms by which addiction occurs. But I do think that, you know,
46:01
for me, where I end up landing is that does it ultimately matter
46:06
that we're using a disease model to describe this, because many times it's you
46:09
know, truly, when you think about it, the disease model is just
46:13
kind of a metaphor for what's going on. It's not an actual like disease
46:16
that can be observed it's kind of like this metaphor for describing what's going on.
46:21
I actually don't think it's that much of a problem to call it a
46:23
disease in terms of kind of the lay person discussion. I think it becomes
46:29
more of a problem when it comes to having that discussion inside of medical circles,
46:34
where it neglects these other factors. Right. So, I think that
46:37
calling it by solely using a disease model, I think it neglects that social
46:43
learning. I think it neglects psychological processes in ways that I think maybe more
46:46
comprehensive addiction treatments don't actually do. Sure. Yeah, I think that that's
46:52
fair. And you sort of said this, and now I'm agreeing with you
46:54
on this because I think when I initially have thought about this and talked about
46:59
it, I just really balked at the idea of calling addiction a disease.
47:05
It felt counterintuitive to me. Yeah, and it also had a problem.
47:08
I had a really hard time putting my finger on exactly what that problem was.
47:13
And as we've talked about this, as you have sort of said,
47:15
I think I've actually evolved and say, like there are a lot of parallels
47:21
between looking at understanding disease and how we look at addiction. Like even when
47:24
we talk about things like cancer, and we can often draw that specifically to
47:29
something like smoking or using some substance that is very likely to cause cancer,
47:35
create the opportunity for cancer to develop. It starts to become really fuzzy because
47:39
there are specific behaviors that are associated with that too. So there are a
47:43
lot of parallels. And the other point that you made that I really liked
47:46
was that like, the medical portion of this is a portion of this,
47:50
it is a component. What I think it does is it's not a comprehensive
47:53
component. And so as you said, what I like about it is that
47:58
the whole intention originally was like, let's remove the blame side of this from
48:02
people. And that is what I think a psychological perspective on addiction is it
48:07
looks at like the thing that you're doing, you are doing because all of
48:12
the circumstances in your life provided the opportunity, motivation, and direction toward that
48:17
thing. And that thing in this case being an addiction using heroin, using
48:22
cocaine, using meth, you know, whatever it is, or behavioral addictions,
48:28
all of the circumstances You couldn't have done that if you didn't have the
48:30
opportunity. You wouldn't have done it, if you didn't have the motivation.
48:35
All of those things had to converge. They drove you there. You ended
48:37
up in this place. So calling it a choice is useless. It's beyond
48:42
useless. It's harmful. Right, And so I see why the addiction or
48:46
the disease model has so much appeal to advocates for supporting people through their addiction.
48:52
Absolutely it does. Where I think I'm starting to be able to articulate
48:58
why I don't like it is it comes actually back to this idea of powerlessness.
49:02
When we have like hepatitis. I can't just be like I've seen the
49:07
light. I'm gonna change my behavior and my hepatitis will go away, right
49:12
Like someone can put in a set of circumstances that will have me change the
49:16
things that I'm doing and my disease will be cured. That's just not how
49:20
those work. And so it's this powerlessness that I do not like about the
49:24
disease model. Where again, it's not that it's all bad. I see
49:29
a lot of overlap and utility in it. Yeah, but when we start
49:31
to then say, like, like so many diseases that are out of control,
49:37
addiction is out of your control. Then again, what we've done is
49:39
we've withdrawn the ability to start to build those new skills, because if it's
49:45
outside of your control, skill building won't do anything. It's outside of your
49:47
control. Right if it was within your control, like you'd be able to
49:51
get over it, but it's not, so you can't and you're just screwed.
49:53
And that's just not how behavior works. And so that's the part that
49:57
I feel like I've sort of finally able to articulate that I don't like about
50:00
the ideas the disease model is that it takes away our ability to look at
50:07
this as how can we be productive and counter to this because the person does
50:13
have control over this. They don't have control over their cancers. They can
50:15
stop doing the thing that gave them cancer in the first place. They could
50:19
take their medicines, but there's nothing they can do that's going to make it
50:22
just go away. We can give them skills that will make their drinking stop,
50:27
that will make their substance use decrease. We can watch those things happen.
50:30
And so like it's complicated, it's difficult. There's no guarantee that it's
50:36
going to work. But what like, if we treat it as if there's
50:38
something that you can't do about it, then what do we do? You
50:43
know, we can't do anything. And so that's what I don't like about
50:45
it. I think, is it or the part of it that bugs me.
50:50
It's not that I don't I think that it's completely useless. As I've
50:52
articulated now, I think a couple of times I totally get the value that's
50:58
brought by the disease model. I can totally draw a million parallels between disease
51:01
and addiction. And the problem that I have with it is this idea that
51:06
it then withdraws the ability to intervene by empowering the individual to make different choices.
51:13
And I think that the advocates would say that it doesn't, but I
51:15
just strongly disagree. Yeah, by saying you don't have power over this thing,
51:21
you are literally saying you can't control it, and we just know that
51:23
that's not true. So that's I think what I wanted to land on is
51:27
just sort of imparting that piece that the disease model to me and how I
51:32
hear it, and maybe people disagree and they just don't hear it this way,
51:35
and that's fine, But what it applies to me is a lack of
51:38
ability to do something about it. And I don't think that that's useful.
51:42
I agree with that too, And I think this is the same problem that
51:45
we run into with any model of treatment in any space, is that it
51:50
often gets treated as the monolith, as the only thing that's being done,
51:53
and that's not what's going on here, like, not even close, right,
51:57
I think by itself, yeah, there are gaps, just like I
52:00
think any theory, any model, any practice has gaps. I mean,
52:04
we talk about this with behavior asm all the time. The gaps and behaviorism,
52:07
they do exist, and so I think, you know, subscribing to
52:09
a single I mean, I would say, I would make an argument that
52:12
behaviorism clears more of those gaps than other models do. Yes, I would
52:16
agree, yeah, But I think at the same time, like I think,
52:20
alone a disease model is it can be a problem. I think in
52:23
combination with these other models of addiction, I think together I think that you
52:29
get a more comprehensive, more progressive, more forward moving model of treatment that
52:36
is designed to give somebody sustained skills and move away from the detriments the in
52:43
the poor quality of life that comes with addiction and addiction disorders and substance abuse
52:46
disorders. Absolutely, I think that that's that's what we have to say on
52:52
this. Is there anymore that we we should add? I don't know.
52:53
I feel like I've I went on the longest of all rants, and but
53:00
I thought you ended that beautifully. No, I actually don't have anything else,
53:01
all right, lovely, Well, if you would like to write in
53:05
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53:07
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53:21
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53:25
also do like to do this really fun thing where we recommend some things that
53:29
are pretty much always completely unrelated to our discussion at hand, which will be
53:32
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53:37
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We love you indeed, but you know, if you can't or don't want
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54:40
it's fine. It all works. You're your own autonomous person, do
54:45
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not make this show happen. Writing in fact checking from Shane and myself.
54:51
Shane, thank you so much for recording with me today and for putting together
54:53
all the notes on today's discussion. Hey, anytime. No, this is
54:57
great. Absolutely. All the editing mad that makes it sound like we are
55:00
speaking in normal sentences comes from Justin and then our social media coordinator is Emma
55:07
Wilson. Is there anything you would like to add or anything that I forgot
55:08
before we get to our recommendations? Not on my end? Okay, now
55:13
you get to the fun part. We're gonna recommend some stuff for you,
55:15
so stick around. Yay after these ads. Oh okay, let's get to
55:28
some recommendations. We just came back from an audio transition. We'll do another
55:31
quick audio transition. Yay, recommendations. I am recommending something I'm not sure
55:45
if I've recommended this before. Maybe I have, but I'm gonna recommend it
55:47
either way. This is a brand of knives called Cutco Knives. There's a
55:53
couple of things I like about Cutco Knives. First of all, I think
55:55
many people will who are on the spectrum of things will appreciate that that this
56:00
is an American company. So if that's your bag, cool. They also
56:04
to just make really high quality knives. And here's one of the things that
56:07
I like about Cutco. They tend to have like lifetime guarantee warranties or not
56:12
even that, but like forever warranties. I think something like that. I'm
56:15
not sure on the policy because I believe that you can pass these down like
56:19
generations. And so essentially where I think this is awesome in particular, is
56:24
that that means that they guarantee their product indefinitely and if it breaks, if
56:31
it chips, if something goes wrong, you can send it in they'll replace
56:36
it. All you have to pay for is postage, right, Yeah,
56:37
And that means that for them, the incentive is to build the best quality
56:43
product they can because they really don't want to have to continually ship out new
56:49
versions of their product. Right, ye, And so they tend to make
56:52
these really high quality knives. I mean, they are fantastic. They're really
56:55
well designed, they're ergonomic, they're very very sharp. They have all kinds
57:00
of different designs for different types of cutting you might do. There's very very
57:04
thin knives, there's very very thick knives, there's serrated knives. There's all
57:07
these different designs, and they have these specific uses for them that they recommend.
57:12
Of course, the knife is basically a sharp piece of metal, so
57:14
use it to cut things. But some of them cut the other things.
57:16
You know, some things better than others, and so that's they have these
57:20
recommended Anyway, they just make these really high quality knives. They are expensive,
57:23
but again you get that big guarantee. And it's been one of those
57:27
nice things where after getting a whole set of cut coat knives that I used
57:31
to go to the store and whenever I'd seen one of those nice fancy knife
57:35
blocks, I'd be like, oh, I wish I had those knives instead
57:37
of the knives I currently have. And since I've gotten cut coat knives,
57:40
I literally don't even notice those other knife blocks anymore. Wow, So like
57:44
I don't care, because like I have the best knives that I will ever
57:46
need because they're they're really fantastic and as I said, they are on the
57:51
price your end, but it is like the last time you'll ever buy that
57:53
type of knife, and then they cover it forever. I really like them.
57:57
They also, by the way, they'll have representatives come and sharpen your
58:00
knives at your house for free, Like you can buy a knife sharpener,
58:04
but like they have these special blocks just for sharpening the serrated blades. Yeah,
58:07
and so they'll just say, like how often would you like to come
58:10
out once a year, every two years, every two years, and then
58:13
that person will stop by to like, you know, they'll message you to
58:15
its schedule appointment, they'll stop buy, they'll sharpen your knives, be on
58:19
their way and they'll just do that as a service that they provide. I
58:22
strongly recommend Cutcoat. I really like their products. They seem like they really
58:28
actually care about making a good product and they've put the onus of responsibility on
58:32
themselves to do that. And just as a side note, they also make
58:36
cutting boards that are really nice. They make a whole bunch of pots and
58:37
pans if that's your thing, and a few other accessories like apple peelers and
58:42
ice cream scoops and can openers and stuff, and it's just like all high
58:45
quality stuff. So anyway, that's my recommendation is cutcoa knives. I love
58:50
that. I want so badly to go take cooking glasses just so I can
58:53
learn some new skills. Yeah, you know, one of the things I
58:55
wanted to get was like my own like set of knives to just be like
58:59
the your mind, don't touch them, don't use them, Let me use
59:01
these. So I'm gonna look into this. This will be fun. Yeah,
59:05
and there might be like some kind of referral thing that you can like
59:07
kick back a credit my way or something. So yeah, if they ask,
59:10
I drop my name, Yeah I gotcha. Yeah, but it's worth
59:14
looking into. They'd like set up all kinds like they'll set up at like
59:16
Costco, and they'll set up at like malls and stuff. Sometimes they'll have
59:21
his little setup so if you look around and notice them, you might stop
59:23
by and just check out their stuff. I recommend getting a block at least,
59:27
because that way you have like a nice way to sort of store your
59:29
whole set. But you know, whatever works for you. I just think
59:31
they make really good products. Yeah, I love that. So my recommendation
59:36
doesn't involve cutgow knives. There are bone knives in this movie. So I
59:40
got to see Godzilla x Kong New Empire, and let me tell you,
59:46
dude, here's the thing. I think that people are so up their own
59:51
butts about fun and they just do not let themselves have fun. This movie
59:55
is so ridiculously fun because it's it's exactly what you want out of a movie
1:00:01
with Godzilla and King Kong. It is giant monsters destroying a lot of things
1:00:06
and just beating the crap out of each other. How could you want anything
1:00:08
else? Like when I describe it, it goes like this, it goes
1:00:13
The movie starts with King Kong running from giant mutant wolves, and then he
1:00:17
destroys all of the mutant wolves, and then he has to fight Godzilla.
1:00:22
Then he fights Godzilla with his own robotic arm prosthetic, and he carries an
1:00:27
ax that has a scale from Godzilla embedded in bone. He has a bone
1:00:32
axe that he fights, and he also fights a giant orangutang named scar King
1:00:37
that has a bone whip. Like it rules, I don't know why people
1:00:39
don't like these movies, it's just so fun and you don't have to think
1:00:45
about it, and it just rules and it just confirms that King Kong might
1:00:50
be the coolest you know, I gotta say, cause it's like I never
1:00:53
got really into the Fast and Furious movies, and the reason for me was
1:00:58
they seem like they were trying to be grounded in some form of reality and
1:01:01
they were just really hard to swallow. And I just also, I'm not
1:01:06
interested in cars, but so like, I never really followed that franchise.
1:01:09
No, you know, no disrespect to people who like it, it just
1:01:12
wasn't really in my bag. Any movie that completely is like reality be damns
1:01:17
like that puts out the window. This is just nonsense for the sake of
1:01:21
nonsense. I'm pretty easy to suspend my disbelief and just get on board with
1:01:24
because I already knew walking in the door what I was getting right, Like,
1:01:28
this is a fantasy thing. It's not meant to be grounded in reality
1:01:31
in any way. And I mean, Godzilla wielding a bone act with the
1:01:36
scale of Godzilla is just good writing, right, Yeah, that's what I'm
1:01:39
saying. Yeah, it's absurd. It's just someone who's like, let's really
1:01:45
have fun with this, and they just went ham on it, and like,
1:01:49
good for them, So that's lovely. I'm happy to hear this.
1:01:53
It's so good. There's a scene where King Kong rides on Godzilla's back into
1:01:58
battle. How do you hate that? How do you hate that? If
1:02:02
you hate that, grow up? That's pretty fabulous. Yeah, it's so
1:02:07
ridiculous. So anyway, it was a blast. Go see it. Really,
1:02:09
at that point, all you need is just like, you know,
1:02:12
make the movie make some amount of sense and just write fun parts and then
1:02:15
you're good as long as it gets just like sort of following it. Honestly,
1:02:17
I'd go one of two directions. Either have a nice, easy to
1:02:21
follow narrative that like is it helps just sort of tie the whole story together
1:02:24
and like this thing makes sense when it happens this thing, or completely abandoned
1:02:28
the narrative and just like have fun with a lot of super crazy images of
1:02:32
people of like giant monsters fighting each other. We need. That's what this
1:02:36
movie did and it was great. Great. If you like to talk to
1:02:38
us about cutcoa Knives or Godzilla or anything about addiction as disease that we talked
1:02:43
about here should reach out to us, But I already said that part,
1:02:45
So I think that that's all I have. Is there anything else you'd like
1:02:46
to add? No, nothing else, all right, then, thank you
1:02:49
for listening. This is Abraham and it's a Shane. We're out. See
1:02:52
ya. You've been listening to Why We Do What We Do. You can
1:02:57
learn more about this and other episodes by go into w w D w w
1:03:01
D podcast dot com. Thanks for listening, and we hope you have an awesome day