I have been in the addiction and recovery arena in one way or another for almost 30 years. About half of that time was spent battling addiction personally, in and out of treatment centers and detoxes, with fleeting stints of sobriety. The other roughly half of that time has been in continuous, sustained recovery. During my time in recovery, I’ve been able to see things from the eyes of someone who struggles with addiction, someone who has his own recovery path and someone who has spent time as a substance abuse counselor. My attitudes and biases have naturally changed as I have grown and gained knowledge, which seems to be a requirement if one is to defeat an enemy who is constantly at the gate. Here are five things I have learned about addiction.
ADDICTION IS ONE OF THE MOST MISUNDERSTOOD ILLNESSES ON THE PLANET. There is an old saying that has to do with alcoholics being around since man first learned to crush grapes. If you believe that as I do, that covers many centuries. In more recent times, Alcoholics Anonymous was founded somewhere around 1935, and the American Medical Association declared alcohol addiction an illness 1956. If my math is right, that is 85 years and 64 years ago, respectively. One would think that with all of the technological, scientific and sociological advances made during that time, we would have a better handle on the symptoms, causes, treatments and recovery paths for something so destructive. And we would have a better view of the illness as an illness, and not a punch line, a head shake or an opportunity for horrible advice.
Yet, addiction is still widely misunderstood, even in 2020. Doctors prescribe treatment they believe will help, yet medical professionals have over prescribed opiates to the point of being one of the catalysts to an epidemic. The War on Drugs has gone on for over 45 years and has cost well over a trillion dollars, with really no meaningful, positive change. In fact, the War On Drugs has been called an abject failure, but that is another post for another day. I promise.
Family members, friends and coworkers close to someone with a substance use disorder are often heard saying, “I wish they’d just quit this nonsense,” or “If they would just stick to beer.” Movies portray addicts in ways that seem to exaggerate the symptoms to make a point. Even the news media is involved. It is not uncommon (in my area is it very common) for the local news to report on a burglary, high speed chase, standoff, or some other crime where charges result in, among other things, possession of heroin, methamphetamine and/or THC. These are just a few examples, and I’m not picking on anyone.
In modern society, we fix things with pills, when often pills are what get us into trouble in the first place. (Don’t believe me? Two words: television commercials.) Family members, friends and coworkers also mean well, and often travel to the ends of the earth, and to the edge of sanity and well passed exhaustion, to help. But, despite the best efforts of everyone involved, sometimes we contribute to the muddying of the waters and don’t do well to separate the myth from the truth concerning addiction, treatment and recovery.
All too often, if something is said enough times, if we see it in the news or on social media enough, even if it is completely wrong, it somehow becomes truth (see: politics). Stigma is a huge issue that perpetuates the myths concerning addiction. Underfunding by our national, state and local governments is another barrier in the understanding of addiction, the reduction of stigma and the availability of treatment for those who struggle. We can do better.
ADDICTION COSTS A LOT. According to the National Institute on Drug Abuse (NIDA), substance abuse in the U.S. to alcohol and drugs costs over $520 billion annually. Let me say that again. FIVE HUNDRED-TWENTY BILLION DOLLARS per year. The Institute includes crime, lost work productivity and healthcare costs in its numbers, while the healthcare numbers alone are $27 billion for alcohol and roughly $11 billion for illicit (illegal) drugs and $26 billion for prescription opiates. (The cost concerning opiates will surely go up as new data is processed and becomes available.) To put that into perspective, the cost of the effects of tobacco use and addiction in the U.S. costs roughly $300 billion a year, with over half of that ($168 billion) being healthcare costs. Not only is addiction and its consequences costly for the person who struggles and for those close to that person, it is also a huge drain on our economy. Imagine if we spent anywhere near that on education, intervention and treatment accessibility and availability. And what if we spent money to develop prevention programs that work?
ADDICTION IS NOT A CHOICE. I grew up in a small town in a neat neighborhood. My sister and I had lots of friends within a few blocks and the neighborhood was always alive with activity. Some of us wanted to be doctors when we grew up. Others wanted to be cowboys. Princesses. Astronauts. Dirt bike riders. Mechanics. Nurses. Sometimes our future career choices depended on the popular TV shows or movies of the day. At the risk of dating myself, I’ll stay clear of listing those here. But, of all the kids in my the neighborhood where I grew up, not once did anyone ever say they wanted to grow up to be an addict.
Addiction is a primary, progressive illness. It can travel alone or, as it often does, it can occur with other conditions like depression, anxiety disorder and so on. It’s also impossible to predict with certainty who will become addicted to alcohol or other drugs or when it might occur. But there are some risk factors including genetics, age of onset (use), a preceding mental illness and trauma.
People make the choice to abuse, that is, to use a substance to gain a desired affect. People choose to binge drink. People choose to take pills or take a various array of other chemicals in many ways to gain or lose something in their lives, even temporarily, and I’m sure you’ve heard some of these reasons. To lose boredom. To gain excitement. To gain energy. To lose sadness. To lose stress. To gain camaraderie. To gain concentration. To lose weight. We could go on and on. But people choose, whether it is drinking to access, or to double a prescription dose, or to smoke, sniff or inject a substance. Obviously, we all make choices, and sometimes those choices have far reaching consequences. However, to make the connection that since one chooses to abuse, one then also chooses addiction, is irresponsible and really lazy. We choose to abuse. But we don’t choose to become addicts.
ADDICTION IS TERMINAL IF LEFT UNTREATED. The American Medical Association classifies addiction as a disease and follows a disease model, much the way it classifies diabetes, heart disease and cancer. The AMA also says that causes are sometimes determined by biological, environmental and behavioral factors. There is much debate about addiction as a disease or an illness, and a quick Google search can open up all sorts of thoughts and ideas on what addiction is to different people and organizations. Here is where I usually ask people to do all the research they can. Ask questions, reach out. Find credible sources. Think critically.
This July will mark 18 years of continuous long term recovery from alcohol and drugs for me, but I believe truly and completely that I am only in remission. One drink or drug will surely activate my illness. You may ask how I know that. I gained valuable yet costly, first-hand experience on relapse personally before I gained long term recovery, and I’ve watched countless others do the same.
NIDA defines addiction as, “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”
There are other definitions that echo this idea, some are quite long and more in depth. For simplicity’s sake, I like to use this definition, and it describes my own addiction, and the addictions of the countless others I have met over the years, perfectly: “Addiction is chronic, and as such will get worse and never better over time if left untreated.”
According to the National Institutes of Health, approximately 88,000 people in the U.S. die each year from alcohol-related causes. The CDC estimated that in 2017, there were over 72,000 opiate overdose deaths, which included both prescription and illicit drugs. To put that number in some sort of perspective, that was 197 people per day, every day, in 2017, from opiates alone.
ADDICTION IS BEATABLE. Now that we have all that other stuff out of the way, we can get to the good stuff. Addiction is treatable, it is beatable, and you or someone you love can get their lives back. There are millions of people around the world who celebrate long term recovery. For all the data involving the negative aspects of addiction, there is also data on recovery. There are many pathways to recovery, and each path is as unique as the individual who makes the journey, and there have never been more pathways to recovery than in years past. Recovery from addiction is possible, and there are millions of us who are proof of that, and there is plenty of room for millions more.
One of the most basic keys to recovery is that it is self-directed, meaning that the person recovering is in charge of determining the path he or she will follow. Of course, there is much help out there to help guide along the path, or even to help one make the decision of which path to follow. The intervention someone who struggles with a substance use disorder receives, meaning the interruption of behavior, whether family, law enforcement contact, medical, or self-directed, can come in many forms. Whatever form that intervention comes in, considering consequences, can be the foundation for an effective plan for recovery.
This is certainly not an unabridged, comprehensive reference guide on addiction. These are merely a few things I have learned along the way. There are many resources available online to learn more about addiction treatment, recovery groups, detoxification when needed, and often a medical professional can assist in finding the best option and level of care