Labels belong on jars, not on people living with addiction.
The issue of loss of control over the substance, heralding today’s concept of addiction, has been discussed since the 17th century. The complex etiology of addiction is reflected in the frequent pendulum swings between opposing attitudes.
Is addiction a sin or a disease? Should treatment be moral or medical? is addiction caused by the substance; the individual’s vulnerability and psychology, or social factors; should substances be regulated or freely available?
It’s taking us effing years to figure out what Mental Illness is and we are only now scratching the surface. Only a few years ago if you have no lived experience with Mental Illness or you didn’t work in the eco-system you just didn’t “get it”. People who had mental health issues fell into two buckets.
1) You’re suicidal.
2) You should be able to smile.
We now realise that’s not the case, so why did addiction get forgotten about? Why do we still think you should just be able to quit or you are a criminal?
Addiction is not a problem in of itself. It expresses something about people’s lives and the nature of the society that we live in and also about how we develop in a particular environment.
Having worked with people with Addiction daily and after supporting my mum, Rosemary my whole life, addiction takes on a human face.
When you talk to people about their lives, you get that addiction is the endpoint of a long process suffused by suffering from early childhood. If you open to yourself, you get to see that you’re not that different. I’m not that different from the people we support, I’m more fortunate in a lot of ways, but there’s a lot of fundamental dynamics that I can recognise and resonate with.
So what is it?
Addiction is any behaviour that has negative consequences, but a person continues to crave it and relapse into it. Despite the negative consequences. And if you look at it from that point of view, there are many addictive behaviours in our culture.
If you look at it from the point of view of brain physiology, the shopaholic and the workaholic, they’re just trying to excite and release the same brain chemicals that the drug “addict” presents…
30% of adults in Canada between 19 and 64, years of age, define themselves as workaholics, which is to say, they feel listless and unhappy when they’re not working and ignore their families for the sake of the adrenaline and dopamine kick they get out of work.
There's that compulsion to get something right away or to “get right away” whatever your muse is. Gambling, porn, sex, sugar, your phone. These are all solutions to the problem, until that solution becomes the problem.
So I'll drop everything and I'll run down to the store and buy that new video game, ignore my partner in the shower calling out for a towel, not feed my dog and spoon the kids' ice cream for dinner. I'll go to the store again, buy the gamer headset and chair, I'll spend $4,000 in a week, not because I made a conscious choice to do so but because I was compelled to keep going back and going back thinking, “one more item”. The main negative impact is that I lie to my partner. Another is I undermine my relationship. I feel shame about ignoring the kids. He reminds me of it, I spiral and lock myself in my room to avoid the guilt.
Myth: Chicks don’t like video games
Truth: They do
For the family… what does the kid feel when his mother is with him but is actually just thinking about her next purchase?
Injecting heroin on the other hand… that’s a whole new level. Right?
There’s a huge mind split, on the one hand, tobacco smoke kills five and a half million people around the world every year. As many people are killed by the illegal and fully advertised activity of tobacco smoke as killed in the Nazi genocide in the whole course of the Second World War. So for what reason we decide that heroin is a more dangerous drug than tobacco?
I have no idea. I’m not even talking about alcohol.
As a society, we tend to want to create another move on when we can choose our sins and the things we don’t like about ourselves. I think it’s an escape phenomenon and I think we’re in a highly addicted culture. We don’t like to look at the extremity of the addiction, what is the substance? So, we ostracize and marginalise those who seem “extreme” to hide from ourselves. “it’s ok that I smoke at least I don’t do crack”
That actually adds to the problem of people fighting Addiction.
Now, we also often hear about addiction, the notion that addicts are born not made.
There’s not a lot of science behind it, or at least the science behind it is laughably illogical. General consensus if 50/50 genetics & environment on addiction. And I think it’s almost a helping factor, ie people donate way more money to breast cancer because it’s genetic and “not their fault” vs lung cancer has less funding because “they chose to smoke”. This Doesn’t mean people are born addicts, they might have a harder time vs someone else and that’s why it should be treated medically, not morally. Born or not, no one wakes up saying “I want to be a heroin Addict”.
Consider heart disease. It’s partly due to genes and partly due to poor life style choices such as bad diet, no exercise and punching durries. The same is true for other common diseases like adult-onset diabetes. Many forms of cancers are due to a combination of genes and lifestyle. But if your doctor said that you had diabetes, you wouldn’t think you were a bad person. You would think, “What can I do to overcome this disease?” That is how you should approach addiction. Addiction is like most major diseases. You wouldn’t kick someone out of rehab for “relapsing” and eating a jelly bean.
Addiction is not a weakness. The fact that addiction crosses all socio-economic boundaries confirms that addiction is a disease. People who don’t “get it” will tell you that you just need to be stronger to control your use. But if that was true then only unsuccessful people or unmotivated people would have an addiction, and yet 10% of high-functioning executives have an addiction.
In the Vietnam war, 20% of Americans came back addicted to Heroin. Within a few years that number dropped to 1%, which means that IF the drug was intrinsically addictive those people should have stayed “addicts”, but they didn’t. There was stress and isolation. The most susceptible amongst those, however, did not stand a chance.
Nobody argues that pack of cards causes gambling addiction or that food causes food addiction or that the availability of open stores, the shopping addiction. So, there has to be a predisposition and that disposition is set.
Myth: Addiction is a lifestyle choice for people who like taking drugs recreationally.
Truth: Addiction is a chronic illness which is a result of substance abuse, which in itself is just a coping mechanism for some people who deal with trauma (think abusive relationships, sexual assault, loss of a loved one) or mental health (stress, anxiety, depression) or the solution to some sort of temporary or ongoing physical pain.
Myth: Addiction is binary — every time people use drugs again, they relapse and are addicted again. If they are sober, they have recovered.
Truth: There is no ‘cure’ for addiction — it’s a fight every single day. When someone uses drugs again after a period of sobriety, it’s not failure but an indicator that they still need to learn how to cope with certain situations in different ways. A single-use does not represent a full relapse into old patterns. Miss steps happen, Shaming and yelling at people just makes them want to use drugs more.
Myth: Addicts are poor and homeless.
Truth: “People who are fighting addiction” are not defined by one of the challenges in their life, so we prefer not to label them as “addicts”. Today, about 1 in 5 people in Australia needs help with alcohol, drugs or gambling. it affects all parts of society such as stay at home mums, cab drivers, and company executives.
DSM-5 (2013) finally combined Abuse and Dependence, getting rid of separating physical dependence from psychological dependence as different things, we also now finally include behavioural addiction (ie gambling disorder) understanding it’s the same neurological reward systems creating addiction.
Yes pushing a button too much and shooting up Heroin is now in the same bucket.
Shoutout to Dr Gabor Mate, Addiction expert and best selling author of the book I just finished (In the realm of hungry ghosts) for making me so opinionated
Shoutout to Elyssa Wiecek for sending me lots of science.
To end: Be kind to people fighting Addiction, talk about it with people, ask your co-workers if they are struggling or supporting a family member or friend. When they say yes, act cool. They are just sick.