On a daily basis drug and alcohol services get 100’s of calls from parents, partners, wives, husbands etc. that don’t understand why the person they are calling about just can’t stop. They explain that the person they are calling about are, in the realm, very capable people but feel let down by the persons inability to just “man (or woman) up” and sort themselves out.
Addiction as a disease
Since 2011, there has been a growing acceptance of addiction as a chronic brain disease with the possibility of recovery. At the same time, there is growing acknowledgment of the roles of prevention and harm reduction in the spectrum of addiction and recovery. In most professional circles there is a general acceptance that addiction can be defined as:
Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviours that become compulsive and often continue despite harmful consequences.
Furthermore, we know that prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases, such as diabetes. Yet despite this, there is still popular belief that addiction is the result of weak character or a moral failing. Parents, partners, wives, husbands etc. that do not have an issue with controlling their drink and drug use don’t understand why someone just can’t stop.
So why is addiction not looked at in the same way that we view other chronic diseases like diabetes, why are those diseases are not regarded with same stigma and shame that addiction is?
At this point I feel the need to share. Diabetes runs in my family. My uncle has had his legs removed, my father is on insulin and I am often threatened with being put on Metformin, a well-known medication to treat type 2 diabetes. Uncontrolled type 2 diabetes can lead to chronically high blood glucose levels, causing several symptoms and potentially leading to serious complications.
I am aware of this, it is not my fault, it is not a moral failing on my part that I have to deal with this and fortunately none of my own family have it; but I know it is lurking in the background.
Furthermore, like addiction, I know that I have this to deal with this all my life and as such I do have some responsibility in this. I know that if I follow the following advice, I can probably manage my type 2 diabetes.
- Include foods rich in fibre and healthy carbohydrates in my diet. Eating fruits, vegetables, and whole grains will help keep my blood glucose levels steady.
- Eat at regular intervals
- Only eat until I’m full.
- Control my weight and keep my heart healthy. That means keeping refined carbohydrates, sweets, and animal fats to a minimum. Which is hard as I love a good sweet counter!
- Get about half an hour of aerobic activity daily to help keep my heart healthy. Exercise helps to control blood glucose, too.
So why don’t I get a hard time from my family about this, why does society not demonise me?
Well, addiction is more complicated. Addiction is a disease that not only affects the physical body but over time requires a preoccupation with obtaining and consuming substances which can become psychologically, and is some cases physically, compulsive. This is often accompanied by deceitful and irresponsible behaviour, taking its toll on relationships, family commitments and work. In some instances, it will involve violence and even the police. So, it is easy to demonise the individual for bad behaviour – lying, cheating, and stealing, as well as the angry and irrational outbursts – rather than putting the focus on the disease that creates those behaviours.
Having been involved in the treatment of addiction and mental health for over 20 years I can assure anyone reading this that the addicted person is not proud of those behaviours. They feel shame and guilt at an intense level. In fact, this high degree of shame is one of the main reasons people with developing drug and alcohol problems do not come into treatment early. This is also another reason they throw up shields of denial.
Denial plays an important role in addiction. People with developing drug and alcohol problems are notoriously prone to denial. Denial is basically a defence mechanism in that they use denial in order to prevent threatening emotions entering conscious thought. I can assure those reading this that people with drug and alcohol problems are, in the main, all internally giving themselves a really hard time for not being able to control their addiction – an intense feeling of letting themselves down and others. Being shunned by family, friends and society only contributes to greater shame and self-blame. It is therefore difficult to have compassion for people when their presumed “bad behaviour” is confused with the disease characteristics that undermine it and society sees people with drink and drug problems as “bad people who are undeserving.”
Evidence informs us that there is a genetic predisposition for addiction, as well as a range of environmental factors, especially those that occur in early childhood. We also know that trauma affects brain chemistry in a similar way as substances. Further, trauma contributes to mental illness, with individuals often demonstrating symptoms of depression and anxiety and self-medicating with alcohol and other drugs. It is therefore not surprising that in dealing with people with addictions some sort of trauma is identified. When we approach trauma, we ask, “What’s happened to you” not “what’s wrong with you”. We should adopt the same approach in dealing with drink and drug use along with understanding “what is your drink and drug use doing for you” i.e. what need is it meeting?
Approaching treatment from a non-blame perspective and undercovering what’s happened is a cornerstone of Help Me Stops approach to treatment. Accepting that addiction is not anyone’s fault, or a moral failing is a good staring point for the individual that has the problem themselves and those associated with them.
New methods of drug and alcohol treatment are changing that. If you or a loved one now suffers from substance misuse wants to stop the issue before it gets worse, there are options for you. Find out more about Help Me Stop’s non-residential Dayhab programme in London, which is intensive integrative psychotherapy in group sessions with a weekly one-to-one counselling session including. We also offer accessible aftercare and family support options, to minimise the risk of relapse and to maximise the support of friends and loved ones that is so important to long-term success.
Our Online Rehab programme is even more affordable for the 6-week programme. It’s an excellent choice for adults who may have a smaller budget and are working and can’t access services in the day. Families can also access support online.