A personal disease cannot be controlled. A person becomes stricken with disease through no fault of their own. They are accosted from within, ravaged by pain, and humbled by their own mortality. Families are pillaged to pay medical costs. The individual emotional distress can be overwhelming. Cancer and bipolar disorder fall into the category of personal disease.
A societal disease is an affliction that cannot be controlled by the entity effected by it. Whether it is slow and degenerative (like religion) or swift and chaotic (like AIDS), the results are often devastating. Many of these diseases can be constrained by legal restrictions or common sense for a period of time before exploding on a world-scale. Drug and alcohol addiction fall into the category of societal disease, not personal disease.
So everyone say it with me: Drug and Alcohol addiction is NOT A PERSONAL DISEASE. Why? Because a person can decide at any time to put the beer down and back away from the cocaine. No higher power is required. There is only one step. Personal responsibility is a necessary lesson in life, and many people fail the test (and ruin it for the rest of us) by refusing to learn to partake without excess.
Forget the excuses. Addiction runs in my family, too. In fact, it runs in every family. Just because no one calls someone who plays video games 12 hours a day an addict doesn't mean he's not one. We all use escapes, some more obsessively than others. To practice them in moderation is the key, but you must be taught to do so. Temperance is not something that is seen often in America, and many of our societal ills have a lot to do with what we teach our children. If we teach people to refrain from drug and alcohol use, we are not teaching them to live in the world around them. There is a time and a place (and a limit) for everything, and addicts have not learned to recognize that fact.
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24 comments:
Polanco
Thank you for your opinion. Please remember that it's just that--an opinion.
We agree on many thing, but on this we will disagree.
Yeharr
BP,
I know you have personal experience, but this is not only an opinion. There is a lot of knowledge out there to back me up. The most recent evidence shows that dependence is created by using something too early in age or too often, and as a result, the brain chemistry changes. The drug or alcohol kills or mimic chemicals our bodies produce naturally. When you remove the drug or alcohol, you go through withdraw because your brain is frantically trying to replace those chemicals. Some cannot be replaced and people continue to use. Some can and people lead relatively normal lives. Either way, if they were responsible enough to use in moderation in the first place, it wouldn't be an issue.
My sister has a diseas. Barbara's daughter has a disease. It is unfair that people who cannot be responsible for themseves get the same, or in most cases, more benefits than those who are ill through no fault of their own.
Boy do I agree with you.
A couple of things to think about:
Many psychological disorders are classified together and the symptoms mimic those of addicts. If left undiagnosed/treated these people will attempt to self medicate using drugs (legal or illegal). Looks a lot like addiction. But it could be depression or a bipolar condition (or whatever) from which the person is trying to escape.
Also, we (our society) tend to want to slap labels on people and hand them a prescription. I see this happening in our schools and with adults too. How about we teach people coping skills? The problem with this current trend is exactly what you, PC, suggested in your comment to BP. If we medicate children (and adults) aren't we screwing up their chemistry? Are they doomed to some kind of chemical dependence forever? I think we are CREATING another brand of addiction.
I do agree 100% that people have the right and the obligation to learn moderation. I'm concerned though that some in our mental health community are doing more harm than good. I'd like to see more therapy and less drugs.
Every disease has personal and societal dimensions.
At first blush, it looks like Public Health (e.g. epidemiology) exists because we want to be nice to people. It doesn't. It exists out of fear. It exists for the harsh reason that society wants to control people. When a crack addict breaks into your house and robs you at gunpoint because he's hungry, it's everybody's problem. Maybe it's not such a bad idea to provide basic social services to people with drug addiction if it prevents violent crime.
I'd argue that you can't take personal responsibility away from anyone with any disease. My relative with cancer chose to forgo chemotherapy. My friend with bipolar chose to check himself into a hospital. Hypothetically, I hope the coworker with avian flu will make the right choice and not go into work. Sometimes the choices are easy, but mostly they are defined by circumstance with no idea of the ramifications.
But if your main qualm is the issue of fault--did the alcoholic who drank too much deserve to die? did the manic depressive who jumped off the bridge deserve to die? did the monogamous gay man with AIDS deserve to die?--then I don't want to be part of this conversation.
I am getting nervous. I am beginning to agree with you more and more often. Maybe the world is going to end or something like that.
I hope you had a happy holiday. I wish you a Happy New Year !! (I love greetings that can be, more or less, universal (except for Chinese and ---- oh well so much for that)
Excellent post, p.c.
Addiction does run in families, and I bet every person with whom we come in contact has one addiction or another.
Happy New Year!
PC-I could also quote studies supporting the opposite, and we could go round and round.
But what would that prove? And in the end, who would it help?
Maybe it's an addiciton, and maybe it's not. The thing is: there are uncounted thousands who are in recovery now precisely because they treat it as a disease.
And why does this bother you? I fail to understand why this is such an issue.
Yeharr
Like Balls-upon a Floor
I felt a Cleaving in my Mind-
As if my Brain had split-
I tried to match it-Seam by Seam-
But could not make them fit.
The thought behind, I strove to join
Unto the thought before-
But Sequence ravelled out of Sound-
Like Balls-upon a Floor
- Emily Dickinson (1864)
"Emily Dickinson captures with her customary startling simplicity the distress of the ADD mind." -Edward M. Hallowell, M.D.
One often overlooked component of addiciton is ADD/ADHD. It's not just a childrens disorder.
Maybe I'm missing your point, but I feel it does a disservice to the treatment of addicts to simply say they could quit if they wanted to. No treatment can start until an education or understanding into what drives their compulsion. Most if not all addiction is a defense or coping mechanism for something else. Unfortantely they are self medicating and that is like trying to put out a fire with gasoline.
Medication to treat disorders like ADD/Depression/Bipolar/Schizophrenia etc are very valuable and in some cases are the only way. You can not discount the effect of chemical imbalance in many of these types of disorders. Medications are one of the many tools available to people with mental disorders. I'm not saying we should start there or that a large portion of our society is not unnecessarily over-medicated. I'm just saying that patients and their health professionals should use every tools available to treat these illnesses that often lead to addicition and the associated negative behaviors.
Beating an addict down with labels of weakness and criminality is one way to ensure that person never gets help. Do you honestly think that any addict is happy with their condition?
As far as moderation goes, what, at the root of the addiction, is the difference between a heroine addict that moderates his or her addicition functioning normally and one who can not and ends up "a street addict?" Nothing.
Before we start judging addicts we all need to look in the mirror. That morning coffee you can't live without, those cigarettes, career obsession, the compulsion to argue with a moron long after the argument has descended into mud-slinging :) are all part of the same human condition. They are just different degrees.
Some of the most destructive addicts are the alcoholics that have taken the cure and have become 12 step nazis seeing an alcoholic in every refridgerator with a beer in it or even worse born again xtians.
Crank--
Then those people aren't really following the 12 steps and 12 traditions. They are as false in that as the ID proponents.
Yeharr
True enough BP. It was really bad in the military. Some of the biggest drunks became the most judgemental wagon riders. They seemed to rely on their self-diagnosed superiority to keep them sober. Hey, if it worked and they got their life back on track then more power to them.
But with many of these guys they never really understood why the abused alcohol to such an extent and continued to struggle with the same root demons. I don't think they were really cured. They just stopped drinking.
Always,
By that logic, the actual condition is the disease, not the addiction. The addiction is actually just a symptom of a deeper problem. I don't agree with medicating children. Adults have had time for their brain to develop and sometimes need help filling in some chemistry holes. That is messing with their body chemistry, but so is eating beef that has been injected with hormones. So is treating people for cancer. A medical treatment is more contolled and specific than shooting heroine into your arm.
Jessica,
Yes, it is everyone's problem. So instead of spending money on feeding, housing, and jailing people who have lost control of themselves through their own devices, let's teach people to practice moderation in the first place. Screw the crakhead. Get a better security system.
They do not have a choice to get the disease. They do have a choice in how they cure it or keep it. The idea was that addicts choose their poison, people who are afflicted with disease do not.
Three Score,
Why does that make you nervous? It simply means that people who disagree with you on some things agree with you on others. It also means that you shouldn't use lables as absolute qualifiers.
BP,
First, I have a problem calling it recovery. They are nto sick. They're just irresponsible. Second, when people think it's a disease, they treat addicts differently. They make allowances they shouldn't make. Third, when addicts believe they have no control over it, they are not learning personal responsibility. They are sheltering themselves. Fourth, only a third of addicts stop using, and most of them practice avoidance rather than responsibility.
Besides all of that, addicts place a financial burden on their families, but especially on the government and health care system, who spend millions each year on "recovery" programs, emergency room services, etc. As a reult, there is less money to spend on ACTUAL diseases and diseased people. That really pisses me off. There are a lot of people who are ill through no fault of their own and they don't recieve disability, social security, or medicare when they should or as much as they should because our country is supporting addicts.
Cranky,
I didn't say they could quit if they wanted to. In fact, I said the opposite, that the drugs replace chemicals in the brain and as a result, people become dependant. What I said was that addicts could stop themselves from using in the first place and that if they were taught to use in moderation and were responsible enough to do so, there wouldn't be a problem.
Cranky,
Sorry, didn;t finish responding. The differnce between a finctioning addict and a non-functioning addict is that one is not a burden on society and should be left alone to do as he pleases. He has learned moderation. It is hypocritical to make some addictions illegal and not others. Coffee, alcohol, and video games are more addictive than marijuana.
I also mentioned in my post that we all have addictions. I don;t think I mentioned specifics, but I'm addicted to reading, coffee, and chocolate. My addictions do not effect others financially or emotionally. They do not degrade society. And, I am in control of all of them. I don;t sit around my house all day in my underwear reading, drinking only coffee, and eating only chocolate to the detriment of my relationships and my health.
The twelve steps are crap psychologically. They don't encourage counseling to get to the root of why people are using in the first place, they assume everyone believes in god or suggests that you have to believe in god to not be an addict, and they encourage avoidance rather than responsibility. It's more like a cult than a health program.
So you only have a problem with addiction when it is not handled well, moderated or when it costs money? Are drug addicts that don't place a burden on society considered responsible? Isn't there a cost in terms of the quality of their work and/or relationships, lost opportunity etc... Consider the father who comes home from work and drinks himself to sleep every night, but manages to meets all of his outward obligations, is never violent and does not cause financial problems. But he is not emotionally available to his family and many lessons his children need for success are missed. They may grow up with issues and the cycle continues.
I guess I'm missing something here. What do we as a society do about the hopeless crack head? I agree early intervention is key and medicating children should be considered with extreme caution. I guess it goes to an understanding of what causes people to self-medicate to begin with. I also agree that drug avoidance isn't the answer either. If we trust our children and are open with them about drugs we could head off some of the trouble before it starts. Stigmatizing does nothing to help the problem and most likely causes people to hide problems for which they would otherwise seek help.
Maybe we are agreeing after all - Understand the root cause and guard against that moment when the individual self-medicates and becomes the addict. There is nothing wrong with recreational drug use when knowledge and moderation exist.
I guess where we disagree is in how we classify and treat people once the become addicted.
I supposed my feelings toward obesity make my drug opinions somewhat hypocritical. I feel obese people are, for the most, wholly responsible for their affliction and society should not have to bear the ridiculously high cost of their weight related health problems.
Put down the fork! Right?
Great subject though, I wish more people talked about addiction.
Cranky,
With functioning drug addicts - you can offer help, counseling, education, etc... but you can't make them go. If their work suffers, they are fired and fall into the non-functioning category if they can't support themselves. Society cannot be expected to help those who will not help themselves.
The father in question sucks, but again, society cannot be expected to make up for the stupidity of the masses. Reality sucks. Some people are like that. The kids have what they need and they're not being abused. They don't have a father around and that sucks, but all I can really do about that is to volunteer to sponsor them as a big brother or big sister.
The father made his choice and there are programs in place to help the kids and the mother cope. There is another responsible adult present in the equation, and though it's not an idea situation, no one is being physically harmed. I would suggest counseling for the father, but can't make him go. What else do you suggest be done?
I guess, the point of the father illustration was to show that there are no drug or alcohol addicts that are without a societal cost. In some small way society as a whole suffers every time another individual succumbs to drugs and alcohol.
I just don't think it's fair to say, "you use drugs so screw you" because at some level they have a choice start using . You would have to extend that to every preventable disease. In this day and age there are very few diseases that are not preventable at some level.
What to do? Decriminalize the disease (personal, societal, whatever) of addiction and treat it as a medical condition with every available resource. Start real drug education at a very young age and get rid of the "war on drug" mentality of "just say no."
The cost in the ravages in society from drug and alcohol addiction are far too great to ignore. Where can the money come from? How about the billions being wasted on the war on drugs? What about the billions being used to incarcerate drug addicts? The money is there. It is not a zero sum pie in which drug addicts are treated at the expense of other people who are ill. That is nothing more than the greedy medical industry inserting another boogie man into the equation, like frivolous lawsuits.
I actually agree with the idea of extending that to every proven preventable disease. If you have been educated about the risks and you still take them, you need to be responsible for the cost and consequences, except in the case fo children. Emergency health care is one thing, but recovery, treatment, etc... is your own damn problem if you continue your inappropriate behaviors (overeating, not exercising, drug use, alcohol use, cliff diving etc...).
The legalization of certain drugs would take a lot of the strain off of the system. The war on drugs is a waste of money. It could be spent on education (for children and adults) and counseling programs to teach people responsibility and help get to the root of their addiction.
There are a lot of government programs to treat addicts, incarcerate addicts, etc... That means my tax dollars are being spent on this bullshit. Why should I have to pay for some asshole who put a needle in his arm?
"Why should I have to pay for some asshole who put a needle in his arm? "
A valid opinion, but an objectivist view I don't share.
Take that conservatives, we liberals can respect each others views while disagreeing with them.
Polanco--
You are completely missing the point of recovery.
Here are steps four through ten of the 12 step program:
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.
Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed, and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
How is this 'not learning personal responsibility'?
This is not victimization. This is not sheltering. This is all about taking responsibility for your actions, and doing everything possible to be useful, productive members of society. This is recovery. What is your problem with it?
You state that "only a third of addicts stop using, and most of them practice avoidance rather than responsibility" as if this somehow bolsters your position. This only shows how hard it is to control this disease.
I try very hard to not use absolutes, but Polanco, you are completely wrong in this.
Brrrrrrrr. PC, I do believe you have just joined Tom Cruise in the highly evolved ranks of the ruthless. I was beginning to feel a little suffocated by the sanctimony hanging heavy in the air, so I decided to surface and save my soul.
Footnote . . . THC stays in the brain for about one month after use. How young were you when you started using?
I'm an addict because I want to be and sometimes to be an addict is a great thing.
BP,
I know the steps, which is why I reject them. I'll do a separate post on why I reject each of the steps.
Stroken -
I was 23. I was in severe pain and had looked for all other alternatives. When none of them worked, I tried something I thought to be "bad" because of all my school and my parents had taught me. It was then that I started to learn how much our parents, schools, and government lie to us about things.
I understand that you think my position is cold, but it doesn't come out of nowhere. Tom Cruise is incredibly ignorant, very religious (if scientology can be called that), and extremely arrogant. His opinions are based on one set of standards, and he doesn't do his own research. I am very offended that you would compare us, especially when you haven't offered your own opinion on the subject.
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