By Kelly Reed
Over the time since I have been privileged to take the helm at Huther Doyle, I have been especially attentive to how society views the issue of addiction. Surprisingly few folks offer social media comments of sympathy and kindness when an article or story appears in the news or on their Facebook or Twitter feed telling of a lost life - of someone whose battle ended with an overdose - or a body that just simply gave out from the misuse of drugs or alcohol. Instead, what I see are comments like “Good! Another one, I don’t have to pay taxes to support”, or “He got what he deserved”, or “It was her choice to put that first needle in her arm.” Negative commentary such as this, demonstrates to me how profoundly misunderstood the DISEASE of addiction really is. Disease is highlighted here because the evidence is abundantly clear – it is not just my opinion, it is medically proven - addiction IS a disease.
THE DISEASE OF SUBSTANCE USE DISORDER
The National Institute on Drug Addiction defines this disease as a chronic, relapsing brain disease that is characterized by compulsive drug (or alcohol) seeking and use, despite harmful consequences. They note that their use of the term addiction is meant to be equivalent to a severe substance use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition – the “DSM-5.” They go on to point out the fact that addiction is much like other diseases – for instance, heart disease. Both disrupt the normal, healthy functioning of the underlying organ, have serious harmful consequences and while both are preventable and treatable, if left untreated, they can last a lifetime. The article agrees with the general public opinion that the initial decision to use drugs is typically a voluntary decision. However, they also emphasize that continued use will result in a person’s impaired ability to exert self-control. In fact, they point out that brain imaging of people with addiction demonstrates actual physical changes in the areas of the brain that are critical to judgement, decision making, learning, memory and behavior control. Most experts agree that these changes in the brain can remain even after a person stops using substances. These changes essentially take away willpower. This is a key point in how and why substance use disorder is such a complex issue and why – I think – the disease has become so misunderstood.
PUBLIC PERCEPTION AND POLICY
In a study done by John Hopkins Bloomberg School of Public Health, researchers found that, in today’s world, people have decidedly more negative feelings towards folks with an addiction to drugs (or alcohol) than they do towards folks with mental illness. In fact, the study suggests addiction to substances is seen as a “moral failing” and those holding this perspective also do not believe health insurance, housing or employment policies should benefit those who are addicted to substances. On the contrary, in recent years those with a mental health diagnosis are seen as needing support and understanding as well as concrete personal supports such as housing and employment. This study, conducted in 2013, involved a nationally representative sample of 709 participants who were asked a number of questions on both mental illness and drug addiction. The questions were designed to elicit their attitudes towards both conditions and focused on important topics such as treatment, public policy, stigma and discrimination.
HOW WE “SAY IT” IS HOW WE “SEE IT”.
Commenting on the findings, the researchers imply that the media coverage of addiction as a condition suffered by those living on the street and desperate as opposed to any person who is struggling with a chronic health condition that is hard to bring under control, may have helped to shape the negative public opinion that was demonstrated in the outcomes of the study. One of the researchers, Colleen L. Barry, Ph.D., MPP, opines that while it was once taboo for people to openly discuss that they take antidepressants, it is actually normal to do so today. In fact, think about the number of television commercials that promote antidepressants and other types of treatment for mental health concerns these days. Barry believes this kind of frank and public discussion has helped advance both the public perception of mental illness as something anyone can face and the understanding that it is treatable. These changes in perception help to shape public policy supporting those with a mental illness diagnosis. The public also seems significantly more tolerant of diseases - other than drug or alcohol addiction - that may result from degrees of personal choice. For instance, diabetes is a chronic disease often associated with poor diet and exercise choices and can also be linked to genetic makeup. While personal choice and genetics are also identified as factors contributing to Substance Use Disorder, there is far less societal understanding and far more social consequences for those suffering from this disease. Another of the researchers, Beth McGinty, Ph.D., MS accurately points out that, “The more shame associated with addiction, the less likely we as a community will be in a position to change attitudes and get people the help they need.”
My friends – we MUST change this! It is my fervent hope and my absolute commitment to help our community replace the shame with understanding, the condemnation with compassion and begin to recognize that addiction as a treatable health condition. And treatable it is! Every month when the employees of Huther Doyle gather for a staff meeting, we share the first names of the individuals who have graduated from our Outpatient Program - hundreds of them every year, who bravely fought their demons and take each day as a new beginning - a renewal, a healthy choice to be in recovery and to remain there.
Overcoming the stigma should not be the focus of this effort. Recovery is the focus. Recovery is the story. Compassion is the path that will lead us there.