Addiction ~ Part 1: What is addiction
Greeting Planet Fames!
I hope you are all enjoying a fun, and safe, Labor Day weekend!
What can I say, I must be excited about starting this series! I'm actually getting the blog out on the day I originally said I would! haha That said, I want to remind everyone that while I encourage debate, questions and conversation, personal attacks will not be tolerated. I also want to say that while I may include some facts and statistics, this blog is about my thoughts, opinions and experiences. You may think, feel, believe differently and that's OK! I may even be...wr...wrrr....wrong, in my opinion. (God that was hard to type! haha) The point is to start a dialogue, and to help educate and remove the stigma on this topic. Viewer discretion is advised, as I may get just a little...real for some of you. So please don't be offended.
OK! So where does one start a blog series on Addiction? I've given it a lot of thought over the past week, and I really believe that before we can go too far down the rabbit hole, we all need to be working from the same basic understanding of what addiction is. So what is addiction? Well, I believe there is physical addiction, and psychologically based addiction. Physical addiction, a person can be born with. They have their first beer, and BAM! Chemical in their brain go off, and they are off and running. That's probably...being generous...10% of people suffering with addiction in my opinion. Psychological addiction, comes from an event, emotion, experience, or something outside the individual that causes them to seek escape from that situation. In the industry, we call is self medicating. Each person is different, and their root causes can be anything. Their need to escape, or inability to process that thing though, cause the person to use drugs or alcohol. Over time, a psychological addiction becomes a physical addiction. For purposes of this blog, I am focusing more on the psychological addiction.
It amazes me! To this day, there seems to be an almost infinite number of definitions and ideas about what addiction is. Primarily though, they can be categorized into one of two things.
1. A moral, ethical, or spiritual failing. The definitions of addiction that fall into this category, always place blame for the addiction squarely on the individual. In some rare cases, the individual might be cut a little slack for their addiction, due to outside factors. Those factors can include things like, coming from a broken home, having abusive parents, experiencing violent or sexual trauma, I have even encountered a person who believed addiction was caused by not believing the "right way".
No matter what the actual definition is in this category, and even when those suffering with addiction are cut some slack, ultimately blame is placed squarely on the person.
It starts with: "It's terrible what happened to John/Jane when he/she was younger, I can't imagine going through something like that."
It ends with: "You have to learn to put those things behind you though. At some point you have to stop letting things in your past control your life. You have to take responsibility."
Now the ending doesn't sound so bad, right? There is a lot of truth in that statement, to an extent. What has happened though, is we have taken our empathy for the individual and used it like a club to beat the addict over the head with it! Yes you had this horrible experience I can't comprehend, but get over it already. Supportive huh?
These definitions also operate from the idea that, if a person simply tried harder, was a better person, or found God or spirituality, they would be able to beat their addiction. Those who relapse, once or multiple times, simply aren't trying hard enough. If they were, they would stay sober.
To me, these definitions are kind of like saying to a person that wears glasses, "If you tried harder, you wouldn't need those glasses." Try it sometime...I dare you. HAHA!
2. Addiction is a disease. Definitions of addiction that fall into this category, take the stand that addiction is in fact a disease. Like any other disease, those suffering from addiction require treatment and care for their illness.
Would you be surprised to learn, that the American Medical Association (AMA) classified addiction as a disease over 30 years ago? It shouldn't. That's because the American Medical Association classified addiction as a disease OVER 60 YEARS AGO! In 1956, the AMA published their classification of addiction as an illness. 62 years ago!
In 1991 the AMA went even further, including addiction as both a medical and psychiatric illness in the International Classification of Diseases. Granted it only took them an additional 29 years, but they got there.
I'm not sure about you, but if some of the smartest people on the planet, spending millions of dollars every year on research classified addiction as a disease more than 60 years ago...I feel pretty confident with an addiction is a disease definition. I personally believe and accept the disease model definition, and so my thoughts and opinions will be coming from that viewpoint.
So if the AMA classified addiction so long ago, how do we still have such a large portion of the population holding onto the "moral failing" model? Well, there is a problem with the disease model. That problem is, we don't really have a clear understanding of the disease or how to treat it!
There is no blood test, x-ray, MRI, or other known test that 100% proves a person has an addiction. It's much more like former U.S. Supreme Court Justice Potter Stewart said about pornography, "I know it when I see it."
What we have, are psychological tests, and evaluations developed my psychiatrists and therapists through their work with individuals struggling with addiction, that help us to diagnose addiction in others. In my experience though, if your therapist or psychiatrist is administering one of those tests on you....guess what! You probably have a problem! The tests and evaluations are often administered AFTER there is already a concern, or there is already a problem.
Another fundamental flaw in addiction as a disease model, is that there are really no universally accepted thoughts on how to treat addiction! The most commonly thought of and accepted approach to "treatment" in the United States, is traditionally the 12-step model. The vast majority of that model, being Alcoholics Anonymous. While different sources will give you different statistics, AA arguably has an at best success rate of 31%. At its worst, AA has a success rate of 5%! This has been the "go to" treatment model in the U.S. since Bill Wilson and Dr. Bob Smith founded AA in 1935. I'll dig more into treatment methods and approaches next week, but a 5-31% success rate...we should do better! There is also a fundamental flaw with AA in my opinion. EVERY SINGLE TIME a person in AA relapses, the first thing other AA members say is: "Well they weren't working their program hard enough." Remember earlier? Where we cut the moral failing person some slack, and then smacked them with it? Guess what the fellow AA member just did?!
Again, I'll talk about treatment more later, but just to be clear I support AA and think its done some wonderful work. I have A LOT to say on the treatment aspect! My point here though, is that even the majority of people who think addiction is a disease model have managed to end up back in the same place the moral failing model does! The blame is placed on the individual, and thus the shame, which then I believe can prevent the individual from seeking further treatment. If no matter what, it's the individuals fault...how do we expect different results?
The definition of addiction is minimal at best. The understanding of treatment is worse. Yes addiction is a disease, but what kind of disease and how do we effectively treat it.
I believe that addiction is a disease unlike any other disease that we understand. I believe, and through my experiences both personally and professionally, that addiction is a disease of the thought process. It is a fundamentally warped and distorted way of thinking, and an equally warped and distorted way of interacting with the world around you.
To simplify it, I believe suffering from an addiction is like a person who needs glasses but not only doesn't have them, they don't even know they need them. On top of that, they only speak english but are living in rural China! The person struggling with addiction sees the world incorrectly or unclearly, and they don't know or understand how to interact with the people and the world around them. It isn't that they don't want to see clearly, or interact with the world around them, they simply aren't capable. THAT is what I believe addiction is.
I know this was a long one, and I try to keep them shorter usually, but I am passionate about this subject. I welcome your thoughts, comments and questions!
Next time, I hope to dig a bit more into treatment theories and approaches. Until then, Much Love Famers!
I hope you are all enjoying a fun, and safe, Labor Day weekend!
What can I say, I must be excited about starting this series! I'm actually getting the blog out on the day I originally said I would! haha That said, I want to remind everyone that while I encourage debate, questions and conversation, personal attacks will not be tolerated. I also want to say that while I may include some facts and statistics, this blog is about my thoughts, opinions and experiences. You may think, feel, believe differently and that's OK! I may even be...wr...wrrr....wrong, in my opinion. (God that was hard to type! haha) The point is to start a dialogue, and to help educate and remove the stigma on this topic. Viewer discretion is advised, as I may get just a little...real for some of you. So please don't be offended.
OK! So where does one start a blog series on Addiction? I've given it a lot of thought over the past week, and I really believe that before we can go too far down the rabbit hole, we all need to be working from the same basic understanding of what addiction is. So what is addiction? Well, I believe there is physical addiction, and psychologically based addiction. Physical addiction, a person can be born with. They have their first beer, and BAM! Chemical in their brain go off, and they are off and running. That's probably...being generous...10% of people suffering with addiction in my opinion. Psychological addiction, comes from an event, emotion, experience, or something outside the individual that causes them to seek escape from that situation. In the industry, we call is self medicating. Each person is different, and their root causes can be anything. Their need to escape, or inability to process that thing though, cause the person to use drugs or alcohol. Over time, a psychological addiction becomes a physical addiction. For purposes of this blog, I am focusing more on the psychological addiction.
It amazes me! To this day, there seems to be an almost infinite number of definitions and ideas about what addiction is. Primarily though, they can be categorized into one of two things.
1. A moral, ethical, or spiritual failing. The definitions of addiction that fall into this category, always place blame for the addiction squarely on the individual. In some rare cases, the individual might be cut a little slack for their addiction, due to outside factors. Those factors can include things like, coming from a broken home, having abusive parents, experiencing violent or sexual trauma, I have even encountered a person who believed addiction was caused by not believing the "right way".
No matter what the actual definition is in this category, and even when those suffering with addiction are cut some slack, ultimately blame is placed squarely on the person.
It starts with: "It's terrible what happened to John/Jane when he/she was younger, I can't imagine going through something like that."
It ends with: "You have to learn to put those things behind you though. At some point you have to stop letting things in your past control your life. You have to take responsibility."
Now the ending doesn't sound so bad, right? There is a lot of truth in that statement, to an extent. What has happened though, is we have taken our empathy for the individual and used it like a club to beat the addict over the head with it! Yes you had this horrible experience I can't comprehend, but get over it already. Supportive huh?
These definitions also operate from the idea that, if a person simply tried harder, was a better person, or found God or spirituality, they would be able to beat their addiction. Those who relapse, once or multiple times, simply aren't trying hard enough. If they were, they would stay sober.
To me, these definitions are kind of like saying to a person that wears glasses, "If you tried harder, you wouldn't need those glasses." Try it sometime...I dare you. HAHA!
2. Addiction is a disease. Definitions of addiction that fall into this category, take the stand that addiction is in fact a disease. Like any other disease, those suffering from addiction require treatment and care for their illness.
Would you be surprised to learn, that the American Medical Association (AMA) classified addiction as a disease over 30 years ago? It shouldn't. That's because the American Medical Association classified addiction as a disease OVER 60 YEARS AGO! In 1956, the AMA published their classification of addiction as an illness. 62 years ago!
In 1991 the AMA went even further, including addiction as both a medical and psychiatric illness in the International Classification of Diseases. Granted it only took them an additional 29 years, but they got there.
I'm not sure about you, but if some of the smartest people on the planet, spending millions of dollars every year on research classified addiction as a disease more than 60 years ago...I feel pretty confident with an addiction is a disease definition. I personally believe and accept the disease model definition, and so my thoughts and opinions will be coming from that viewpoint.
So if the AMA classified addiction so long ago, how do we still have such a large portion of the population holding onto the "moral failing" model? Well, there is a problem with the disease model. That problem is, we don't really have a clear understanding of the disease or how to treat it!
There is no blood test, x-ray, MRI, or other known test that 100% proves a person has an addiction. It's much more like former U.S. Supreme Court Justice Potter Stewart said about pornography, "I know it when I see it."
What we have, are psychological tests, and evaluations developed my psychiatrists and therapists through their work with individuals struggling with addiction, that help us to diagnose addiction in others. In my experience though, if your therapist or psychiatrist is administering one of those tests on you....guess what! You probably have a problem! The tests and evaluations are often administered AFTER there is already a concern, or there is already a problem.
Another fundamental flaw in addiction as a disease model, is that there are really no universally accepted thoughts on how to treat addiction! The most commonly thought of and accepted approach to "treatment" in the United States, is traditionally the 12-step model. The vast majority of that model, being Alcoholics Anonymous. While different sources will give you different statistics, AA arguably has an at best success rate of 31%. At its worst, AA has a success rate of 5%! This has been the "go to" treatment model in the U.S. since Bill Wilson and Dr. Bob Smith founded AA in 1935. I'll dig more into treatment methods and approaches next week, but a 5-31% success rate...we should do better! There is also a fundamental flaw with AA in my opinion. EVERY SINGLE TIME a person in AA relapses, the first thing other AA members say is: "Well they weren't working their program hard enough." Remember earlier? Where we cut the moral failing person some slack, and then smacked them with it? Guess what the fellow AA member just did?!
Again, I'll talk about treatment more later, but just to be clear I support AA and think its done some wonderful work. I have A LOT to say on the treatment aspect! My point here though, is that even the majority of people who think addiction is a disease model have managed to end up back in the same place the moral failing model does! The blame is placed on the individual, and thus the shame, which then I believe can prevent the individual from seeking further treatment. If no matter what, it's the individuals fault...how do we expect different results?
The definition of addiction is minimal at best. The understanding of treatment is worse. Yes addiction is a disease, but what kind of disease and how do we effectively treat it.
I believe that addiction is a disease unlike any other disease that we understand. I believe, and through my experiences both personally and professionally, that addiction is a disease of the thought process. It is a fundamentally warped and distorted way of thinking, and an equally warped and distorted way of interacting with the world around you.
To simplify it, I believe suffering from an addiction is like a person who needs glasses but not only doesn't have them, they don't even know they need them. On top of that, they only speak english but are living in rural China! The person struggling with addiction sees the world incorrectly or unclearly, and they don't know or understand how to interact with the people and the world around them. It isn't that they don't want to see clearly, or interact with the world around them, they simply aren't capable. THAT is what I believe addiction is.
I know this was a long one, and I try to keep them shorter usually, but I am passionate about this subject. I welcome your thoughts, comments and questions!
Next time, I hope to dig a bit more into treatment theories and approaches. Until then, Much Love Famers!
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