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Saying no is not enough

  • Minna Betancourt.

     No, they are not addicts, junkies, crack-heads or low-lives. They are human beings, just like you and me. They are anything but addicts. They are mothers, fathers, sons, daughters…. They are human beings.

     Grouping based on one particular characteristic, without taking other ones into consideration, is stereotyping. The views of individuals with drug addiction are more negative when compared with mental illnesses. Moreover, in a study conducted in 2009, Natan et al. state that people who are in recovery are mostly seen as “non-compliant, are focused on getting high at the expense of using safe injection equipment, do not have strong communities, and are out-of-control and unwilling to change their risk behaviors”. Additionally, these researchers describe a study wherein drug users are viewed by hospital nurses as “violent, having weak characters, being unhygienic, having contagious diseases, and being dangerous.”

     We live in a very complicated world where humans are pulled from many sides. We also live in a world that has been interconnected by communications.

Because we are able to look at and feel the events in other countries and cultures in real time, it would make sense for us to be aware, informed, open, knowledgeable, and accepting of the differences.  But are we?

     According to President Donald Trump, “The “best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don’t start, they won’t have a problem. So if we can keep them from going on–and maybe by talking to youth and telling them: No good, really bad for you in every way. But if they don’t start, it will never be a problem.”

     This Trump quote is from a Fortune Magazine article written by Professor William R. Kelly, a noted criminologist who has published three books on criminal justice reform.

     According to Trump’s logic, if I were not hungry, I would not become obese. But the fact is I do feel hungry and thus, I eat. The truth is sometimes we eat for reasons other than the need to replenish lost energy; conversely, once we eat and have replenished our lost energy, we don’t always stop.

     Addiction is much more than a will power or disease issue. It is a complex disease that involves maladaptive pattern of behavior, but that also involves many neurotransmitters and many areas of the brain. In essence, addiction is much more complicated than simply not doing things. If that were so easy, Nancy Reagan’s famous campaign: Just say NO to Drugs, would have shown much more positive results.

     Chemical addictions result from a complex interaction among biological, psychological, and social variables. Recovery requires a broad spectrum of treatments applied to each of these levels. This complexity creates a unique challenge for researchers because no single branch of science is capable of describing all aspects of addiction.

     Despite the new discoveries by neuroscience, it is crucial to treat individuals with a hopeful, can do attitude to avoid stripping recovering individuals of their individuality and to infuse hope in the future. It is important to treat addiction for what it is: an illness. But we must be careful with this definition, as it may sound like a death sentence. In a study by Woo et al. “Patients reported that the biogenetic model often makes them feel “trapped” and “fundamentally flawed,” as it provides little hope of recovery or being “freed” from the condition. The key is to treat patients as unique valuable and special.

     According to the Centers for Disease Control and Prevention, opioids killed more than 33,000 people across the country in 2015, more than any year on record. But a study recently published in the Journal of the American Medical Association (JAMA) also found that alcohol use disorders have almost doubled, especially among women, minorities, and older people.

     According to JAMA, between 2001 and 2015, the number of alcohol-induced deaths rose to about 33,000. In addition, according to an analysis of data performed by Centers for Disease Control and Prevention from 2006 and 2010, alcohol is linked to 88,000 deaths each year!

     Understanding and effectively treating addiction is crucial to society. Although neuroscience has improved the understanding of the brain and its synaptic connections in the process of addiction, which in turn have made available promising drugs like Naltrexone, Gabapentin, and Suboxone and Narcan, a wide range of studies suggest that utilizing a multidimensional approach improves treatment success. As Yale psychiatrist, Dr. Bruce Rounsaville, put it: “Removing the moral taint may reduce the shame of admitting addiction and seeking treatment.”

     In order to do this in an effective and sustainable way it is imperative to stop the stigma associated to this problem, since a major challenge for those who suffer from addiction to drugs or alcohol is facing and overcoming the shame imposed by society, communities, friends and family members. We must also debunk the myths of addiction, starting with the assumption that “not doing it” solves the problem. History has shown that such idea doesn’t really work.

     Another widespread myth has to do with hitting rock bottom before being treated. Nothing could be more ridiculous or farther from the truth. That is telling a patient with lung cancer to wait until it spreads to all other organs! Do you really think that a lung cancer patient stops feeling the cravings for a cigarette the minute the diagnosis is in? Do they really stop smoking? Most of the time they continue smoking, whether openly or in hiding. Shall we tell them that their lifestyle led them to suffer the disease, and thus they should not waste the financial resources of others? Or that we will take them into consideration once they are in the brink of dying?

     How about obese people? Or people suffering from diabetes? Their lifestyle led them to their current diagnoses! Treating these take, time, compassion, education, and medication. So, why is it any different for substance addiction? Brain tissue is "plastic", meaning that the brain can always change in structure through relearned thought-patterns and choices. The scientific foundation behind it is called neuroplasticity.

     As one enters treatment, the brain is wired to relay happy feelings, pleasure, and avoidance through alcohol or drugs, simply because the individual has made this a learned habit. However, the brain can re-learn these associations, just as we learn to speak or drive a car! They are all learned behaviors! Labels and beliefs can create self-defeating thoughts and lead to a self-fulfilling prophecy.

     In 2013, behavioral health consultants Evans, White and Lamb argued that the approach to treatment is not as important as instilling in the patient the knowledge that there is hope and a light at the end of the tunnel; and the only way to achieve this is by accepting each individual where they are at the moment they seek treatment and being able to walk with them any new and effective path that will allow them to achieve their goals in recovery.

     Thus any treatment must take into consideration resilience and recovery to avoid the depersonalization of the individuals we aim to help. Either we actively jump into this boat to assist in rowing towards a successful goal, or we will be responsible for so many drowning in the process. A middle point no longer exists.

Editor’s note: Minna Betancourt is a mental health and addiction counselor at the Assisted Recovery Center in Savannah.

 

 

Issue Month: 
Wednesday, September 6, 2017