Addiction: The disease that lies

slimvictor

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Editor's note: Dr. Marvin Seppala is the chief medical officer of Hazelden, a private not-for-profit alcohol and drug addiction treatment organization. He's the author of "Clinician's Guide to the Twelve Step Principles."

(CNN) -- Anytime I hear about a death that may be linked to addiction, I am reminded that this is a misunderstood and deadly disease. Deaths caused by addiction have risen astronomically in the past decade. Drug overdose is now the No.1 cause of accidental death in the United States; more common than death by car accidents.

"Glee" actor Cory Monteith, who was found dead at a Vancouver hotel on Saturday, had said that he struggled with substance abuse since his teenage years. The British Columbia Coroners Service said he died as a result of "a mixed drug toxicity, involving heroin and alcohol."

Whenever someone with addiction dies, I grieve the lost potential and wonder about the limitations of our ability to address this cunning, baffling and powerful disease.

I am also humbled by my own experience with addiction and recovery, and grateful for the help I received.


It seems nearly impossible to believe that people with addiction would continue to use drugs and alcohol to the point of death, but that is what people with addiction do: They deny both the consequences and the risks of using. As we continue to learn about addiction, we're understanding more about why addicted people behave the way they do. But that's little solace for friends and family.
Addiction is a brain disease, and our knowledge of it has expanded significantly, which has informed our treatment programs and altered our perceptions. We know that addiction resides in the limbic system, a subconscious part of our brain that is involved with memory, emotion and reward.

Replacing addiction with a healthy obsession

We refer to this area of the brain as the reward center, as it ensures that all rewarding or reinforcing activities, especially those associated with our survival, are prioritized. The reward center makes sure we survive by eating, drinking fluids, having sex (for survival of the species) and maintaining human interactions.

In late stages of addiction we can see how reward-related drives, especially those for survival, are reprioritized when people risk their families, their jobs, even their lives to continue to use drugs and alcohol. The continued use of the drug becomes the most important drive, at a subconscious level and unrecognized by the individual, undermining even life itself.

When a methamphetamine-addicted mother makes the nightly news after neglecting her children for four days while on a meth run, we can't comprehend how anyone could do such a thing and tend to think she does not love her children. She may have been going out for groceries with the intent to return home and feed her children, but ran into a dealer and started using.

Addiction took over, and she was driven by subconscious forces even though she loves her children as much as I love mine. Her love and her natural instincts to care for and nurture her children were overridden by her own brain, the reward system reprogrammed to seek and use drugs at all costs. Unbeknownst to her, drug use has become the most important thing in her life.

When we witness the incomprehensible behaviors associated with addiction we need to remember these people have a disease, one that alters their brains and their behaviors. We tend to believe we all have free will, so it is difficult to understand how the addicts' perception has been so altered as to drive them to destruction.

5 damaging myths about addiction

We also assume they can make their own decisions, especially when it comes to help for their addiction. In so doing we are expecting the person with a diseased brain to accept the unacceptable, that the continued use of drugs is not providing relief from the problem -- it is the problem, and they need to stop that which has become paramount.

They are unable to make such decisions because their brains have been altered to prioritize use of the drugs, even above survival itself.

Relief of psychic pain, the real, unimaginable pain of addiction, is part of the problem. People have many reasons for seeking relief from pain; some pain precedes the addiction, but most pain is the result of the addiction.

The addicted neglect their primary relationships and they may lie, cheat and steal to continue drug use. And they know this at some level, they recognize their uncontrolled behaviors, but they can't change, they can't stop.

Hopelessness becomes a way of life. Self-loathing, shame and guilt become the norm as the consequences of continued drug use accumulate.

They use drugs to ease the pain, but the very remedy exacerbates the problem. The answer to their dilemma goes unrecognized due to the neurobiological changes that have occurred in their brains.

From drug addict to yoga instructor

cont at
http://edition.cnn.com/2013/07/15/health/addiction-relapse-cory-monteith
 
When we witness the incomprehensible behaviors associated with addiction we need to remember these people have a disease, one that alters their brains and their behaviors. We tend to believe we all have free will, so it is difficult to understand how the addicts' perception has been so altered as to drive them to destruction.

We also assume they can make their own decisions, especially when it comes to help for their addiction. In so doing we are expecting the person with a diseased brain to accept the unacceptable, that the continued use of drugs is not providing relief from the problem -- it is the problem, and they need to stop that which has become paramount.

They are unable to make such decisions because their brains have been altered to prioritize use of the drugs, even above survival itself.

Relief of psychic pain, the real, unimaginable pain of addiction, is part of the problem. People have many reasons for seeking relief from pain; some pain precedes the addiction, but most pain is the result of the addiction.

The addicted neglect their primary relationships and they may lie, cheat and steal to continue drug use. And they know this at some level, they recognize their uncontrolled behaviors, but they can't change, they can't stop.

Hopelessness becomes a way of life. Self-loathing, shame and guilt become the norm as the consequences of continued drug use accumulate.

They use drugs to ease the pain, but the very remedy exacerbates the problem. The answer to their dilemma goes unrecognized due to the neurobiological changes that have occurred in their brains.

This can easily be a load of crap. There are many functional drug users who are swept up by this net of generalizations because to the recovery industry, people with a psychoactive chemical in their body are incapable of exercising free will.

I don't deny that there are people who have lost control and need help, but the recovery industry is all too eager to prey on people who are not addicts but have been forced into rehab by law enforcement.

I have a very deep dislike for these people.

Your industry would have a hard time existing if people weren't forced to buy your product. Therefore, I am highly skeptical of anything you say.
 
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This can easily be a load of crap. There are many functional drug users who are swept up by this net of generalizations because to the recovery industry, people with a psychoactive chemical in their body are incapable of exercising free will.

I don't deny that there are people who have lost control and need help, but the recovery industry is all too eager to prey on people who are not addicts but have been forced into rehab by law enforcement.

I have a very deep dislike for these people.

Your industry would have a hard time existing if people weren't forced to buy your product. Therefore, I am highly skeptical of anything you say.

So good I'm reposting it. However I do prefer rehab over jail time...
 
Although I highly doubt it would be my first choice, if I was offered a chance between prison or rehab (record or no record), obviously I'd choose the latter instead of further blemishing my history with the popos.

I'm not saying I agree with this guy's views, but at least (apparently) he's got first hand experience regarding what it means to constantly be chasing that fix. For me, he's got a lot more credibility than an "addiction expert" who's never touched a recreational drug (other than perhaps booze). Just sayin'.

That being said, I'd still like to open my very own opium den. I got some great ideas for interior decor.
 
I wonder if opium is a better recovery tool than abstinence. I imagine an opium habit is much more manageable, provided a steady "legal" source. And chances of overdose are greatly diminished.
 
Chewing coca leaves or drinking some coco tea has also been given zero chance as an option for a less harmful alternative. Generations of Bolivians farmers used it with no problems.
I don't like the addiction recovery industry either. Someone dies and you use it as a chance to promote your clinic. Instead of profiting off people sent to their programs by the court they should be helping people who want to quit and want to be there and can't afford it.
 
I wonder if opium is a better recovery tool than abstinence. I imagine an opium habit is much more manageable, provided a steady "legal" source. And chances of overdose are greatly diminished.

IME, I believe it would be the one of the less riskier ways of using opioids/opiates (smoking it, that is).
 
Replacement is a good alternative in some cases.

But for the most part, some people are pretty grumpy high... Especially if you catch them in a nod.

Abstinence is the ultimate goal.

Snatching the rug from under people make’s them not want to stand up, once they realize laying down is comfortable...

IME, I believe it would be the one of the less riskier ways of using opioids/opiates (smoking it, that is).

You still must realize there is still inherent danger. Lung disease is a factor. People will also have to spend more money because if you don’t freebase your heroin, you are wasting a lot of dope.
 
You still must realize there is still inherent danger. Lung disease is a factor. People will also have to spend more money because if you don’t freebase your heroin, you are wasting a lot of dope.

Yes, smoking opium can cause lung cancer. However, I was referring to what could be a considerable option when it comes to opiate dependency or addiction.

It takes quite some time and effort to grow your own, fully matured Papaver somniferum plants, then to harvest the "milk of the poppy" (I was watching too much Game of Thrones lately) and store it for later use.

The aforementioned opium combined with codeine CWE were the only two ways in which I didn't develop a very unpleasant physical dependency.

In contrast, after I became fed up and quite lazy with having to repeat the process of both the CWE and growing another batch of plants - that's when I really began to get hooked.

The point I'm trying to make is that I just find, at least in my experience, in this day and age where narcotics are tightly controlled by the government and usually expensive to obtain on the black market that it's harder - but not necessarily safer from a long term adverse effects perspective due to possible risks such as lung cancer - to get hooked to opiates if you're smoking your own homegrown opium.

That being said, I openly acknowledge the fact that no drug use, in any way, shape or form is completely safe and/or risk free.
 
I think part of the reason so few people are able to kick their addictions is that addiction is constantly hyped by anti-drug advocates and users. There are a number of reasons for this widespread embellishment.
Obviously, distortion of fact serves the anti-drug cause by crafting a false idea that both fosters and feeds on fear and is intended to draw support from those ignorant on the matter.
Many people enjoy attention and pity more than they let on. As with all things, if you were to mention a particularly rough personal experience with a drug, there will undoubtedly be a person who has to leech attention by inventing a far worse experience of their own.
Some people are unable to step back from anecdotal evidence (which is, by no means, an easy task sometimes). A program may have worked for you, but that does not mean it is the only way possible. If you needed a 12-step to kick your DOC, don't beat yourself up for needing help, but also refrain from telling those trying to quit on their own that the situation's horrible or hopeless. When you build addiction up as if it's some primal force that wreaks havoc on one's self, then you're sending the message that it's hopeless. I remember the first time I came down from a 3-day stim binge; I was tired for several days, but never experienced the crushing depression, desire to support my habit by stealing, or thoughtless aggression that many would term core characteristics of stimulant addiction.

If you remove the responsibility of their actions from a person, you often leave said person with a convenient excuse to continue their usage. I see this everyday, as I live in America, where obesity is an epidemic. Though anecdotal, I find the number of obese associates of mine who content themselves with paltry rationalizations, as opposed to actively working towards better health, to be chilling. I have relatives who have eaten and couch-potatoed themselves into diabetes. They all seem to blame genetics and continue on eating 5 meals per day plus a ridiculous amount of snack food. This angers me not only because I'm told that my exercise regimen, dieting, and successful loss of almost 100 lbs are all for naught; but also because I've seen this mentality spread like an illness and come to dissuade younger and more impressionable relatives from even attempting to maintain a healthy lifestyle.

It doesn't even make sense that addiction affects all people in the same way. Addiction will obviously pose different problems for different people. How one reacts to any given situation, including drug addiction, is shaped by one's genetically unique brain and personally unique experiences.

What's messed up is that drug addicts aren't always lying when they say they can quit anytime they want to; it's just that they end up not wanting to quit. Programs, supplements, and deleting your contact information may be helpful, but will not wholly substitute for self-discipline. Sure, one may get cravings for and obsess over one's DOC, but it is ultimately one's own hands that pick the pipe or rig back up.
I just wish everyone could refrain from speaking in absolutes.
 
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I chose to go to rehab on my own. There were thirty individuals there. Four of us chose it. The rest were there because of drug court. Most of the people that were ordered there were smoking spice in their bathrooms and either making fun of the counselors during group or trying to fuck each other. As we graduated and were sent to our respective halfway houses the divide between those wanting help and those forced to take it became wider, and more apparent.

Two people (on drug court) got sent back to jail for assaulting one of the other tenants. Four (on drug court) were selling various drugs out of their rooms (one of which was my roommate). One person was kicked out for stealing from other tenants. I'm not sure if the thief was on drug court.

The atmosphere in both the rehab and the halfway house was that of a jail. It was very tense much of the time.

The point I'm making is: it is very hard to get the message of rehab when one is nearly surrounded by others who either don't care or are actively trying to get you to use. I understand that one will be in those situations in life, but why not give those that are trying to quit a better place to do so?

The way this rehab stayed open is by getting its patients on food stamps and Medicaid and then billing the state.

It is indeed up to the individual to let recovery into their heart, but if you need rehab and can't afford one of those expensive private rehabs then good luck at re-jail.

I did get quite a bit out of it though. There were two counselors in particular that tried very hard.
 
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Some people are unable to step back from anecdotal evidence (which is, by no means, an easy task sometimes). A program may have worked for you, but that does not mean it is the only way possible.

Absolutely true.

It doesn't even make sense that addiction affects all people in the same way. Addiction will obviously pose different problems for different people. How one reacts to any given situation, including drug addiction, is shaped by one's genetically unique brain and personally unique experiences.

Again, very true. There's a ton of factors which factor into how someone's habits can make them behave.

I just wish everyone could refrain from speaking in absolutes.

IME, this is a huge problem and has always been a huge problem in society. For example, "Addict A" seems to believe that the effects he felt when he used his DOC (or when he didn't use and subsequently went into withdrawal) is the same for everyone else. In truth, the human body is so complex that I sincerely believe that no two people will experience the same high when using any given recreational drug. There will always be a difference in intensity, adverse side effects, drug half-life, long term consequences, and so forth.

This problem is obviously not just limited to drug use - it's everywhere. I can't tell you how many times I've had people tell me - in very specific detail - how "this" music will sound, how "this" food will taste, how much "that" hurts... you get the idea.

I'd say it's rather arrogant of someone to act like he or she knows you or I better than we know ourselves. A lot of my former doctors have behaved in this manner (e.g. "This procedure won't hurt" .... actually yes it does).
 
^ Yes, it is not quite so simply as either X or Y, I also think.
It may be a choice that some people are genetically pre-disposed to make.
It may be a disease that one ultimately has some control over.
Calling addiction either a disease or a choice are both misleading and oversimplifying, imo.
 
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