Drug addiction: Dogma be damned

By Los Angeles Post-Examiner Staff Member

If the reaction one has to drugs is an issue worth considering, the reaction of the general public to drug addicts is of even greater significance. Public reactions often (sadly) determine public policy, regardless of whether logic and history support such decisions.

Some topics require a little meandering when you come at them honestly — and personally. Excuse the following, as it is heavily laced with the fog of personal experience.

Talking to people about drug addiction can feel like speaking to a staunch conservative or a definitive liberal, like debating the devout religious follower versus the equally convicted atheist. It’s difficult to maintain a balanced view.

By balanced, I mean endorsing ideas that lie in the all-too-rarely explored territory of healthy ambiguity rather than the no-man’s land of completely idiotic (and phony) compromise or the ultimately unstable castles of self-congratulatory perceived knowledge. No, you don’t know it all, but neither are you a pawn or a victim incapable of coming to conclusions. There is information out there, and there are solutions.

The two camps I encounter most often when talking about addiction and dependence are the “Disease” folks and the “Matter of will power” crowd. Both views oversimplify a complex issue. If addiction were just a disease, we would see greater commonality amongst those afflicted. If it were a matter of will, any addict who loved their family could use that love to motivate their recovery. And yet we see addiction in every demographic from every walk of life.

We see family ties severed despite deep regret and self-loathing. We watch people run to the thing they hate, the source of their problems, despite repeated negative outcomes. Obviously, addiction is not just something we can cure. Neither can it be willed away by even the most compelling rationalizations and good intentions. It is a different battle for every individual.

Trying to explain to friends that I neither condone nor condemn the defining choices in my family is like trying to explain relative morality to a concrete fundamentalist. I didn’t realize that “choice” is a word that implies different levels of accountability to different people until I began talking about addiction from a personal standpoint. For instance, just because someone has a “choice” in whether or not to do something does not mean that the choice is an easy one to make, or that their guilt resulting from a wrong choice will be enough to prevent them from repeating that irrational, immoral or irresponsible decision.

Yet when I lament the brokenness in my own family, I’ve had someone shrug and say, “That was their choice.” I can’t argue: Sticking heroin rigs into your arm is a choice, but from that one slip of judgment can come a fountain of consequences and an array of new “choices” to be made — each with a set of challenges and resources that are highly dependent upon factors like basic biology, environment, health, education, social support, stress levels, and financial stability.

Most people at least have a few friends or family members who have problems with alcohol or smoke more weed than they think they “should.” They usually report doing this for stress relief. Then there’s my background, which opened my eyes to the argument no one seems to make, which is that the right choices for one person’s recovery don’t work for the next person in line, and that sometimes “hope” for someone’s recovery seems to come at the expense of those suffering through every — “hold-your-breath” — relapse. I don’t remember feeling resentful when I found out that my mom had never truly stayed clean. Forget any clinical terminology; Opiates can be insanely fucking addictive.

On some level, I understood that most people in her circumstances (she had lost a husband to cancer, two children to drug addiction, and rarely had the social or financial support necessary to support even a remotely comfortable life) would probably fall prey to a “quick fix” that turned into years of yet more drug abuse. It was only after her choice to subject another child to this lifestyle that I turned sour, that I found myself tempted to lose sight of what a monster addiction really is and let myself slip into a dogmatic view.

Was it vanity? Was it the lies she told herself for self-efficacy? Was it a warped need for love given and reciprocated? Why would you attempt to raise a child — a living source of never-ending stress — into your life while attempting to recover from habits you formed as a means of… stress relief?

It seems a little bit like moving next to a Burger King after getting weight loss surgery. You gave up so much to better your life, only to jump into the line of fire. All the more poignant is the weight of a child in the mix, and there goes another generation, unless salvation comes in the form of family upheaval. Even though I’ve seen a few relatively affluent folks get off drugs with the help of doting family members, and I studied any method I could find in addiction treatment and recovery, my sense of hope has tested against my innate personal background in frustration and doubt.

Fortunately, most people in the addiction field are a little more upbeat, at least professionally speaking.

Treatment for drug addiction should (and does, increasingly) take into consideration the varied nature of addiction and those who suffer from it. Still, I see far too many treatment options that either rely heavily on individual and group therapy methods or take their cue from abstinence-only, formula-heavy textbook classes.

One thing to remember about any “class,” whether it’s Kindergarten or an upper division college course, is that groups are usually taught in a uniform fashion. In essence, for a group to learn something, the material must be empirically sound or at least consistent. For something to have that level of uniformity, it must either be provable, over-simplified, or propaganda. My fear is that people who are unable to admit to all the unknowns in addiction may often oversimplify the arguments on all sides.

Ultimately, using a combination of social support, psychological education and medically, empirically proven treatment is the best approach to just about any human ailment. But every camp wants their say in order to prove their worth. Perhaps it’s a bit more personal than we care to think.

The people running therapy groups may be the type to find benefit in social affirmation, while the scientific crowd finds more comfort in the success rates backing new medication trials and detox methods. To further complicate matters, it’s not as though all services are made equally accessible and presented by professionals with the same credentialing.

Starting an Al Anon group requires the ability to contact a District Representative, secure a designated location, and consistently stay on task with the initiative to run an open club. To be a Drug and Alcohol counselor at the most basic level (CADC I) requires the equivalent of an Associate’s degree or Minor in Addiction Studies and completion of a Certificate program, taking the CADC exam and some counseling experience supervision hours. Meanwhile, becoming a social worker requires at least a Bachelor’s degree to start, with various licensure requirements as per state policies.

Addiction itself can be rooted in physical dependence, psychological, or both. It’s partly due to this that we need people with different educational backgrounds and techniques.

Arthur Blume, a professor at Washington State University in Vancouver and renowned psychologist in the field of addiction, wrote a book called Treating Drug Problems that is probably the best Drug Addiction and Treatment 101 course you can find. It’s not written for students of Addiction Science, nor for experts in the field. It is not a self-help book for those struggling to overcome addiction, and it’s not a guide for families of addicts.

It is a tool for just about anyone who wants an enlightened explanation of the nature of addiction, the biopsychological model as it applies to the topic (biology, environment, behavior as factors behind addiction), risk and protective factors, and theories behind recovery programs and relapse prevention.

Books and people like these embrace the need for all experts to weigh in, for resources to be explored, and for us to take addiction seriously as a complex problem with many solutions. For now, those multiple solutions are the source of both frustration and hope.

The author wishes to remain anonymous. Part 1 Here.