Addictions treatment requires broad perspective

When I was a child, I knew that, when I grew up, I wanted to be an addict. I found the lifestyle glamorous and I could see that it would get me places in life. And I had a wide array of choices of future lifestyles from which to pick.

  • Sep. 16, 2014 8:03 p.m.

When I was a child, I knew that, when I grew up, I wanted to be an addict. I found the lifestyle glamorous and I could see that it would get me places in life. And I had a wide array of choices of future lifestyles from which to pick.

It sounds ridiculous — and it is. No one chooses to be an addict.

Chris Salomons’ well-intentioned commentary on drug culture (Advocate, Saturday, Page A7) concludes by stating that it “will require all of society, and every facet of it, doing everything its power to make a change.”

This is a tall order, with its use of categorical statements like “all,” “every” and “everything.” It is also misdirected.

Drug culture is a part of the larger problems of substance abuse and addiction. Essentially, Salomons make no specific or concrete recommendations about approaching the problems of addiction. Space limits me here, but I will point out several clarifications for his discussion.

First, there is a significant difference between the act of starting to use a substance and the chronic, continued use of a substance. We must ask why people begin to engage in habit-forming activities when they are previously not addicted to something. Physical addiction from chronic use is a different set of personal variables from a person who has no initial physical addiction. Beginning use is a question of prevention; chronic use is a question of treatment. They require different approaches.

Second, Salomons focuses almost exclusively on substance addiction. Yet, it is clear that behaviours are also addictive. Gambling is the usual example. It’s not a substance, although it may create physiological chemical responses in the gambler. Other examples can include sex, gaming and computers, shopping, food (either its ingestion or refusal). In fact, almost anything can become addictive. Some people are dismissive of this argument.

Third, we need to be clear on the definition of addiction. It is not simply about substances. It is any behaviour that negatively affects a person’s life to the point of losing other things that matter to them like family, job, friends, money, etc. And, it is a condition that becomes self-perpetuating. This definition is clearly related to the distinction between starting and continuing an addictive behaviour. Using a substance once does not make one an addict, nor does it necessarily lead to addiction.

Fourth, if we choose to use an illness model for addiction (there are other models), the addict is not so much the sickness as the symptom. The addict is not the problem, and it does little good to blame the addict as someone who is abnormal, who is sick, who has made bad life choices, who has no willpower. Rather, we must ask what kind of conditions would make a person want or need to engage in a behaviour (drug use, for example) that is clearly destructive. Addicts are generally not happy when they are not in the altered state of their addiction; they know it is destructive and unhealthy.

Fifth, there is no consensus among addiction experts on the causes or the cures for addiction. Perhaps the closest thing to consensus is a belief that addiction begins in suffering, be it emotional, physical, political, or spiritual. The addictive behaviour is an escape from pain, a temporary relief of suffering. Suffering need not lead to addiction; often it does not. But, it appears to be a common denominator among addicts.

Addiction does not discriminate. It cuts across almost all demographics of age, race, religion, country. The value of Salomons’ piece is his focus on the need for increased social change of our society, not singularly personal change of the addict. Addiction is a social problem that manifests itself most visibly in individuals.

Most people can probably point to that one person who “turned his or her life around,” but, if we continue to see addiction as a personal failing of a weak individual who must be saved, we will make very little headway on the large scale problems of addiction.

Roger Davis

Red Deer

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