Patricia Keeton
English 102 Class 12287
Joan Snyder
Draft, Review and Reflect
Addiction a Disease or Behavior?
Hey are you feeling down? I got something that will make you feel better. Feeling left out like you don't fit in to the crowd? Come chill will us. Things are bad at home? You got a couple bucks? Let's go have a drink and ease the pressure of a long day. Addiction begins so easily and takes over without any warning. It can begin with a bad day, peer pressure, consequence, or even easier as a teen trying to find a way to fit in within their pre-adult world. One pill or one hit is all it takes.
The National Institute on Drug Abuse (NIDA) provides the most current information on drug abuse. It treats adults and teens as equals in hopes to educate, treat, and inform our communities about changes in treatment, drug facts, and current drug trends. Today, because of education, drug use of heroin, cocaine, and marijuana among teens has declined. But, prescription and over the counter drug use has risen. NIDA provides scientific facts as to why prescription drugs are becoming more commonly abused. A lot of this has to do with common misconceptions about over the counter drugs. Many people think that because they are prescribed by a doctor, they are less addictive and safe. NIDA says this is false. Also, because they can be prescribed by a doctor they are easy to get. Prescription drugs are deadly! Especially when mixed with other prescription drugs, or illicit drugs. Commonly they are also used with alcohol. Dr. Drew Pinskey, who currently hosts his show, Life Changers and also has a radio show well known called Love Lines. He is a very well educated leader in understanding drug addiction. He stated on his radio show, Love Lines, that when a person dies from a drug addiction it involves prescription drugs 9 out of 10 times.
Drugs affect every person and every family in our country in some shape or form. Everyone reading this paper has been impacted, known someone, or felt the pain of a loved one suffering from addiction. Drugs have started wars and have influenced powerful leaders such as Hitler who used methamphetamines and gave it to his military. In school we learn of the prohibition period where alcohol was fought over and again made legal for economic gain. Filling our history books drugs are going to forever be a never ending battle. "Educating our youth" says NADA and is agreed by Dr. Drew are the leading reason why trend in drugs and statistics decrease. This became apparent in the mid 1980's and the early 1990's when Ronald Regan was president and his wife Nancy Regan created the "Just say no" campaign. Drug use among high school seniors experienced the biggest decrease in drug use in our United States history. Drug experimenting dropped in cocaine and heroin the biggest drop was in marijuana. In 1979 students in the 12th grade that had experimented with marijuana was 50%. In 1987 it dropped to 36% and in 1991 it hit an all time low of 12%.
If education is the key to understanding addiction, then what is addiction and how should it be treated? Many theories about how dependency comes about have been created. The most recent is the Behavioral theory which supports addiction as a circumstance of bad choices, consequence, or a product derived from the outcome of the environment in which we were raised. With current changes in technology, we have also been able to study the brain with imaging. This has lead to the most supported theory that addiction is a disease. Addiction is a disease of the mind, just like cancer or diabetes and it can happen to anybody.
These two theories strongly challenge each other and have led to great debate among philosophers and brain researchers. The theory of free will, compulsion, and addiction through irrational behavior have researched that addiction stems from making bad choices based on having low self-esteem or a lack of confidence. This can stem from childhood. A victim of abuse is more likely to use than a child who grew up in a healthy environment. Poverty can also lead to addiction because these children are more likely to come from a household which cannot provide a good education. Sometimes poverty stricken children are forced to drop out of school to work and add to the household income. People who drop out early find it easier to sell drugs for an income and therefore end up using and become addicted. Sometimes people just make bad choices. The natural pressures of life such as bills and a stressful job can also lead to addiction. The behavioral model of addiction also suggests that addiction can be passed down through families and can become a learned behavior. For example, a child who watches their alcoholic father will be more likely to become an alcoholic because they learned to cope from an alcoholic parent. Dependency as a learned behavior which can be passed down through generations of family.
Because addiction has been so difficult to define other than ill will as in the behavioral theory, it has been very difficult for people to get treatment because insurance will not pay. In 1985, studying addiction as a disease began. Nora Volkow is the director of NIDA. Her imaging studies of the brain have helped her change the way people view addiction. The images have provided proof that the brain of a normal person and that of an addict have distinct abnormalities. . Volkow says that, "she has shown that abnormalities in the prefrontal cortex of addicts create a feeling of need or craving that addicts know is irrational but cannot prevent".
Defining addiction as a disease has forever changed what philosophers have long studied. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV) is a manual that health professionals use to diagnose patients. Patients must meet certain criteria before a diagnosis can be made. Insurance companies will not pay for a patients care unless certain criteria are met. (DSM IV) Volkow also agrees that addiction begins with a choice. Some people do become addicted due to genetics where others may not. She strongly believes that a person becomes addicted before they know it. She states, "Despite devastating consequences a person is still unable to stop using once addicted". As opposed to the behavioral view of addiction the disease model does not support theories of abuse based on economic status. Anyone can make the choice to use but, not everyone becomes addicted.
These arguments made me curious as to how is the best way to treat addiction. If addiction is a disease then why are our prisons full and becoming increasingly over populated with drug offenders? Shouldn't we treat their disease rather than throw them in jail? If abuse led to a bad choice will the addiction go away if the abuse is left untreated? To further my research I contacted a U.S. probation officer and also a treatment provider in seek of some answer to these questions. Matt Thompson, a US probation officer, told me that people need to be accountable for their mistakes. A person who is abusing controlled substances is breaking the law and needs to be held accountable for their actions. While also holding this person accountable for their action, which usually involves jail or prison time, part of this must to include treatment for their addiction. Most people who are addicted do not seek treatment on their own. Treatment usually comes as a part of their prison sentence. A person who is sentenced to jail for a drug related charge can reduce their sentence by volunteering for a drug program such as drug court while incarcerated. In order to get your sentence reduced, you have to strictly adhere to the rules of the program and pass with the approval of your counselor, probation officer, and the judge. These members make up the drug court team. The goal of this program is to help people who have made mistakes in their lives and wish to better their lives by not only seeking help, but by listening and learning from what the classes teach you and apply it. It assists people in the huge transition they must go through of radically changing their lives. They learn coping mechanisms and must end all unhealthy relationships. Drug court also helps people transition from incarceration by assisting people with employment and housing under strict supervision. Drug court recognizes that relapse is a part of addiction so they have a punishment-reward system. Punishment can include additional time added to their drug court time frame, re-incarceration and for repeat offenders they may be terminated and required to complete their full sentence. Rewards include 1 year off of your probation period, help with housing and they often give gift certificates for gas or food to someone who is doing well and working their program. At graduation a person also receives a certificate of completion.
One thing where this program fails is determining the reason why this person became addicted in the first place. This program treats the addiction but does not look to see if there are underlying issues which caused the addiction in the first place. I spoke with Art Garcia who is a counselor for New Horizons drug treatment care center. He has also counseled on the drug court team. I asked if the underlying issues are not resolved, is the person susceptible to going back to drug use to self medicate themselves from those issues. He stated, "The judicial system only looks at the drug use and not the psychological issues which could be causing the drug use". The reason why the system does not go into the psychological issues that may have lead to the drug abuse is because of managed care which revolves around the current issues with medical insurance. Insurance only allows for a certain amount of time to treat a health issue before they will no longer pay. The judicial system also has a budget which they must follow and time constraints to attempt to rehabilitate a person. One of the consequences which usually follows addiction is unemployment due to the inability to maintain or keep a steady job. Therefore many people who need help do not have health insurance which places a heavy burden on society to pay for treatment for those who cannot afford it on their own. Treatment is not a quick fix and it's not "one size fits all". What works for one patient, may not work for another and the time to treat each individual varies greatly. Because of these constraints placed on care providers, patients are given the general care and guidance to help them as much as the system and time will allow. All we can do is hope and offer them the tools that they will take this care and move forward on their own. Non profit self help groups offer the greatest potential to help people because they are funded by donation which means they are free and you are surrounded by people who are in the same situation which you are in and this provides a level of comfort and companionship which motivates the person to overcome their addiction and live a productive life. People who use 12 step programs and seek a sponsor are more likely to stay clean. For many this is a lifelong process and it must become a way of life. (Garcia) From my interview with Garcia I found that treating addiction in the early stage can take up to a year of intensive care. The addiction must be treated first before they can attempt to treat any co-occurring mental disorders in which may have manifested from forms of neglect or abuse. Drug treatment providers may refer a person for other mental health issues to another mental health provider but whether a person seeks or follows through on this referral is up to them. He believes it is important for a person to address issues of abuse because it can lead them back to using but his treatment center only treats addiction and can only offer referrals for more serious deep seeded issues.
Regardless of which theory you choose to follow, addiction is a very serious issue. Addiction being caused by bad choices, behavioral problems, or a disease of the mind, education and treatment is the key to overcoming addiction. Both theories agree that educating the general public on the harmful effects of drugs is the fundamental way of reducing drug addiction. The Department of Philosophy of Dowling College wrote an article called "Bridging the gap between philosophers of mind and brain researchers: The example of addiction". This article states that, "It is important to embrace the neuroscience and the philosophical approach of the understanding of persons". Genetically speaking, everyone is different so therefore the way one person responds to one medication or treatment will be different to how another responds to that same treatment. Because each and every person is different, you must treat each person on an individual basis and do what works best for that person. One thing that is agreed among everyone is that a strong support system is valuable and powerful tool in helping a person succeed in their treatment. If a loved one who abuses does not seek treatment, it is important for the family or loved ones to know that they must keep a positive attitude and help is available for them in order to move forward in their lives. Support groups such as Alanon are made available for families who are trying to cope with an addict who does not seek help. Dr. Drew supports these groups strongly. He holds a strong view that the affects of addiction and alcoholism can be passed down through generations of family and if left untreated it continues to be passed down. For example, a daughter of an alcoholic abusive father is likely to marry an alcoholic who will also be abusive. This is a form of co-dependency. If a person seeks treatment they can end the cycle and change the direction in their lives and their children will be able to lead more successful productive lives. Dr. Drew supports trauma counseling for abused children. "Abuse is easy to treat, the problem is getting abuse victims into treatment." says Drew. A victim of abuse who has dependency issues must receive treatment for both the addiction and the abuse. First the addiction must be treated followed by trauma counseling for the abuse. This is a stance Dr. Drew strongly suggests to his audience.
I am a victim of abuse and I have also experienced the devastation that a drug dependency can cause a family. I received treatment for my addiction and I could not have achieved the life I have now without attending a rehab program. My disease seriously affected my behavior and my ability to make good choices. Years after learning to cope with my diseases of addiction I sought trauma treatment for the abuse I was exposed to as a child. Because of this counseling I have learned to create and maintain healthy relationships with loved ones and I have a wonderful relationship with a good partner. I am the only sibling of my family who has received any treatment. I'm the only sibling that graduated and attended college. My children are all showing signs through good grades and by achieving goals they create that they too are going to achieve a healthy life. My siblings who have not received treatment and who are now also parents still experience difficult times. Their children are struggling and having a lot of problems. I am an example of what seeking help can do.
Addiction is a disease. Addiction is a disease that begins by choice and manifests by changing our behavior. (Volkow) If you or someone you know is struggling with addiction or abuse seek help. A person with the disease of addiction may never know if they learn to say no to that one drink or that first hit.
Works Cited
CLEI | DSM-IV Substance Abuse Criteria. N.p., n.d. Web.
Gorski, Terance T. "If Alcoholism Is Not a Disease, Then What Is It and How Should Society Deal with It?" Disease Model of Addiction. 10th Annual Dual Disorder Conference, n.d. Web.
"NIH News in Health." Featured Website: Easy-to-Read Drug Facts. National Institute on Drug Abuse, n.d
Perring, Christian. "Bridging the Gap between Philosophers of Mind and Brain Researchers; the Example of Addiction." Brain, Mind and Consciousness 9.1 (2011): 193-201. National Center for Biotechnology Information. U.S. National Library of Medicine.
Thompson, Mathew. Phone Interview.
