Choice Negates Disease?
What always surprises me about drug addiction is the high amount of ignorance and lack of empathy that arises when brought up in conversation. Wither its calling someone a tweaker on the streets or making comments such as “Well, if they really wanted to stop they would” a clear majority of people have a delusional understanding of what it means to be an addict. They’ll judge and formulate options thinking as their healthy brains would we’ll giving no thought to the context of how an addict would think. I know this because I was one of them. I wouldn’t understand why someone using drugs wouldn’t just stop after seeing what drugs can do to a person. I couldn’t wrap my mind around how people could develop habits to steal from people they love or how they could use again after getting clean. I didn’t understand why anyone would make the choice to use drugs. I viewed drug addicts as weak, terrible people and to be frank, subhuman. What changed for me is experiencing addiction first hand in my own family. My dad was a wonderful man and taught me the most important thing which was the value of a sense of humor, but his addiction caught back up with him and affected my family greatly which eventually lead to him taking his own life when I was seventeen. The pre and post journey towards my father’s passing lead both of my younger brothers down this dark path and February of this year I lost one of my brothers to a heroin overdose. What these experiences did for me was humanize an addict.
I didn’t think anything less of my dad for being an addict because he was my dad and second that was a minimal part of the man he was. I would watch my brother struggle with trying to stay clean and the utter shame he felt when he would slip and use again. I would see his constant turmoil having to battle with himself every day. The first time I asked my brother why he stole from our own mother he described it as being unable to stop himself knowing full well what he was doing and following came the extreme guilt and remorse. I talked to one of my uncles about his struggle with addiction and he told me he was clean for several years, had a relapse and has been clean again for over 2 years. He told me his problem was the first time around he would have one beer and the voice in his head would tell him that if he could handle that, then he could handle a little more, until a little more became a lot more and before he knew it he had escalated into a full-blown relapse. His second time in recovery he heard a story in a meeting where a man relapsed after 15 years and lost everything. He said in that moment he realized an addict is never really cured. He told me “every day I have to wake up, look myself in the mirror and tell myself I’m not going to use today and every day I have to start the battle with the demon inside of me all over again.”
When I see an addict now I think of my father, my uncle, my brother and I remember that addicts are people too. They all have mothers, fathers, childhoods and families. The second thing it did was spark a curiosity of trying to understand how someone becomes an addict. I spent too much of my time judging, thinking I didn’t understand, but in reality, I wasn’t spending any time trying to see what was actually going on. I started with what do drugs really do to someone. I decided to focus on the drug that took my brother, heroin. Heroin is an opioid and directly effects the pain and pleasure receptors of the brain. On a basic level heroin releases a wave of dopamine chemicals. Okay, dopamine is the feel-good chemical and one of its roles directly effects the reward center of the brain. Which is why dopamine is released when we eat delicious food, have sex or work out. Where the problem lies is how heroin will change the brain to stop producing dopamine naturally. Heroin like many other types of opioids creates a chemical imbalance in the brain. Learning this surprised me. I’ve known heroin produces a dopamine increase, but it’s a whole other ball game learning heroin rewires the brain to hinder the natural production of dopamine which can cause a remapping of the reward center of the brain to lead to inexplainable behavior, cravings and the effects of withdrawal.
I focused next on this idea of choice. The first error many make is generalizing all drug addicts to “simply choosing to use” while spending little to no time factoring the complexity of why they choose to use based on the genetic, mental and environmental factors of the individual experience of the person. The second error is judging without context and the most important error is disqualify the disease because of choice. The first error occurs because we default to making assumptions based on our own experiences and will project them on to others. It’s easier to do with someone we have no personal connection to. We tend to be more conscience of the experiences of the people we care about and will factor them into the equation when making assumptions or formulating options. On top of that if someone is convinced they wouldn’t make the choice themselves to use they generalize anyone being offered the same choice based on their own person reasons either known or unknown. This is where the second error comes into play. Everyone’s situation is different, and it is unfair to judge a choice without the context. Let’s take my brother for example. My brother was 15 when he used for the first time and was encouraged by my father to do so and then was later punished by my father for it. Here is a 15-year-old kid, who is dealing with our parents splitting up and deciding to go live with our dad during his darkest moments and someone is going to tell me he simply just made a choice? My brother not only was in an upset and vulnerable state with our parents splitting up (while holding a lot of anger towards our mom at the time), but was convinced into using by our own father. How can you expect a 15 year-old kid to really understand the full implications for what he was doing? Does the conciseness of blaming someone for choosing to use stay the same if that someone is persuaded or manipulated to make that choice? What if the choice at first was the best option, such as taking pain killers after surgery? CBS news did a story where they found that more than 1 out 3 Americans were prescribed pain killers in 2015. Although I by no means want to discredit the opioid epidemic currently happening in this country what it does show is that not everyone who takes a pain killer will become an addict.
We also can't neglect the biological predisposition to become an addict. My dad’s bloodline is riddle with addiction. My dad, both brothers, my aunt, both uncles and several cousins on my dad’s side of the family all struggle with addiction. A person’s genetics plays an important role in determining if someone will become an addict. I’m not discrediting environment factors, but my brothers where raised in the same house as myself, we all lost a father, but what separates me from my brothers is that I’m not from my father’s blood line. I found out when I was 13 that my dad wasn’t my biological father and my dad meet me when I was 1 week old. I never knew any different nor did anything change when I found out, but I can’t take that as just coincidence. Genetics may also play a role in the reserve as well. I’ve had a friend recount the time he tried heroin and I asked him “how did you not do it again?” He told me, that he knew better than to trust something that made him fell that good. He made the choice to use, but that didn’t make him an addict. All these factors need to be put into play before the claim of “simply a choice” is used because a choice isn’t always simple, and the choice doesn’t always lead to becoming an addict. Which is why I agree with my mother because she often says “you can make the choice to use, but no one makes the choice to become an addict”.
The last error I want to correct is the idea that choice negates addiction as a disease. The medical definition of disease is “Illness or sickness characterized by specific signs and symptoms.” And the definition for mental illness is “health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities”. Regardless of how one becomes an addict being an addict is a form of mental illness which then defines it as a disease and nowhere in the definitions does that change because of choice. If one believes that the initial choice does factor in to defining a disease, then is it also the case with type 2 diabetes? Or sexually transmitted diseases? What happens when you apply that logic to other ideas? If I slammed my arm on the desk I’m currently sitting at and break it would my arm by that logic not be broken because I made the choice to break it? That question seems silly, but the point is that wither my arm is broken by accident or my own doing, my arm is still broken. You may be less empathetic if I chose to brake my own arm, but you couldn’t tell me that because I made the choice my arm isn't broken. Classifying addiction as disease is no different.
We need to stop attacking an addict because they made the choice to use and start attacking the people providing the choice in the first place. Truth.com states that “the prescribing rates for controlled substances in adolescents and young adults nearly doubled from 1994 to 2007”. We need to try to better understand the why to help put in prospective that addicts are people too. We need to stop judging and generalizing because addiction is painful to an addict and their families. We need to focus on educating to help understand how real and extremely dangerous drug addiction is and quit trying to belittle the problem because of the miss notion of “being a choice” or am I the only one?
Work Cited
https://www.cbsnews.com/news/more-than-one-third-americans-prescribed-opioids-in-2015/
https://americanaddictioncenters.org/heroin-treatment/brain-damage/
https://www.medicinenet.com/script/main/art.asp?articlekey=3011
https://opioids.thetruth.com/o/the-facts/all
https://www.psychiatry.org/patients-families/what-is-mental-illness
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