A disease of despair

 

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Addiction, specifically opioid addiction, has been in the news recently, as drug overdoses are now the leading cause of death for individuals under the age of 50.    While Big Pharma and its flooding of prescription pain pills to the market is a major factor in the epidemic, it is also important to look at the psychological and social factors that are influencing the rise of heroin-related deaths across the country. Heroin is less expensive than prescription pain pills, thus making it a cheaper high. Many individuals who use heroin began by using opioids such as Dilaudid and Oxycodone (often prescribed by a doctor). But to simply crack down on the Big Pharma pill dispensers will not and has not lead to a reduction in heroin and opioid addiction. The current treatment model for addiction is one rooted in a medical model, where individuals are told they have a medical condition (disease) that is treatable by opioid agonists and antagonists to reduce and stop cravings and urges. But, these bio-chemical treatments continue to underperform, as addicts stop taking the blockers or misuse them to achieve a high. Therefore, to understand addiction more accurately, and to begin to assess and explore the sharp rise in addiction, we must look to other explanations of addiction.

As my title states, addiction is not only a disease of dependence and physiological craving, but also one of despair. Addiction is a paradox, in that people invest in their drug use (scheduled times of use, financially and socially), but are also divested from the world, as addiction robs the user of his or her relationship to the outside world. In my working with substance abusers, the best modality for treatment has not been through a medical approach (I am not a doctor, but work with providers), but through a careful examination of complete loss of hope, loss of morals, loss of identity and loss of integrity. Addiction robs the individual of his dignity, yet also replaces prior values with deceptiveness, lies, theft and misery. To understand addiction, one must first understand the perils of drug use.

As a society, more and more communities are becoming fragmented, isolated and self-absorbed. The breakdown in face-to-face socialization, nightly family dinners and shared responsibility are influencing addiction. With the loss of work in towns across Ohio, Michigan, West Virginia and Kentucky, people are becoming increasingly isolated and depressed, seeing little hope for recovery. One can easily see the correlation between this mind set and the rise of addiction.

To effectively treat addiction, we must help restore the things that have been lost on those who identify as addicts- integrity, honesty, dignity and optimism. Hopelessness can be reversed if treatment can focus on individuals regaining their identity before addiction set in.

While medication plays a role in the treatment of addiction, it will not solve the problem. To “fix” the growing tide of addiction, there must be a societal response, as well as a push for greater access to treatment, a communal sense of providing support without enabling and greater understanding of the psychology of drug abuse.

 

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