disease concept
is addiction a disease? please post your views here...
posted by sostulsa | 7:03 PM
About Me
- Name: sostulsa
- Location: Tulsa, Oklahoma, United States
Secular Organizations for Sobriety (or Save Our Selves) is dedicated to providing a path to drug abstinence, an alternative to those paths depending on supernatural or religious beliefs. SOS was founded to provide a neutral ground where alcoholics and addicts can safely explore a secular path to recovery. We respect recovery in any form, no matter which path achieves it. Our focus is on the priority of abstaining from all mind-altering drugs.
2 Comments:
I'm trying to make my first post on one of these blogs..(at this point) I don't even know which one it's going to.. Tommy
Larry, I have edited my last post (i.e. fixed errors – I am not obsessive, I am not obsessive, I am not obsessive . . . hahahaha) and ask you to post this one rather than the last version. Thanks!
Connie
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I previously said:
“When I surrender to and/or accept the fact that I cannot use mind or mood altering substances, even in the smallest amounts, without ultimately getting back to a bottom, it is the most practical thing I can do. To do less is to live in denial of this reality, which gets me nowhere.”
The disease concept is just a model, a structure upon which a solution can be built, one perspective that allows for a system of treatment and recovery; it was the first model that had some efficacy. Notice that I did NOT say “the solution” or say that it works for everyone. We all must be free to fashion our own recovery; after all, WE are responsible for our recovery.
Prior to 12 Steps, addiction was simply considered a moral deficiency and “once an addict, always an addict” reigned. Addicts were considered hopeless and no one wanted to deal with a hopeless condition in others. Addicts were put away in insane asylums or jailed or they died, and their death was a relief to others. Of course, this model didn’t help the addict or the people in relationships with the addict or society that had to spend resources on the problem. Compassion was nil. So don’t throw the baby out with the bathwater and don’t criticize what works for others simply because you need something different for yourself or that the recovery paradigm is evolving to one we hope is an improvement. If it works for others, then the fact is that it does work for some, continues to work for some and has some usefulness.
I think that Jeff R. used aa wording in response to someone’s take on aa and aa’s viewpoint of powerlessness that was inaccurately portrayed, IMHO. Twelve Steps does not say that we continue to be powerless, but that after the admission has been made that addiction has kicked our butts, then we gain the power of choice. When I am finally willing to face the fear of being out of control, powerless, then I can go to the place where I find the solution, which is abstinence. And I find the courage to use that solution in my support group of like-minded people (and I am reminded to “hang with the winners” because apparently they are successful in abstaining and can show me how to do the same). But if I don’t admit that I cannot use moderately with any success, I will use any means to justify returning to the behavior, moderately, of course, in the beginning. ;-) This is what Larry has been saying.
Sometimes the concept of powerlessness is frightening because of the uncertainty attached to it. I hate uncertainty, and anything I have no control over brings me uncertainty in abundance. I have noticed that fear is a big contributor to my addiction, and the concept of powerlessness can feed this fear and also feed my denial, until I finally see that the desire for control is the ultimate addiction. Recovery for me lies in losing attachments to certainty, to control, to the delusion that if things are done my way it will somehow be the better way. This loss of attachments opens my mind for new perspectives. Of course my daddy told me my mind was so open my brains all fell out. ;-) But when he became terminally ill he had to face his own fear of loss of control, of powerlessness over life and death; I was able to remind him that his religious faith was there for just such an occasion, and he took great comfort in that. My father’s problem was similar to my wrestling with my addiction in that until I admit that something has whipped my butt I will not look for solutions. He had to admit that cancer was leading to his death in order to find acceptance of his reality; I had to admit the same for my addiction. And one of the major dysfunctions of addiction is that it tells me that the next fix will fix me, and that the only problem I have is where to get that next fix, and who do I have to manipulate or even simply kick out of the way to get to the next fix.
Addiction tells me in a very convincing manner that I am OK when it is in the process of killing me, AND that it is everyone else’s fault that I do what I do. Blaming behavior is the sickest behavior that we as humans exhibit. Blaming behavior is the tool of denial that leads to the powerlessness. If we blame everyone else we will never take responsibility over our own actions and never be free of addiction. I think I see Duaine’s viewpoint here at the personal responsibility phase of recovery; he simply wants to bypass the concept of powerlessness because of the discomfort of uncertainty and lack of control. What I hear (and I could be wrong) is that he believes that the concept of powerlessness delays or prevents an addict from getting to the self-responsibility phase of recovery. I can see that, for people who abhor self-responsibility and want to stay in active addiction, the concept of powerlessness not understood properly would be a ready-made prescription for relapse. But 12 Steps does not leave us there in powerlessness and non-responsibility if we choose to continue past Step One. If I stop at Step One, I will never see that 12 Steps requires me to be responsible for my recovery. The concept of powerlessness is a very necessary, but very small, part of the 12 Step process of recovery.
My addiction is not due to a moral deficiency, which is a great relief, because if I had to believe that addiction was a symptom of a moral deficiency, it could mean that I was a hopeless case. I knew before I went to treatment that I had a problem with addiction. I was simply hopeless; I did not believe that there was any hope for me to live a drug-free existence and I felt that I was some horrible defective monster because I could not stop using. When I agreed to go to treatment it was simply, “Okay, it won’t help, but I’ll try it.” I could not visualize life without drugs. Going through the process of recovery did not give me a moral compass; I always knew right from wrong. However it did make me a better person, more compassionate, less judgmental. I am still human, still imperfect, but I understand better the human condition and am grateful for grace anywhere I can get it.
Larry, I think you are onto the root of the problem being discussed: define addiction more exactly and a better model could possibly be revealed. Let’s go for it!! I’ll admit, I think the disease model is pretty good simply because of the known physical effects, especially those on the brain chemistry, and the obsessive nature of addiction (mental illness); also, the treatment/disease model simplifies government involvement (which is a necessary vehicle to address/ameliorate the social costs of addiction). But I am keeping an open mind, always looking for a better model. Hope my brains don’t fall out! ;-)
Thanks for listening to my long post,
Sister C
Connie K. Page
Assistant Public Defender
Tulsa County, Juvenile Division
315 North Gilcrease Museum Road
Tulsa, OK 74127
(918) 596-5948
connie.page@oscn.net
duaine said...
Hi Larry;
Duaine M here:
Larry said [[it seems to me that you are trying to change the meaning of addiction or are willing to avoid defining it]]
Right back at you Larry.
I believe what ever meaning I put on Addiction you will try to tie Disease to it.
I haven't answered your question because I just figured everyone knows what an Addiction is.
Here is my poor attempt at how I understand Addiction.
There is Cellular Addictions and Physiological Addictions.
On a Cellular level My understand is each cell in the body is addicted to a subsidence like a narcotic.
When the abstinence is removed then Cravings take place and the pain of withdrawal takes place.
Am I on track so far? [[yes, i think so]]
A physiological Addiction is a learned habit that is repeated so often that the brain expects it to happen and when it doesn't there is pain of it being removed similar to a cellular Addiction.
An Addiction is caused by a chemical like Alcohol or some other drug and a physiological Addiction is caused by "I'm not really sure but think it may have something to do with repeated behavior"
I don't believe ether of these classify as a Disease.
[[i understand your position... it is at least similar to that of szasz (who is radical extreme on disavowal of mental illnesses) and to stanton peele (who does set "adjusted social drinking" as the therapeutic goal... see http://www.peele.net/)... possibly that is why i kept connecting "not a disease" to "why not go back to recreational use?"... i do think we are doing what connie asked... = looking for common ground...
you are right to say a broken leg or an ingrown toenail is not a disease, but what about the paresis example? where spirochetes (http://www.ccsf.edu/Departments/Biology/ctoebe/spirochetes.htm) enter the brain as a result of advanced, untreated syphillis (al capone!)... seems like a disease, an STD, n fact)... okay, it has a communicability mechanism... the spyrochetes are transmitted during sex... drug addiction, alcoholism, even inhalent poisoning, however, lack this communicability mechanism... (though the famous paul o., dr. alcoholic addict of p. 449, big book, 3rd edition, fame said, "you do catch the disease of alcoholism... you do it by coming into aa, but you don't catch it by what goes in your mouth by drinking, you get it by what goes in your ears in the meetings... so if you're not an alcoholic, be careful who you sit next to in open meetings!)... well, as you're getting to know, i can ramble with the best of them...
how do you "catch" drug addiction? is there any disease that does not have a communicability element?...
oh! what about genetic diseases?... lou gherig's disease, CP, even diabetes or "heart disease"
we are sure alcoholism and addiction run in families... see, e.g., (http://learn.genetics.utah.edu/units/addiction/index.cfm) as well as many twin studies
i'm reminded here too of the "diathesis-stress" model of disease... many diseases have a genetic component (the diathesis part = predisposition) that is only triggered by environmental factors (the stress part)... surely there have been many potential alcoholics who never took a drink in their lives... could you be an alcoholic and never drink for a lifetime... technically, no, but you could easily carry the genetic predisposition to become a full-bore alkie
well, here we are again... counting the number of angels that can dance on the head of a pin...
what does it mean for recovery? not too much, exactly, but it does seem to relate to treatment... szasz says, "you got yourself into addiction, it is up to you to pay for your treatment to get out"... that seems overly harsh... we give governmental tax breaks to the blind (even if you went blind by staring at the sun or other self-inflicted injury)... why do we do that?... slipping into politics, here, but government-funded treatment is a political question...
drug court is a way to provide treatment... sometimes harsh treatment in the lack of tolerance for those who do not live up to the drug court-client contract, but treatment as an alternative to immediate prison lock-up... i happen to think that is a good thing... okay, i've rambled a bit off the subject again... back to duaine's effort to define "addiction")
Except for Doctors who what to classify it as Disease to collect money from Insurance Co.
Is there any one else who has a different understanding of Addiction?
I beat an addiction to several drugs, alcohol being one of them and tobacco another.
I beat them and if I never introduce them into my body I will never be troubled by them, ever again.
Please don't try to tie in Moderation into this because Moderation means putting the subsidence back in my body and the cycle will repeat its self and new battle to break the addiction will start over again.
[[okay... fair enough, we both advocate total abstinence (at least for ourselves)]]
I quit. I don't want to do it over and over. I did it once and that's enough for me.
I'm not Diseased nor have I ever been Diseased in any form that caused me to journey into a destructive addiction. [[now i'm wondering if you had the genetic predisposition... did you have many addicts/alcoholics in your family?]]
I also don't understand why someone would put a label on themselves for life like Alcoholic or having a life time Disease. [[for me, i like to remind myself that i will always be vulnerable to lax thinking brought on by neglect of my recovery, carelessness about triggers, depression/dispondency brought on by viscious vicissitudes, or who knows what... even after 20 years clean i do not believe i can turn my back on my potential for reactivation of this insidious illness... that's one of the reasons i seek recovery by typing and typing and typing emails... it keeps me mindful]]
I was addicted (Past tense) I am no longer addicted and never have fight that battle, ever again because I chose Abstinence.
[[and, of course, i wish you the very best of luck... i'm quite sure you reciprocate]]
[[thank you so much, duaine... i do think we are moving toward common ground... still some daylight between us, but i love thinking about this stuff... what famous scientist said he had a harsh critic, then to his misfortune, his harsh critic became his friend and he lost a valuable critic? i forget who that was... anyway, may you never be muzzled, my friend]]
from Larry H.
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