Mental Illness

Addiction is a Disease

With the tragic death of Amy Winehouse, addiction is in the news front and center. Different voices in the media and among the general public push different interpretations of Amy Winehouse’s life and death: she was a tortured artist, she brought this on herself, etc. People are quick to put her on a pedestal or throw her in a gutter: very few people continue to see her as a person. That is a problem.

A relatively recent book by Dr. Howard Markel, The Anatomy of Addiction, traces the use and effects of cocaine use and abuse by two men: Sigmund Freud, one of the most famous psychologists of all time, and William Stewart Halsted, a pioneer in surgical techniques. The book chronicles the rise and fall of cocaine, from miracle cure to potent drug, and how it helped make Sigmund Freud’s career and helped break William Stewart Halsted’s. Dr. Markel is quick to point out, however that, “Genius is not found in a bottle, pill, or potion”¦ The titanic legacies of Sigmund Freud and William Halsted were ground out page by page, stitch by stitch, patient by patient, insight by insight, day after day, year after year.”

There are some strange inconsistencies surrounding drug culture. On the one hand, it’s glorified in pop culture and through the mythology surrounding musicians and artists who have been deeply affected by or even killed by their addictions. On the other hand, people with substance abuse and dependence problems are seen as weak, as morally bankrupt, and as fully responsible for everything their addiction does to them, regardless of the psychological, social, and genetic factors that led them there in the first place. The addicted person is both villain bent on self-destruction, and a symbol of idolized tortured artist, but they cease to be a person.

Much of the judgment of addiction and substance dependence comes from the idea that people should know better than to let themselves become addicts. I cannot wrap my mind around this reasoning. Heroin and cocaine were both developed specifically to make people feel better. Heroin was marketed for pain, cocaine was marketed for both pain and as an anti-depressant. Freud himself was overjoyed at the prospect of using cocaine to treat depression and opium addiction. These drugs were developed to provide relief for people. Once their impacts on health were understood, these drugs were banned, but they still do the same things they were developed to do: these drugs make people feel good.

And once people start using the drugs, for some people eventually, if the person continues to use and develop a tolerance, a substance dependence problem can develop. The brain’s chemistry changes in response to prolonged drug use. People are no longer able to feel happiness, joy, pleasure, without the drugs. When the brain’s hardwiring changes to such an extent, it is ludicrous to suggest that a simple fix is universally possible.

Substance dependence, or addiction, is a disease, and like any other disease, addiction should not be the subject of value judgments. It is a particularly tricky and insidious disease, but it is not something to be glorified or demonized.  It is something that demands some understanding.

Addiction should be treated,  but the limitations of treatments for serious drug addictions should be acknowledged. Psychological and medical treatments of addictions, ranging from cognitive behavioral therapy to alternative drug therapies, such as methadone, are growing more and more effective, but they’re not at 100% cure rate yet.  Addiction is a disease that the person will have to battle for the rest of their lives, and returning to old haunts, to old peers, to old stresses, can make staying sober much, much more difficult. Addiction is a disease and it robs people of so much of their lives. It  should not rob people of their humanity.

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