Everybody is an expert when it comes to sports and politics. Canada would win every Olympic gold medal in hockey if the couch coaches were consulted. Canada would be a utopian paradise if only the prime minister would listen to the coffee shop sages.
Most of the time, no one has the audacity to claim they know more about health care than doctors and nurses, except for two significant exceptions.
The first is vaccinations. Somehow, despite centuries of success and hundreds of millions of lives saved around the world, there is still a significant segment of the population, both at home and abroad, convinced that vaccinations are to blame for all sorts of illnesses.
The second is addictions. No need for a background in social work, medicine, counselling, therapy or policing for most people to share their view of addictions and addicts. Their self-destructive urges are a sign of weakness and laziness, they are a drain on the health care and law enforcement systems, their so-called disease has destroyed lives and, worst of all, the world would be a better place without them.
Well, yes, the world would be a better place without addiction, just as the world would be better without cancer and the world is a better place without smallpox (thanks to a vaccine) and - very soon - polio (also thanks to a vaccine).
To help educate more people and shatter myths and prejudices about addicts and addictions, The Citizen's weekly sister publication, 97/16, is running an anonymous column called Ask An Addict every Thursday. "Ann" works in the mental health and addictions field. Her knowledge is both academic (two advanced degrees) and real world (a recovering alcoholic and addict). Each week, she will answer questions from readers wanting to know more about addictions. This week, she answers the question "Is there such a thing as responsible drug use?" Next week, she tackles perhaps the most important question of all: "When does someone know they're addicted?"
Ann defines addiction as continued use with the full knowledge of the harm it is causing and the possibility it may even lead to your own death.
Even non-addicts would agree with that definition, yet they seem oblivious to the cruel irony of wondering why addicts can't just will themselves to stop their self-destructive behaviour. If they could do that on their own, they wouldn't be an addict. That's what being addicted means.
Some people come up with complicated reasons to support their prejudice towards addicts and addictions. They admit that addiction causes chemical changes in the brain but argue that these can be overcome by the mind, as if the mind somehow exists apart from the brain. A growing body of research has shown how addiction reshapes the brain and has helped demonstrate the effectiveness of methadone and other drugs in curbing cravings and reducing effects of withdrawal from opioids.
Accidental opioid addicts are now sadly all too common, from teenagers all the way to seniors who were prescribed powerful pain medication in the aftermath of a horrible injury or as part of an ongoing illness, only to discover that their bodies and brains are now dependent upon receiving that constant relief.
For decades, the prevailing belief has been that tough love, perseverance and motivation are all that addicts need and if that's not enough, well, that's on them.
Brain scans clearly show that motivation is literally a chemical process involving dopamine. One guess on which chemical is significantly reduced in the brains of addicts. In other words, telling an addict that they can beat their addiction if they try harder is literally telling them to will their brains to produce more dopamine. That would be the equivalent of telling cancer patients that they need to motivate themselves to produce more white blood cells and stop making malignant cancerous cells.
If only it were that easy.
Addiction in its many forms is part of who we are as humans because our brains (and the brains of our mammalian cousins) are hardwired to seek ongoing gratification. Both the social prejudices and the accompanying government reliance on law enforcement have not only not improved the situation, they've made matters worse.
A better path forward to help addicts combat addiction is abundantly clear but it will require a change in attitude across society. Billions of dollars could be saved each year, from emergency rooms treating overdoses to police officers arresting frequent offenders, if addiction was treated as a medical issue. Ongoing care, combined with therapy, counselling and other supports, such as housing, would still be significantly cheaper on taxpayers than the current model and that doesn't even touch on the lives saved and the families kept together.
Science has clearly demonstrated the popular understanding of addiction is as false as believing the Earth is flat and the sun revolves around it because that's what it looks like.
It's time to change and hopefully Ann's column can help make a difference.
If you have a question for Ann, please send me an email (anonymous if you prefer) at ngodbout@pgcitizen.ca and I will forward it to her.
-- Editor-in-chief Neil Godbout
