The contradiction of addiction

I’ve spent the past year working as a Psychologist in a community-based alcohol and drug service.  While this does not make me by any means an expert on addiction, it does mean that when a Huff Post Politics article like this one start’s doing the rounds on Facebook, I do have one or two opinions about it to share.

The article, entitled, “The likely cause of addiction has been discovered, and it is not what you think”, is by Johann Hari.  Hari has recently authored a booked called “Chasing the Scream: the first and last days of the war on drugs”, and the article is a bit of a promo for the ideas he writes about in the book.

Now I just want to preface this by saying that, while I haven’t read the book, the article makes a number of very good, very valid points.  For example, the idea that addiction is not caused by the “chemical hooks” of the substance itself, but rather by a lack of human connection.  That drugs aren’t the driver of addiction; disconnection is.  And that we shouldn’t be imprisoning people for drug crimes, but rather offering them rehabilitation services that help them to reconnect with the world.  These are all points with which I absolutely agree.

However, as you may have probably guessed, I can also see a number of problems with the article as well.  First and foremost being that the author announces each of the above as though he is the first person in human history to discover it.  We have known that psychological and social problems are strongly related to addiction for many, many years.  That’s why counselling services, like the one I’ve been working at, exist in the first place.

Of course, once you start using large amounts of alcohol or certain drugs you can become physically addicted to them.  But the substance itself is rarely the reason that a person begins to use it in the first place.  In my experience, there are usually a whole range of issues – trauma/abuse/neglect, poverty, other mental health problems, disconnection, a lack of meaning and purpose – affecting a person who becomes addicted to drugs or alcohol.  We know that, if we don’t help them to address some of those issues, it’s likely they are going to continue struggling with addiction.  That’s why we offer counselling and psychological services.

The second issue I have is that the author also seems to think that the way services currently operate is medically based.  While that “chemical hook” isn’t everything in addiction, it certainly isn’t nothing either.  If someone is using large amounts of alcohol or certain other drugs, then it can in fact be quite dangerous to their health to stop using suddenly (for example, they can be at risk of seizure, or worse).

Even without the risks, detoxing from a substance that your body has become physically addicted to often leads to some pretty severe and uncomfortable withdrawal symptoms.  This is, of course, one of the reasons that it can be so difficult to stop using a drug once you have become addicted.  So it is important to support people with medical interventions to help them get through this stage, and then follow up with good mental health services afterwards.

To be fair, the article is pitched to an American audience, and is focussed on the larger political issue of the so-called “war on drugs”.  I would agree that it’s not so much a war on drugs we need, as a war on the many different social issues – the lack of meaning and belonging – that lie behind problems with addiction.

Hari suggests that “loving an addict is really hard”.  To this I would say, only if you think that the addiction is their fault.  If  you can see and understand some of the wider social issues behind it, then it’s easier to feel compassion for the people it affects.

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