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Author: Justin Mckibben
This is arguably one of the most difficult questions to answer regarding drug addiction without being met with contention and passionate opposition. The troubling part is, despite the fact that the medical community, including the American Society of Addiction Medicine (ASAM) has taken a strong stance on classifying addiction as a disease, others still argue that it is a condition that only exists out of lack of personal responsibility or moral willpower. Stigma against addicts was the driving force behind the way the world understood addiction for so long that now it is an uphill battle at times trying to detach from those old ideas.
Beyond the assumptions most people adopt as fact, science and psychology have taught us that addiction is far more complex and misunderstood than most can imagine.
Still, the great question is the “why” of it all, which is a far more debatable way to ask the question than the “how” of it. Even more debate could surround the perceived motivations, and more controversy comes from the “addiction is a choice” conversation. At first, let us look at what the research tells us.
Why Do People Become Addicted to Drugs: The Brain
Now first, let us look at how addiction is defined according to medical science, offering the evidence from the ASAM.
The American Society of Addiction Medicine (ASAM) gave the most recent definition of addiction as a chronic brain disorder after a four-year process involving more than 80 experts. The ASAM definition notes that two decades of advancements in neuroscience convinced ASAM officials that addiction should be
defined by the activity present in the brain.
For instance, research has shown that addiction affects the brain’s reward circuitry to the point that memories of previous experiences with food, alcohol and other drugs or even sex can activate cravings and induce more addictive behaviors. Also, the brain circuitry that governs impulse control and judgment is altered in the brains of addicts.
Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine and chair of the ASAM committee on addiction’s new definition states:
“The disease creates distortions in thinking, feelings and perceptions, which drive people to behave in ways that are not understandable to others around them,”
“Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”
Dr. Hajela did, however, add that the idea of choice is not completely off the table, but that it is not about choosing addiction, but choosing recovery.
To be fair, there are also neuro-scientists like Marc Lewis, a psychologist and former addict himself; author of a new book “The Biology of Desire: Why Addiction is Not a Disease” who believe that the brain is definitively reshaped by addiction, but do not think it should be classified as a ‘disease’. These scientists recommend cognitive behavioral therapy as a way to reshape the brain and redirect its systems into less self-destructive patterns. While they do disagree with the specifics of the ‘disease’ term, they stand by the neuroscience of addiction.
Why Do People Become Addicted to Drugs: Chronic Medical Condition
Further exploring the definition of addiction as presented by the medical and scientific communities, we find that the American College of Physicians (ACP) calls addiction a “substance use disorder” and states that addictions to drugs should be considered a serious public health issue. The ACP states that substance use disorder is a chronic medical condition.
Several agencies have supported this definition of addiction, including:
- The American Medical Association
- The American Psychiatric Association
- The Institute of Medicine
- The World Health Organization
And if we are going to get really technical, the basic definition of “disease” in the Merriam-Webster dictionary is:
-a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms
Examining this logic, it is clear that addiction meets all the criteria to be considered a disease. In fact, most definitions of disease are pretty spot-on with the nature of substance use disorder.
Why Do People Become Addicted to Drugs: The Formula
Now that we have explored how addiction can qualify as a disease, let us look into the “why” of it. Some insist there is an ‘addiction gene’ that dooms people to addiction. Others say the reason people become addicted is because of their circumstances in life.
One might say there is a kind of ‘formula’ for addiction, but it would be one like X+Y=Addiction.
Research has pointed toward biological differences that make people more or less susceptible to addiction. Certain genes, or combinations of genes, may result in someone’s brain and body developing dependence much faster than others with the same consumption.
So when someone says they drank the same as someone else, or did the same amount of drugs for the same amount of time, we need to understand that it doesn’t mean they will have the same reaction to those drugs. One of the main arguments people use to oppose the idea of addiction being a disease is comparing an addict to other people who drink and use drugs without being addicts… but science has shown us that is not how it works.
Then there is epigenetics, the study of functional, and sometimes inherited, changes in the regulation of gene activity that are not dependent on gene sequencing. In short, it means to examine how environmental exposures or choices people make can actually remodel (mark) the structure of DNA at the cell level or even at the level of the whole organism.
Here is where we openly admit to the actions (i.e. choices) of individuals to influence the development of addiction. Someone’s environment and the way they react to it does contribute to developing an addiction. In general, research has shown that an individual’s health is the result of interactions between their genes and their environment. Of course the likelihood of addiction can be increased by factors like:
Studies from the Nation Institute on Drug Addiction (NIDA) support that an individual’s surroundings also have a particular impact on drug use. According to the NIDA,
“Exposure to drugs or stress in a person’s social or cultural environment can alter both gene expression and gene function, which, in some cases, may persist throughout a person’s life. Research also suggests that genes can play a part in how a person responds to his or her environment, placing some people at higher risk for disease than others.”
When someone starts addressing external issues with drugs or alcohol, it magnifies the problem. Those who are exposed to a different life-style will also have a different risk of developing a substance use disorder. This impacts those epigenetics we were talking about.
In the end, we can say that people use drugs and alcohol as a solution. It is the resource they turned to for escape, for excitement or for a feeling of ease and contentment. It was a powerful element they were able to reach to, that ultimately rewired their brain and changed their DNA.
Why Do People Become Addicted to Drugs?
Some people will say that the Y of X+Y=Addiction model proves that addiction is a choice, not a disease. Well, to argue that choices can still create diseases, we can point out that in 2014 it was noted for the first time in history, “lifestyle diseases” killed more people than communicable diseases. Health care providers and public health officials have recognized for a very long time that unhealthy lifestyle behaviors are the root cause of several diseases, including:
- Type 2 diabetes
- Cardiovascular disease
- Chronic obstructive pulmonary disease (COPD)
- Some forms of cancer
Choices influence these conditions, which the medical community categorized as modifiable risk factors, including:
- Poor dietary habits
- Physical inactivity
- Alcohol overuse
People would argue still that someone who uses hard drugs knows the high risk and chooses. Well, don’t people who eat foods with low nutritional value and over-indulge in smoking while never exercising know the risks?
Why do people become addicted to drugs? There are so many factors unique to the individual with that formula. Genetics, environment, actions, along with physical and mental health all play a part in how a substance use disorder develops, just like numerous other conditions. That is precisely why it is so important we start to recognize addiction as a disease; as a chronic medical condition and one that people should not be shamed and stigmatized for. All these elements of substance use disorder literally rewire the brain and rewrite the DNA.
Though this may seem like a lot of information, it covers barely a fraction of the research on this subject. There is no easy “why” to it, but there is enough to know why recovery is so important. Real recovery is not just removing the drugs, but also working to create new coping skills. Recovery takes work, and a great foundation can make all the difference.
Understanding addiction is one thing. But learning how to make the life in recovery that you deserve takes a strong beginning. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Every once in a while there is that daunting cliché you may hear in the recovery community; that relapse is a part of recovery. It may come from someone who has experienced a relapse themselves, or it may come from someone trying to reassure an individual who has relapsed that they still have a place in recovery. It is never meant to be harmful or frightening. In fact it is typically a phrase used to comfort people who have tried to get clean and sober but sadly found themselves again using substances.
It is an idea used to remind those who slip and fall on the path to recovery that they are still in the fight; that they still have a chance. A lot of people do experience relapse in their journey to get off drugs or alcohol. So, is it true? Is relapse a part of recovery?
Is Relapse a Part of Recovery: What is Relapse?
When looking at the basic definition or relapse, we can break it down a little to show some depth.
- In general – a relapse is to suffer deterioration after a period of improvement.
- In medicine– relapse, also referred to as recidivism,is a return of a past condition.
- With the context of drug use (yes, including alcohol) – relapse is a reinstatement of drug use and drug-seeking behavior. It is the recurrence of pathological drug use after a period of
So the common thread here is that a relapse is when someone:
- Is able to start a period of improvement…
- Is healing from a previous condition…
- Has a period of abstinence… THEN… they use drugs or drink, which ends their period of abstinence and they fall back into drug-seeking behavior and using; activating their condition which can undo their overall improvement.
While some people might have a drink or take a pill and call it a “slip” it is essentially a relapse. Some would say having “recovery” means making improvements to behavior beyond just abstinence, so they might say the real relapse actually starts before you even use drugs; when your behavior regresses to the old destructive or compulsive patterns.
Whether you believe the relapse is the behavior or the actual physical manifestation while getting high, it may determine what your views are on the question is relapse a part of recovery.
Is Relapse a Part of Recovery: What is Recovery?
Before we have discussed that some people will define recovery differently. We will note that in general, recovery is:
- a return to a normal state of health, mind, or strength.
According to the Substance Abuse and Mental Health Service Administraion (SAMHSA) there are 12 “Guiding Principles of Recovery” stating recovery:
- There are many pathways to recovery
- Is self-directed and empowering
- Involves a personal recognition of the need for change and transformation
- Recovery is holistic
- Has cultural dimensions
- Recovery exists on a continuum of improved health and wellness
- It’s supported by peers and allies
- Recovery emerges from hope and gratitude
- Involves a process of healing and self-redefinition
- Recovery involves addressing discrimination and transcending shame and stigma
- It involves (re)joining and (re)building a life in the community
- Recovery is a reality. It can, will, and does happen
All these definitions emphasize the fact that recovery is about healing, and some even concede that there are many paths to recovery and many different beliefs around how people can successfully recover. Now some people may not like it, but hear me out.
Relapse is not a part of recovery.
Is Relapse a Part of Recovery: Why Not?
Now before anyone gets upset and drops a few choice words in the comments, let me explain.
This answer isn’t so black and white. It is just one way to look at the question and try to answer in a supportive and logical way. Because when we say “is relapse a part of recovery” we are not asking about the general concept of recovery as a whole, but about the definition, and specifically the requirements for “recovery”.
To elaborate; relapse is an option. Relapse is a reality many of us face. I have been sober over 3 years myself… after I had a relapse. My opinion is not meant to exclude people who have relapsed. I do not intend to say they weren’t in recovery. I don’t intend to say they aren’t recovering now. What I am saying is that relapse is not a requirement for recovery. While it may be a part of my recovery, it is not a defining feature of recovery. Recovery can exist without relapse.
Let’s say I have a car. If the car has a sun-roof, then of course the sun-roof is a part of that car. It adds a new element to the experience that not every car has… but if the car doesn’t have the sun-roof… does that make it any less of a car? Is the car considered incomplete without it? Some cars come with accessories and features that not all cars have, while having wheels and a gas pedal is a standard. And that is what this whole conversation is about; setting standards.
A relapse is a similar concept. Plenty of people in the world of recovery from drugs and alcohol have never relapsed. Hopefully they never will. They are recovering the same as the man or woman who has relapsed countless times.
Is Relapse a Part of Recovery: Make it Count
The point of all this is to put forth the idea that maybe we shouldn’t put forth the idea that relapse is part of the recovery process. Surely it is a possibility for everyone, and surely some will consider a relapse one of the most critical moments in their recovery, but that does not mean people should minimalize or “normalize” the idea that relapses are the standard.
Setting higher standards is crucial to lasting change. We don’t want to kick anyone while they are down or fault them for their relapse(s)… however we also don’t want someone who has never tried to get clean before thinking they are going to relapse because it is “part of the plan” and everyone is doing it.
This is especially important because a lot of people have died because of relapsing after periods of abstinence. When the body goes without such potent drugs for longer periods the body is no longer as tolerant to them, and when people relapse and don’t realize their threshold has dropped they often overdose and die. If we let people assume they will have to relapse eventually in order to really get it right, they might never get the chance to get it right again.
We should stop telling people relapse is part of recovery. We should continue to tell them there is recovery after a relapse, but once you stop you never have to start again.
Have you completed treatment but went back to using drugs and alcohol? Have you relapsed more than once, maybe even been labelled a “chronic relapser?” If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Wednesday evening, 9 Frederick County residents in Area 31 in downtown Frederick went in front of a camera. But this wasn’t any ordinary photo shoot. Not some promotion for a new shoe or the next big diet plan. These 9 brave individuals went under the spotlight to divulge some of their darkest memories of addiction, to spread home for recovery.
The filming is for a new video on recovery awareness. Stories like these of struggles and survival are incredibly powerful.
The Face of Addiction
The project has the title “I Am the Face of Addiction.” This in-depth film is intended to showcase progressive and empowering narratives from individuals in recovery. Ultimately, the hope is to inspire other residents of the area struggling with substance abuse.
The dream behind the film and a lot of the work put into it comes from Pam Knight, a Libertytown resident. When talking about how the project came to be, Knight stated:
“We just want to break the stigma of the term ‘drug addict,’…This is a major epidemic, but there are still so many people who are too ashamed or too embarrassed to admit ‘my life is out of control.’”
Knight, a former special education teaching assistant at Linganore High School, has her own history with addiction. That history puts her in a unique position to know the power of perspective.
In active addiction, at face-value Knight’s life seemed flawless. Her husband, Daniel, owns a successful hair salon in Frederick. The couple has three adult children and three grandchildren. To some this sounds like the American dream, but many wouldn’t know there could be nightmares behind the scenes.
Under it all, Knight was hid a pill addiction for years. She says it began in 2011 after falling off the bleachers at her son’s high school football game. After she was prescribed Vicodin for pain, she began taking more and more. While in the beginning she said the pills made her feel “like Superwoman,” she later describes the experience of addiction as “purgatory.” Knight stated,
“Towards the end, there was no high anymore. You have to have it to make your brain feel normal. The first thing I would do in the morning is pop my pills.”
It didn’t take long before Knight graduated from Vicodin to Percocet. After experimenting with opiates she began doctor-shopping to obtain prescriptions. She admits that her final years of addiction she found herself buying pills off the street.
Her drug of choice was Roxicodone — known as “Roxys” on the street — an opioid-based painkiller. She would purchase quantities of 30 milligram tablets and take multiple doses at a time. Knight said,
“If I didn’t have them, I would get horrible shakes.”
Seeing the Signs
Knight’s husband and her oldest daughter, Loren Maxwell, admit that Knight’s gradual descent into addiction was easy to brush off in the beginning. The signs were somewhat there, but not easy for her family to see for what they were.
Her husband Daniel said he would notice days when she seemed especially manic or sweaty, but Knight always had an explanation.
Maxwell said her mother’s ability to function made her addiction harder to spot. Many people don’t acknowledge the dangers of ‘functioning addiction’ because they don’t understand it.
During this time the family said the signs were simple to dismiss unknowingly or miss altogether. Now that Pam Knight has gone through recovery, Daniel Knight said,
“I see them everywhere.”
Family Fight Knight
Like many people have experienced, the fight with addiction can often be a family affair.
Knight’s youngest son, Connor, was also struggling with addiction at the same time as his mother. Like Pam Knight, Connor said his problems started with the opioid painkillers prescribed for his football injuries. His struggles with opiates graduated much quicker. At 17 years old, Connor first snorted heroin with a bandmate, and his progressive addiction took off.
After years, both Pam and Connor finally found a new chance through rehabilitation at treatment centers in Florida.
Pam has been sober for three years; Connor for 11 months.
Pam Knight’s motivation for sharing the gritty details of her experience for this film is to show that recovery is possible. Knight currently speaks in Frederick County Public Schools as an advocate for addiction recovery. She says she hopes to screen the finished video for these audiences to spread more of this story.
Other participants in the film also hope their contribution will inspire recovering addicts. A huge part of inspiring others is to help overcome addiction stigma. Statistically we know that far too many addicts prolong their suffering and lose their lives because they don’t know of a better option, or because they are afraid of the assumptions and stereotypes attached to addiction. Breaking those stereotypes is exactly why we need such powerful stories, such as Pam Knights. A mother, a wife and a miracle who has persevered through a great deal of difficulty. We celebrate her and the others involved in this project helping to reach out and change lives by showing people the true face of addiction is not always what you would expect.
Sharing your story isn’t always easy, but once you have a chance to rewrite your story it can be more powerful than you can imagine. It isn’t always easy to change that story, but it is always possible. If you or someone you love is struggling with substance abuse or addiction, please call now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
People are strange when you’re a stranger. Being in recovery it can seem like we are a little extra strange to some, or not strange enough for others. So of course finding a roommate while in recovery can be a daunting task. For some people it is already difficult finding someone you can stand to live with. With a lot of people, searching through room-for-rent ads on Craigslist makes them just as anxious as trying to find a roommate in their halfway house.
Some of us just get lucky, and some of us definitely don’t. Of course with people who have a track record of bad behavior it isn’t easy to instantly establish trust. But now a new website is helping connect sober people with a desire to live in a house build on sobriety. All over America recovering addicts and alcoholics have a recovery roommate website to link up with new living arrangements, specifically for clean living.
A new recovery roommate website is called MySoberRoommate.com. It just launched online this past June and it already changing how sober people everywhere find roommates. MySoberRoommate.com was created by addiction therapist Jesse Sandler, LCSW, who specializes in cognitive behavioral therapy. His partner, Dr. Emily Churg, was also a key contributor to its development. Sandler is based in Los Angeles, and in an interview he said he was inspired to create a website that overcomes addiction recovery stigma. There are sober social media apps, but this is another place where likeminded people in recovery can connect.
So how does this recovery roommate website actually work?
Well, via their page users (who no longer use) can search and connect with sober roommates. It serves both sides, so if you’re looking for a place to move or if you want to rent a room in your own place. So far, the website has already attracted nearly 1,000 members in just two months. And professionals in the recovery field are already seeing it gain traction among clients.
Filling the Space
Now that we touched on the ‘how’ we get to the ‘why’ of it. One aspect of the work Sandler does with his clients includes helping with the transition from inpatient rehab to a halfway house, then to their own place. When asked about the site Sandler said,
“I would sit with my clients in my office and we’d go on the Internet, and there was nothing out there like this. I was shocked to see that.”
The challenge with assisting with the transition from halfway house to a home is finding a roommate dedicated to sobriety. Sandler acknowledged that for many people, when they attend treatment they aren’t even in their home state anymore. Being out of town and on your own can make it difficult to connect with the local recovery community. So to add to that the intimacy of living with another person, finding a recovering roommate in the area can be very difficult.
“One of the most important components in maintaining sobriety is your living environment. When people in recovery move out of rehab or sober living facilities, the worst thing they can do is go back to the toxic living environments they were in before they got clean,”
Sandler told WestsideToday.com when discussing the importance of the recovery roommate website,
“The second worst thing is to live with people who are actively using. And the third is to live alone, which breeds isolation.”
He concluded, as many have before, that one of the best ways to improve the chances of staying sober is to surround yourself with people who are committed to recovery.
Moving In and Moving On
So far it appears the response to the recovery roommate website has been very good. Sandler stated,
“Several of my colleagues have reached out and told me that their clients used MySoberRoommate.com to successfully find a roommate,”
“We have received emails from several members telling us that they had a positive experience using the site.”
The MySoberRoommate team is currently trying to compile a catalog of stories about the “best bad experiences with a non-sober roommate” for an upcoming YouTube series. They are also planning to release the short video reenactments for these testimonials in the next few months. So moving on from just helping people connect, the minds behind this recovery roommate website are also trying to create creative and informative features online to help break the stigma and shed some light on how people in recovery really live.
The question becomes, who would use a recovery roommate website to find their next place? If you’re new in recovery, or been around a while and just ready to start fresh, would you use an option like this to find someone to live with?
When you find the right people to live with they can end up becoming some of your biggest supports in recovery. However, you also have to remember that not everyone in recovery will stay clean. Try to stick with people who are doing the right thing, especially at home. Establishing a strong foundation in sobriety is very important to building a future in sobriety. If you or someone you love is struggling, please call us toll-free. We want to help. You are not alone.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
While we acknowledge the importance of maintaining personal anonymity at the level of press, radio and films, this recent declaration made at the opening night of the Democratic National Convention was one that took a lot of courage and was done with some very real intentions. The Mayor of Boston, Marty Walsh, took what many would be considered a very strong stance on breaking stigma. Marty Walsh opened his speech at the DNC with the line:
“My name is Marty Walsh, and I’m an alcoholic.”
Walsh shared a very personal story about his journey to rock bottom. He talked about his path to recovery, and used both as a means to emphasize his support for Democratic Presidential Candidate Hillary Clinton.
So how much meaning does this kind of declaration add to a political message? Was it right for him to break his anonymity on such a massive media scale?
Rock Bottom Politics
Marty Walsh is already considered perhaps the most prominent elected official who is open about his recovery. As part of his opening speech, Walsh even recalled a dark and hopeless time for him. This kind of transparency is actually quite admirable in a sense for such a public figure.
During his time on stage at the Wells Fargo Center in Philadelphia e stated:
“On April 23, 1995, I hit rock bottom. I woke up with little memory of the night before and even less hope for the days to come. Everybody was losing faith in me, everybody except my family and the Labor Movement.”
Walsh attributed his surviving his alcoholic life to the labor community. He said they helped get him the help he needed that gave him the second chance that changed his life.
This truly isn’t anything new for Marty Walsh, alcoholic. He actually applied it to his incredibly progressive and groundbreaking campaign approach. As a mayoral candidate, he made no effort to hide that he was a recovering alcoholic. During this time leading up to him being appointed to office, Mart Walsh publicly related to and advocated for the recovery community in various public and political venues. This is a man who found his way into politics while still taking steps to apply and practice his principles in all of his affairs. Even though some would look at this as ignoring the tradition of anonymity in most 12 Step Fellowships, it should be noted that he has made it his personal responsibility to help people both on and on the campaign clock.
Working with Others
At 20 years as a sober alcoholic (as of 2013) Walsh was actively attending 12 Step meetings while continuing to work with others both in and outside the rooms of his fellowship. As a state senator, he advocated for more recovery services. Throughout his time in recovery Walsh is actually known for personally helping people find drug and alcohol treatment.
During one 2014 interview Walsh addressed the issue of making such privy information a public fact. He stated:
“I don’t really care who knows I’m an alcoholic because if it helps someone else … then they’ll ask me for help if they need it,”
So was it right of his to let his guard down and share his experience with the world?
Some might say it is safest to tread lightly on such grounds. Others may say that as long as he does not directly name his fellowship or claim to represent it, he should be confident in his actions to shed stigma and raise awareness. Altogether, in my opinion, this is a strong message. To have a politician admitting to the world he is an alcoholic AND a success story in the recovery community could be tremendously powerful. Showing the world an example of a recovered alcoholic who has gone on to help countless people stands to shatter the stigma.
Principles before Personalities
Then comes another question for the importance on anonymity. Walsh went on after making his speech about recovery to endorse Hillary Clinton. This is where the lines blur, because then people start to ask if 12 Step Fellowships are endorsing Hillary, or even the Democratic Party in general. One of the biggest reasons why 12 Step Fellowships aspire to stay disconnected from politics and religious organizations to an extent is to insure that the fellowships remain all-inclusive and attractive for anyone with any belief system or political values.
So I guess the question is now- is this a “violation” of the suggested traditions in 12 Step Fellowships? Or is it up to the individual to decide their own level of anonymity? There are no “rules” in groups like AA, but is this crossing a line concerning principles before personalities?
Personally, I think what he has done his is inspiring and progressive. This kind of open discussion can be useful in the evolution of America’s perspective on stigma. When it comes to dealing with people in recovery, it is nice to see some people step up and show how far they have come. In a way this can give some people hope. His experience, strength and hope could push someone to make a change, and push others to see the addict and alcoholic with a more open mind.
With the presidential race getting closer and closer to its climax, and with progressive politics and compassionate drug programs being so vital, it seems we should be paying particularly close attention to how drugs and addiction are handled on both sides. Meanwhile, safe and effective treatment for the alcoholic who still suffers is more important than ever! If you or someone you love is struggling with substance abuse or addiction, please call toll free 1-800-951-6135