Alcohol and drug addiction is a societal problem that has far-reaching impacts on the individual’s health and relationships, and on their ability to make meaningful contributions to their family and community. The Centre for Addiction and Mental Health (CAMH) estimates that in 2014, substance abuse disorders cost Canada $38.4 billion in health care, criminal justice and lost productivity.
The link between drug abuse and mental illness has been clearly established in addiction research. And yet mental health initiatives continue to be underfunded by most governments. Mental illness accounts for around 10% of health problems in Ontario, but it only receives 7% of health care funding.
Bearing these numbers in mind, it is easy to see why drug use and addiction continues to be on the rise. But while funding in this area is desperately needed, money alone cannot solve the problem. As a society, we need to look at ways to inform people about the realities of drug and alcohol addiction.
There are a number of common myths and misconceptions surrounding addiction, addicts and rehab that could be delaying or preventing the implementation of funding and services to help people with addictions. In this article, we aim to address some of these addiction myths and counter them with facts.
Contrary to what many people believe, opioid addiction, alcohol abuse and other substance use disorders, are a manifestation of poor choices, or a simple matter of the addict not having enough willpower. While the initial ingestion of a substance generally involves a conscious decision, nobody sets out to have a glass or wine or take a prescription pain pill with the intention of becoming addicted.
Once the individual has become physically or psychologically dependant on a substance, ingesting that substance is no longer a matter of choice or willpower. It is something the individual feels is necessary in order to feel “normal”, to function in work or social situations, to cope with the stresses of life, and in some cases, to survive.
For people with addictions, life without the substance can be terrifying. Stopping use of drugs or alcohol is not a mere matter of overcoming cravings: withdrawal symptoms can include nausea and vomiting, seizures, cardiovascular irregularities, insomnia, nightmares, depression, anxiety, and suicidal thoughts and actions.
Addiction is recognized as a critical health concern by the World Health Organization, Health Canada, the American Medical Association, and the health departments of many other nations.
Addiction is a complicated condition that is often accompanied by financial difficulties, tumultuous relationships, periodic attempts to quit, and a stubbornness on the part of the individual to get help. In some cases, addiction can be a spiral of self-destruction that is terrifying to watch. Family members and friends of alcohol and drug addicts are frequently counseled that the spiral is necessary, that the addict has to hit rock bottom before they can start to get better.
The problem with this is that by the time the addict hits rock bottom, the substance they have been using could have caused permanent physical or mental health problems. The addict’s relationships could have been destroyed, any children in the home could have been removed, and the addict could be in a state of financial crisis. Very often, hitting rock bottom could mean the individual causing someone else’s death, or dying themselves.
Where there is life, there is hope, and getting help at any stage during the addiction is certainly better than not getting help at all. But most doctors and therapists agree that early addiction intervention has many benefits, and that people who are struggling with substance use disorders should get into an inpatient or outpatient drug rehab program as soon as possible, before too much damage is done.
Addiction is a difficult thing to treat, largely because the addicts themselves often do not realize or acknowledge that they have a problem. Indeed, family members may not see that their loved one has crossed the fine line from what could be considered normal use, to substance abuse.
If somebody does not know they have a problem, how can they be expected to get help for that problem? After all, from their perspective, nothing is wrong. Even when faced with a growing number of negative consequences – crumbling relationships, financial strain, health concerns and more – someone with an addiction might insist that nothing is wrong, and that what they are going through is just part of life.
Addiction treatment is far more likely to succeed when the person it is targeting acknowledges the problem and wants to solve it. But that is not to say that unwilling people cannot be helped. There are several ways in which people are admitted to addiction treatment programs in spite of this being against their wishes.
In all of these cases, addiction treatment can be successful in spite of the initial reluctance of those receiving it.
Addiction is a disease, and substance abuse is a symptom. Almost every disease and condition known to man can continue to produce symptoms at various stages of the treatment process. This does not indicate a failure of treatment, but it may mean that the treatment needs to be adjusted, intensified or restarted.
This is not unique to addiction. For example, if someone who underwent successful cancer treatment in the past receives a new diagnosis of cancer, that does not mean their original treatment did not work. It simply means that they need a new course of treatment to deal with the current occurrence. People who are being treated for depression, diabetes, hypertension and countless other conditions experience symptoms. Their treatments and supports are not abandoned, but steps are taken to manage or eliminate the symptoms.
For many people with addictions, relapse is part of recovery. Many treatment facilities will readmit a client who has relapsed at no extra charge, to continue working with them and reduce the probabilities of it happening again. With continued treatment, the chances of relapse continue to fall.
When people think of addiction, they often think in terms of illegal street drugs, like heroin, cocaine and crystal meth. Illicit drugs are indeed dangerous, especially since they are frequently mixed with other dangerous substances to make them go further.
What a lot of people don’t realize is that illicit use of legal substances can be just as dangerous. While it is true that prescription drugs can vastly improve the quality of life of a patient who is taking it as prescribed for a specific purpose, those same drugs can have devastating effects when used in the wrong quantities, or by people for whom they have not been prescribed.
A psychological or physical dependence on prescription drugs can develop very quickly, and the addictions can be among the most difficult to conquer. In recent years, communities across Canada and the United States have seen a troubling increase in opiate overdose deaths.
Both countries have been implementing measures to control how opioids are prescribed, dispensed and used. But as long as they are legally obtainable via prescription, they will continue to be a potential danger addicts and to people who are at risk of addiction.
It is widely acknowledged that people who enter inpatient addiction treatment for substance abuse disorders are statistically less likely to suffer relapses when treatment is over. However, for all of its benefits, inpatient rehab presents some challenges. It is cost prohibitive for many people, and not everyone has the ability to simply step out of their lives for several weeks at a time.
This set of challenges, combined with the mistaken belief that inpatient rehab is the only treatment that works, prevents a lot of addicts from seeking help. But the truth is that any help is better than no help at all, and outpatient addiction treatment services are becoming more and more effective for a greater variety of people. By offering individual therapy, group counselling and other treatments, while allowing the patient to continue with work, school and daily activities, outpatient treatment is practically and financially accessible to an ever-increasing percentage of the population.
There is no singular means of managing addiction that works for every single person, but Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) meetings can vastly reduce the odds of a relapse. Many people resist them, however: there is an age-old perception that people go to meetings and talk about God.
A lot of AA/NA meetings do carry a spiritual component, and what this looks like varies from one community to the next. A meeting held in a church might attract participants who feel comforted and grounded by their religious beliefs, while a meeting in a community centre several blocks away might appeal to people who find spirituality in nature, music or art.
These meetings work primarily because it enables people with addictions to belong to a community of people who understand what they are going through. They gain strength from the success stories of others, they learn coping techniques from people who have “been there, done that”, and they can relate their own stories of struggle and triumph in a supportive environment.
In many cases, an addict may have to attend several meetings in different locations, before they find the group that is the right fit for them.
Substance abuse is a broad-spectrum problem that affects people from all walks of life. At one point or another, we all hold stereotypes of addiction in our heads. Some of us visualize rich people snorting cocaine at elite parties. Others imagine homeless teenagers standing on street corners in rough neighbourhoods.
Addiction affects these segments of the population, and everything in between. Someone you work with could be relying on pain medications to get through the day without even realizing that they are addicted. Your school-age child could have a friend who, unbeknownst to you, is in the grip of an addiction to marijuana. Your neighbour could be struggling with an alcohol addiction.
Addiction does not discriminate. It affects people of all ages, from babies who are born addicted, to senior citizens who are not equipped to effectively manage chronic pain or anxiety.
We have all seen those memes on social media that express outrage over the fact that someone who suffers a drug overdose receives life-saving treatment for free, while people with diabetes or heart disease have to pay a fortune for their medications.
These memes, which keep harmful addiction stigmas firmly in place, have virtually no grounding in reality. In North America, all medical emergencies are treated as just that – emergencies. Whether someone is in a life-threatening condition as a result of overdose, a heart attack, a stroke or an accident, emergency responders will do whatever they can to keep that person alive. Someone in anaphylactic shock will receive epinephrine, someone who has fallen into a diabetic coma might receive intravenous fluids and insulin, and someone who has suffered a drug overdose might be given naloxone.
The costs of ongoing treatment will vary depending on the person, the location and the condition, but in emergency situations, overdose patients are not given preferential treatment over patients with other medical emergencies.
Substance abuse is a growing global problem, with increasing numbers of people in all age groups becoming addicted to street drugs like heroin, cocaine and methamphatamines, and to prescribed medications such as opioids and benzodiazepines. The first step in solving this problem is to shatter some of these dangerous addiction myths.
Photo credit: Grace. This picture has a Creative Commons attribution license.— Drug Abuse & Drug Addiction, Substance Abuse