I often write about addictions and how addictive behaviours are considered (by some) as; simply a ‘disease’ that requires treatment. The age-old ‘lifestyle choice verses illness’ debacle rumbles on ad infinitum and that’s something I’ve also written about on several occasions (see example).
Personally, I sit on the side of addiction not actually being a ‘disease’ per se , rather a complex collection of issues and factors.
However, I fully understand why (some) people would cling to that illness notion. One thing is certain, being a person impacted by any addictive behaviours, but particularly substance misuse (or whatever the ‘industry standard’ descriptive is applicable at the moment); finding a way out of that harmful cycle certainly isn’t a walk in the park, either for the person concerned, or those around them.
But, the disease model can also provide people with something of a get-out-clause (a convenient excuse). Especially when it comes to cessation and the subsequent efficacy of any long-term sustained recovery. When you’re impacted by a nasty disease and suffering from a debilitating ‘illness’ (beyond your control) – how can you realistically be expected to recover from that affliction – without treatment and support – after all, it’s not your fault, is it?
This particular model also provides a solid foundation for exponential growth in the flourishing treatment ‘industry’ that is so prominent, particularly within the USA, where illness is undoubtedly an lucrative earner, a source of wealth to be capitalised upon. But that’s a connected issue and complex subject, which I have written about before (see here).
For my readers with a deeper interest in the subject; the Neuroscientist and former ‘addict’ Marc Lewis (below) makes the case that addiction isn’t a disease at all, although it is often branded as such.
Prof Marc Lewis PhD is a developmental neuroscientist and author (see below), he is known for his dynamic systems approach to understanding the development of emotions and personality. Until his retirement in 2010 he was the full professor of developmental psychology, at the University of Toronto.
- The Biology of Desire: Why Addiction is Not a Disease (Amazon UK)
- Memoirs of an Addicted Brain (Amazon UK)
Connection = Recovery
Back in 2015, the author and journalist Johann Hari asked; What really causes addiction — to everything from cocaine to smart-phones? And how can we overcome it? He was surprised to find that almost – everything you think you know about addiction is wrong – and his Ted Talk (below) on the subject subsequently subsequently went viral.
The opposite of addiction is not sobriety, the opposite of addiction is connection! (Johann Hari)
- Chasing the Scream: The Search for the Truth About Addiction (Johann Hari)
- Lost Connections: Why You’re Depressed and How to Find Hope (Johann Hari)
Dr Gabor Maté, who wrote what is now seen as a seminal text, by many in the addictions recovery field – In the Realm of Hungry Ghosts: Close Encounters with Addiction – takes the holistic and compassionate approach, to all addictive behaviours.
He presents addiction not as a discrete phenomenon, one that is confined to a weak-willed few, but as “a continuum that runs through (and even underpins) a large proportion of our society.”
Maté suggests that we should observe addiction not as a medical ‘condition’ but rather the result of; “a complex interplay of personal history, emotional development and brain chemistry.”
Compassionate Inquiry is a psychotherapeutic method that reveals what lies beneath the appearance we present to the world. (drgabormate.com)
Distilling a great deal of cutting-edge research from around the world, In the Realm of Hungry Ghosts avoids “glib self-help remedies”, but instead promotes self-understanding and self-management as the keys to unlock healing and a person’s future wellbeing.
Whichever way you choose to observe addiction, it is undoubtedly a complex issue, one that presents numerous negative impacts, for many individuals and their wider community.
To me, it is clear; addiction (and any subsequent recovery journey) is a longitudinal process, one that clearly presents many impacts, for many people. And not just those individuals who are ‘suffering’ from their ‘problem’.
Addiction, like the currently popular subject of mental-health, is another area of health-care provision that reveals just as many complex causal issues, as it does complex and varied treatment methodologies, which are (hopefully) designed and offered to support individual recovery… rather than simply being a source of organisational revenue generation.
Carl Zuccaro, a professional recovery coach, an ‘expert’ with lived-experience, a previous colleague and someone I’m grateful for as a good friend (he was an absolute joy to work with), recently wrote about the ‘Dithering Dogma‘ in addictions recovery.
In his blog post Carl highlighted how the ‘barriers to recovery’ (actual or perceived) tend to impede progress on people’s individual journeys.
As Carl outlines in his post; “recovery itself has become somewhat of an abstract cliché” – in many ways, ‘recovery’ has become something of a convenient tool, often seized upon for commercial marketing purposes.
There is undoubted value in ‘celebrating success’ – to show others that recovery IS possible – however; despite any valid ‘business’ reasons for marketing ‘recovery’ activities, I’m not so sure that our ‘industry’ always places the needs of their service-users / clients / ‘patients’ first.
I’m also not convinced that the possible negative impacts, for somebody’s individual recovery journey – when subsequently placed upon a pedestal, paraded as the organisation’s ‘success’ story – are always adequately considered.
Today, in the United Kingdom, treatment and support services are commercially obliged to ‘attack’ the gatekeepers of diminished and declining funding streams. They have to apply constant pressure to ensure they can secure new pots of funding, whilst still maintaining sustainable cashflows, within dwindling funds; if they are to continue offering the services they are commissioned to provide, and in business to deliver.
But sadly, some [treatment service] activities can and do present negative impacts for the people they are in business to serve.
Often, long-term and sustained recovery journeys are stymied and delayed as “people in early recovery are often paraded out to prove service outcomes.”
Change needn’t be difficult, only resistance to it is (to paraphrase the Buddha). Find something or someone that inspires you to be the best version of yourself and apply yourself wholeheartedly, you don’t need to have all the answers. There is no quick fix, and those that are pave a road to ruin. The future is yours. The future is now! (Carl Zuccaro)
The dwindling pots of money, that fund most UK addiction services, undoubtedly present significant financial impacts for any continued delivery of high quality and effective treatment and support, which is actually delivered by most commissioned services.
But, in many areas, those services are becoming far less able to provide any long-term support structures, especially within the treatment ‘after-care’ process. Despite those services being a significant requirement for the efficacy of many sustained recovery outcomes.
Financial constraints within funding budgets are often preventing delivery. Yes, the holders of public sector purse-strings (rightly) expect ‘value for [our] money’ in all public service provision however; continued compliance with tiresome rhetoric and political tropes about “Doing More With Less” can’t last for ever.
To my mind, and those of many more within the [UK] addictions workplace, we need to continue finding new and innovative ways to offer all the ‘added value’ we can, when providing recovery support in our addiction treatment services.
Now, perhaps more than ever before, at least within recent times; professionals in the field of addiction must continue to develop and empower people to embrace their own choices for recovery.
One of Carl’s prominent ideologies, which is also something I too happen to subscribe to, is the conceptual tenet of Amor Fati (Latin: “love of fate”).
It’s one of the thought processes so often linked to the Stoic philosophies of Epictetus and Marcus Aurelius.
I have often found that it is productive when we support people to Build Stoic Fortitude; a useful trait and helpful methodology for life in general, but also something that improves recovery outcomes.
Disregarding any obvious religion based connotations, that could be applied by some here; I would also like to see a little more emphasis around another useful Latin term.
Unfortunately, just like many other proverbs and analogies, it is often delivered with nuanced meanings, or can suffer from the impacts of individually motivated interpretations however; it is also one of those phrases that could easily be applied to this particular health-care issue.
This ‘proverb’ could also be used by and applied to individuals. The people who are battling with their whole addiction treatment process, or indeed the variance of methodologies that are applied during those individual recovery journeys – Medice, cura te ipsum (Physician, heal thyself).
The phrase alludes to the readiness and ability of physicians to heal sickness in others, while sometimes not being able or willing to heal themselves. This suggests something of ‘the cobbler always wears the worst shoes’, that is, cobblers are too poor and busy to attend to their own footwear. It also suggests that physicians, while often being able to help the sick, cannot always do so and, when sick themselves, are no better placed than anyone else. (phrases.org.uk)
Finally, this biblical proverb (Luke 4.23), suggests that people should take care of their own defects, before trying to correct the faults of others…