The last post was a little short. After a week where the most complex tools I dealt with were a Swiss Army knife– a small one without too many things on it– and a USGS topo map, I hit “publish” instead of “save draft.”
So where was I? Myths that kill. I was especially interested in the “addicts are bad people” myth. Another name for this would be stigma. At core, this means more than that an addict is bad; it means that he addict is fundamentally bad, inferior, flawed, and so on. In other words, not a person who did something bad, even, but someone who is essentially bad– irredeemable. If someone with severe depression attempts suicide, usually that person’s friends and family will come to their support and rally around them. If someone with addictive disease relapses or nearly dies of an overdose… not so much. In passing let me note that an extraordinarily high percentage of people who complete suicide attempts are found with alcohol or other drugs of abuse in their systems.
The other destructive myth noted in Dr. Sacks’s post that interacts cruelly with the “bad person” myth is that addiction is a choice. This is a little more tricky than just condemning someone, because there is obviously a moment when someone voluntarily puts a substance into his or her system. But how did they know it would trigger addictive disease? Research on alcoholism suggests that about one in ten users of alcohol end up with alcoholism. SAMHSA publications state that about one in eleven users of marijuana will end up with addictive disease. So even those who engage in risky use of alcohol or other addictive drugs are not obviously choosing addiction.
We could take an attitude that “you knew the risks when you did it,” but if we regulated our lives by this logic, would we blame everyone who dies in a car crash for knowingly taking the risk of getting in the car? Would we blame everyone who gets skin cancer for knowingly going out in the sun, or not using enough sunblock, or both? This type of logic could lead to lifestyles calculated to eliminate all possible risks– which would be a very dull life indeed. Or it could lead to attempting to legislate risks out of everyone’s lives– a nightmare nanny state.
There are some warning signs for people to know. If you are male and your father and grandfather were both alcoholics, better for you not to drink. If many members of your family tree on both sides have addictive disease, better to not risk it. There are something like 80 genes known to be involved in contributing to addictive disease and many more under investigation. If you are young and early on your drinking career have really high tolerance for alcohol– sorry, friend, but that’s a sign that you’re heading for alcoholism. ( see my earlier post “I like it too much”).
In the better world I imagine, people would not suffer from stigma if they suffered from addiction. Taking the risk of consuming addictive substances would be no better or worse than the risk of doing technical rock climbing or motorcycle racing, or consuming large amounts of white sugar on a regular basis– another addictive substance. And people would feel relatively easy about telling a friend– or hearing from a friend– “Hey, you might want to look at your_________ use. You might be losing control. the best model for this right now is cigarette smoking, if you think about it. This topic could be continued but I’ll pause here.