Nature of Substance Use Disorder and Social Responsibility

Within the past year, we have heard stories from social media, news outlets, and ongoing conversations around the rise of the opioid crisis. Reading through the various commentary, there is a noticeable trend of individuals caught up in emotional responses. Yet, as a society, do we fully comprehend the nature of addiction and how individuals who are trapped within the toxic relationship lose sight of moral judgments?

When an individual is engaged in active addiction they are self-medicated in a way to cope with normative and everyday stresses we all face. In other instances, addicts medicate themselves because of anxiety, depression, or to overcome particular trauma that they have recently experienced (to include grief and loss). In fact, according to the website addictscience.com, we find this:

Active addicts see alcohol and/or drugs as the solution, they rely on them as medicine to treat their emotional ills and get them through each day. They believe alcohol or drugs are necessary simply to feel normal and function, and because of the brain changes that take place as tolerance develops, that belief is true in the short-term (even while it’s fatally wrong in the long-term)

To gain a better perspective on how addiction affects the brain, Time provides a visual aid to show the extent of what happens to our brain because of substance useHarvard Medical School provides a brief etymology of the word “addiction” in relation to what happens to individuals who rely on chemical substances (alcohol, cannabis, cocaine, heroin et al):

The word “addiction” is derived from a Latin term for “enslaved by” or “bound to.” Anyone who has struggled to overcome an addiction—or has tried to help someone else to do so—understands why.

Along with this etymological definition of addiction, the individual experiences three particular elements to their “enslavement” to the drug of their choice: (1) Craving for the particular substance addicted to; (2) Loss of Control due to the substance one is addicted to; and (3) Continued use despite negative consequences as a result of the substance one is addicted to.

What then is our social responsibility in relation to people who are in a state of active addiction?

1) Educate and understand the nature of addiction to begin with

As members of society, we must approach these types of stories with an eye to understanding and gaining particular knowledge in how addiction works, how it affects individuals who are in a state of active addiction, as well as provide resources and support for those affected by the consequences of active addiction. Without this understanding, we have no means to show empathy toward those who have chosen to allow themselves to be enslaved to this toxic disease.

2) Know that most individuals in a state of active addiction will not seek help on their own volition

Along with educating and understanding the nature of addiction, one must also understand that most individuals in the throes of active addiction are unable to seek help of their own accord. In most situations, those in active addiction experience what is referred to as hitting “rock bottom”. This catalyst can be anything from legal consequences that resulted in an addicts maladaptive behaviors because of substance use, or having experienced significant loss that caused them to turn to seek out help. In addition to this, one of the grand myth’s of substance use disorder is that of an addict having the volition and agency to choose whether or not they are able to pick up or put down their addiction. This is because of the nature of how the brain has adapted to the use of Alcohol and/or drugs (AOD).

3) Recovery is a process for individuals where they face a steep climb toward a healthy lifestyle

No addict has ever awaken to a point of saying “I want to become an alcoholic” or “I want to become addicted to drugs”. It is a process that occurs over days, weeks, months, and even years. Much like addiction is a process that leads toward the compulsion to use AOD, recovery is a reversal of that process. On the one hand, a person who becomes enslaved to their particular substance, the process of recovery is to break the chains and bonds that have enslaved them. This includes developing new coping skills to arrest previous behaviors that have led an individual to use and abuse AOD. It is literally an ongoing battle where an individual has to daily fight to reclaim their life from the effects of AOD.

4) Sobriety is not the end of recovery – it is a maintenance of the lifestyle change one engaged in due to the recovery process

Society sometimes has a false sense of security when it comes to understanding the nature of recovery and sobriety from AOD. This includes individual addicts, friends and family who are associated with addicts, and those outside of an individual’s sphere of influence. Sobriety is not the cure of one’s addiction, it is merely the maintenance of one’s change in lifestyle that has occurred through the recovery process. The addiction and nature of addiction is still there – however, it is in a state of sustained full remission. At any given point, an individual who has gone through the battle of recovery to reach a sober lifestyle must consistently and constantly be vigilant in understanding where their addiction may take them to. A healthy sober lifestyle outside of addiction is a state of “active sobriety” where an individual maintains a well-balanced and meaningful life that is healthy.

So, the question ought to be, how well do we as individuals of society understand the nature of addiction? How are we better to assist other people with recovery efforts? Break from the stigma of those who are enslaved to their substance use of choice? We as a society have a responsibility to detach from dehumanizing people. Instead, let us make better policies and efforts to work with those struggling.

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