Showing posts with label addicts. Show all posts
Showing posts with label addicts. Show all posts

Tuesday, June 18, 2019

An addict by any other name, please

Addiction and Recovery

By Bob Gaydos
  What’s in a name? Maybe, recovery.
"New" me, at 73.
Bob Gaydos
Addiction — to opioids, alcohol, heroin, other substances or behavior — is a medically recognized disease, something for which treatment is available and prescribed so that the person who suffers from it can be returned as a contributing member of society. That’s the official, appropriately concerned line put forth by government agencies, the medical community and those who work in the field.
    Unofficially, which is to say, to much of society including members of the aforementioned groups, a person with the disease of addiction is commonly referred to as an addict. A drunk. A junkie. A cokehead or crackhead. An alkie. A pothead. A pill-popper. He or she is often regarded as someone who is weak-willed, immoral, untrustworthy, rather than someone suffering from a disease. A liar. A loser. Someone not worth the time or effort — or money — to associate with, never mind help.
   One of the major obstacles to persons seeking treatment for addiction is the stigma attached to the disease. It has been framed seemingly forever as a moral issue, a crime issue. Rarely — only recently — has it been framed as a health issue. We have waged a war on drugs as we tried to cure cancer or diabetes.
    Words matter.
    Researchers at the University of Pennsylvania lbast year released a study with the key recommendation to stop using the words “addict,” “alcoholic” and “substance abuser.” The study found the words carry a strong negative bias. Basically, the researchers said, they label the person, not the disease. Study participants not only displayed a reluctance to associate with persons described with those words in fictional vignettes, the researchers said participants also displayed “implicit bias” to the terms themselves when given a word-association task. They were subconsciously reacting negatively to the words.bbb
     If just the words can stir negative bias in people, imagine what an actual person carrying the label “addict” can arouse.
     The Penn researchers said their study was consistent with previous research that found some doctors, even mental health professionals, less willing to help patients who were labeled “addicts” or “substance abusers.”
     The researchers did not discount the fact that conscious bias against persons with addiction — for example, how involved one would want to be with the person described — is often based on personal negative experiences with “alcoholics” or “addicts.”  Family members, friends, co-workers have experienced pain and suffering from their connection to persons with alcohol or substance use disorders and a resistance to not just “calling them what they are” may be understandable.
      But, the researchers said, over time, adopting what they call person-first language (referring to a person with a heroin addiction rather than a heroin addict) — especially by public officials and the media — could help reduce the negative bias and stigma that keeps people from seeking and getting help for their disease.
       In 2017, prior to this study, the Associated Press, which publishes a style guide used by most news organizations, adopted a new policy on reporting on addiction. It recommends that news organizations avoid terms such as “addict” and “alcoholic” in favor of person-first language — someone with an alcohol or substance use disorder or someone who was using opioids addictively, rather than a substance abuser or former addict. Someone in recovery, rather than someone who is “clean.” Shift the blame from the person to the disease.
     This doesn’t excuse or absolve the person who is addicted from any damage he or she may have done, and it may be considerable. But it does provide an identity beyond the addiction and makes the road to recovery more navigable. 
     Earlier this year, the Philadelphia Inquirer and Daily News adopted a policy similar to AP’s.
      The concept is simple: A person should not be defined solely by his or her disease. When mental health professionals stopped referring to patients as schizophrenics, society started referring to people with schizophrenia. Similarly, there are people with diabetes today who once were labeled diabetics. It is often argued that alcoholism or addiction are different from other diseases because the person chooses to use the substance. But experience tells us no one chooses to become addicted and the nature of the disease is being unable to stop — or at least feeling that stopping is not possible. Negative labels can’t help.
       Government agencies have begun using the new language, referring to persons with alcohol use or substance use disorders rather then alcoholics or addicts. Some who have managed to face their addiction and overcome it have abandoned the anonymity of 12-step programs and identify themselves publicly as persons in recovery. The opioid crisis has spawned a program called Hope Not Handcuffs, which steers the person who is addicted to treatment rather than incarceration.
       An exception to the change in language is recognized for those who are in 12-Step programs who identify themselves as alcoholics or addicts at their meetings. These are people who don’t see the terms as negatives, but rather as an honest admission of a fact in their lives. Members of Alcoholics Anonymous have been saying, “My name is xxxx, and I’m an alcoholic” at meetings for nearly 84 years. It’s tradition. There’s no stigma attached, but rather a common bond that holds out the hope there is something beyond being labeled a “drunken bum” or “hopeless addict.”
      The groups recommending the language change say this is not merely “political correctness,” as some have said. Lives are obviously still being ravaged by addiction. If something has to change in approaching the disease, there is a growing feeling that how we talk about it might be a good place to start.
Bob Gaydos is a freelance writer. rjgaydos@gmail.com

Tuesday, March 4, 2014

Socety is still out of touch with the reality of addiction

(My latest Addiction and Recovery column.)

By Bob Gaydos
Philip Seymour Hoffman
 ... on the cover of Rolling Stone
        The congenital disconnect between much of society and the reality of addiction reappeared recently with the death of actor Philip Seymour Hoffman, apparently due to an overdose of heroin.
The Oscar-winning actor was found dead in his Manhattan apartment with a needle in his arm and bags of what was believed to be heroin nearby, according to police. Almost immediately, the familiar reactions were heard: How could he? He was so talented, so  admired, so wealthy, had so much to live for. He had been to rehab and he was sober more than 20 years. How could he risk it all for a fleeting high? And with heroin no less. Who does heroin today?
Apparently, aside from Hoffman and the late Amy Winehouse, a lot of people. And not just the down-and-out addicts who were once the stereotype for what some considered to be “serious” addiction, as opposed to what, one presumes, were considered less serious forms, like addiction to alcohol or cocaine. Addiction pecking order aside, today’s heroin user is just as likely to be your neighbor’s teen-aged son or daughter as a famous actor or singer.
The Substance Abuse and Mental Health Services Administration, which tracks drug use in this country, says a recent survey showed a more than 100 percent increase in the use of heroin in the United States between 2002 and 2012. Slightly less than half a million people were regarded as heroin dependent. How pervasive is it? The states of Maine, New Hampshire and Vermont (so much for stereotypes) report serious problems with heroin addiction and overdoses and deaths as a result of heroin use. Heroin use is up in Pennsylvania, Illinois, Ohio, name a state.
          Much of this increase is tied to the abuse of prescription pain killers, such as Oxycodone, Oxycontin, Vicodin and Percocet, which are opiates, like heroin. Concern over the over-prescription of such drugs and the growing use of them by teenagers who simply took them from their parents’ medicine cabinet, has made it more difficult to get the pills and to crush them for snorting. This makes them more expensive. In comparison, heroin on the street is much cheaper.
        And, quite possibly, much deadlier. Police are examining the many bags of heroin they found in Hoffman’s apartment, among other reasons, to learn if the heroin had been cut with another substance -- a dangerous synthetic heroin” that has emerged -- or if it were too pure. Heroin is not only one of the most addictive drugs, it reacts quickly on the brain, sometimes giving the user insufficient time to react to a bad batch.
Does any of this explain why Hoffman -- famous and sober -- decided to try heroin? No. Relapse, as professionals in the substance abuse field explain, starts in the addict’s brain, with changes in attitudes, behavior, a relaxing of diligence. Dr. Nora Volkow, director of the National Institute on Drug Abuse, in commenting on Hoffman’s death, said, “You need continued awareness of the possibility of relapse. No matter how long you’ve been clean, if you take the drug, you’re at high, high risk of relapse.” Meaning, if you think you can take “just one more hit,” you’re probably delusional and definitely risking your life.
Addiction is considered a chronic, incurable disease because once the brain is reintroduced to the addictive substance -- alcohol, heroin, cocaine -- it can quickly return to its old ways. Addicts often say that when they started using their drug of choice after a period of abstinence, they were right back where they left off, or worse. This is why abstinence and continued treatment, be it therapy or a 12-step program, is recommended for recovery. A change in lifestyle and constant awareness are the keys, the experts say. Over time, the approach may gradually change, but as Volkow reminds, an addict can never forget what he is. And society would do well to remember as well.

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