Thursday, May 22, 2008

Addiction

NOTE: I don't understand a great deal about addiction. Neither of my parents were addicts. I do not mean to be presumptuous in this post. Just state some thoughts I've had and my reaction to comments. I'm always willing to discuss/learn more.

I believe addiction is a disease. It is a disease like heart disease and hyperthyroidism.

I believe it is genetic. It is inherited just like mental illness (and a whole host of other diseases/conditions/traits). I believe some of us are genetically predisposed to addiction, just like some may be predisposed to writing, music, cooking, driving, reading maps or different forms of ear wax.

People can be in denial about their addictions. Denial is very powerful. And addiction (specifically alcoholism) is debated in many circles. What, exactly, makes one an alcoholic? Drinking alone? Drinking liquor/whiskey/bourbon? Drinking in the morning? Drinking every day?

From my limited understanding, the only person who can label or admit a person an alcoholic is the person themselves. (As an aside, this is very confusing to me - as Al-anon is a group for family and loved ones of alcoholics. But a person can join whether or not the original qualifying person admits to being an alcoholic in the first place. So are they really an alcoholic? Should the loved one still attend? The jury is still out.) I'll just admit to not understanding that process.

Yet I feel there is a clear (intuitive) line when a person has a problem with alcohol (or other substances). I'll give two examples.

The first is a friend who was out of work (from my college days). I specifically remember instances where he had to choose between buying a thirty pack of beer or food with his last $5. He chose the beer.

Another person we know has had two drunk driving arrests within a year. In the state we live in, this is an automatic felony. In the second instance, he wrecked the car he was driving. Fortunately (as there are so many, many sad stories of people being killed/maimed by drivers under the influence), no one was hurt.

I could make arguments in both cases that both these people have some sort of problems with alcohol. The exact nature of those problems, I couldn't say. I do know enough to say, you may have a problem when...

What I want to explore further is the power of denial about addiction and the mental gymnastics a person can go through.

When I say mental gymnastics, it's what can happen when a loved one confronts a potential addict about their possible addiction. The addict responds "Well, you can't give up X." I think of X as a relatively harmless substance in moderation: coffee, chocolate, exercise, tv, the internet or frozen juice pops.



What's fascinating to me is the dynamic this creates. It throws the focus off of the potential addict. Because typically, the friend/loved one has to admit that yes, they do love substance x (we'll say coffee). And yes, it would be hard for them to give it up.

My argument is, the conversation should not stop here.

Conventional wisdom is that people can be addicted to anything. Again, examples of chocolate, coffee, exercise, the internet, etc. come to mind.

But it does beg the question of what exactly a "dangerous" addiction is.

Let's just say (for the sake of argument) that I'm addicted to coffee.

-Coffee is not a controlled substance (anywhere on earth).

-If I drink coffee and drive, my driving is not impaired by the coffee itself.

-It's not illegal to drink coffee and drive.

-I don't become violent while drinking coffee.

-I don't black out after drinking a cup of coffee and not remember where I am or how I got there.

-Coffee drinking doesn't take me away from being fully present when interacting with and caring for my children.

-I won't get fired for drinking coffee at work.

-My doctor won't tell me that drinking a couple cups of coffee every day is dangerous to my health, heart and liver. (in fact, some studies show that drinking coffee can help fight diabetes and Alzheimer’s, although the medical consensus is still out on those).

-I don't hide my coffee drinking or lie about it.

-I do get sick when I stop drinking coffee - so that is a yes answer among the others.

With dangerous addictions, when you add substance x to that list and begin answering yes, I submit that you may have a problem.

I'm not implying that alcohol in moderation is always bad for a person. Growing up LDS (well, it was mormon back then), I was taught that alcohol (even a sip) was a sin. If a friend's parents had beer in their fridge (even six month old beer), they were probably alcoholics.

This was/is an unhealthy attitude as well. Someone with beer in their fridge is not necessarily an addict. They are not necessarily dependent or powerless against alcohol - where it is the most important thing in their life. They are not in the position where they will sacrifice everything else to get that substance. An LDS child is not taught to see grey in alcohol consumption, they're not taught what "normal" consumption is and what is abusive/dependent.

What makes this even more complex is that alcohol use is glamorized in our society/culture and in the media. I've seen the sixteen page intake questionnaires that addiction facilities use. I will say, if many people I know answered those questionnaires truthfully, I know quite a few alcoholics.

My point in all of this is not to create paranoia in my readers. I hope to have other posts to respond to the recent addiction posts around the LDS internets.

What I am saying is that if someone confronts you saying "You have a problem with x" - I think it's worthwhile to have a discussion about it. Why do they think that? Research different prevailing medical and therapeutic opinions about addiction. Determine what is a dangerous substance or behavior. Talk to friends and family - what do they see?

But like coffee or chocolate, if it doesn't fit, it's probably not a bona fide addiction. There may be larger issues going on in the relationship. It may be worth going to therapy to figure out what else may be going on.

2 comments:

northnode said...

I agree wholeheartedly.

I have also struggled with the question of what it means to be an addict. Unfortunately, alcoholism and other forms of addiction run rampant in my family and have caused lots of damage. I have questioned myself many times. If I feel like having a beer or two, I sometimes worry that perhaps this is a bad sign. Typically, when I tell other people this, they think I'm nuts, so it's comforting to me that no one else in my life seems to view me as a potential alcoholic.

I think that when it comes to defining addiction, or just about any other illness that has a mental health component to it, things get messy. With purely physical issues, there is usually a blood test, or some other type of clear indicator. Mental health is not nearly so clear. A social constructionist view of psychology would hold that reality is socially constructed. As a society, we define what alcoholism is by comparing someone's drinking behavior to the cultural norm. I dare say it's different in the U.S. than in Russia. But on a smaller scale, I think you're right that it's a good idea to pay attention if the people in your life suggest that you have a problem. Chances are, if they're speaking up about it, it's because in some way, your behavior is hurting them.

Aerin said...

Thanks NN for your comments. I know we've talked about this before so I really appreciate your thoughts on this matter.