A teenage boy lies in a hospital bed with IV tubes attached to his arm. His scalp and eyebrows are missing hair — signs of chemotherapy. He looks worried as he focuses his eyes from one of his frowning parents to the other then drops his gaze as if expecting trouble. His parents take turns launching angry questions and accusations. It becomes clear that they are blaming him for having cancer: Why did he let this happen? Why is he putting them through this? Why doesn’t he just decide to get up and be well?
Anyone viewing this interaction would be stunned. Who would ever be so cruel to treat their child this way when he is going through a devastating illness? The scene pauses and words scroll across the screen: What if we treated people with cancer the way we treat people with addiction? Addiction is a disease.1
The group, First Call created this compelling video for a campaign called “Stop the Shame” with a goal to end the stigma surrounding addiction. By boldly dramatizing the conclusion that many medical research groups have reached, that addiction is a disease, First Call hopes to educate the public. They want addiction to be treated medically and with compassion just like cancer or diabetes.2
Choices Are Involved, But Disease Is Not a Choice
First Call describes how diseases often start with a lifestyle choice, but the disease itself is not a choice. Heart disease and other fatal conditions can be brought on by choosing not to exercise for one in ten people who have the condition. Skin cancer can come from choosing not to wear sunscreen for one out of five people impacted by that disease. And one in seven people who choose to use drugs or alcohol become addicted.1
If everyone who didn’t wear sunscreen developed cancer, we would most likely never leave the house without using it. But some assume that they will be one of the four genetically lucky people who don’t get it. Why? Maybe because it’s easier to ignore the risk than to remember to slather on lotion, maybe they dislike the smell or feel of sunscreen, maybe they just forget to buy it or they want to develop a tan. They might think that the bad consequences of UV light happen to other people, not them. A similar mindset often happens with addictive substances.
The Issue Is Cellular
Not everyone who drinks alcohol becomes addicted, a slightly lower proportion than the number who get skin cancer from not using sunscreen. Watching sunbathers getting bronzed or watching social drinkers who can stop at one or two drinks gives a false sense of security. But science researchers looking into what happens on a cellular level see danger in both situations. Like the microscopic changes that happen in skin cells exposed to UV light, cellular changes happen to the brain when exposed to alcohol, opiates and other addictive drugs.2
Medical experts have done enough research to believe those cellular and chemical changes cause addiction in one out of seven people. It is not a lack of self-control, moral weakness or a criminal mindset that causes a person to become addicted. It is a disease, just like the disease of cancer or high blood pressure, which causes a reaction in the brain that leads to addiction.
Government and Healthcare Leaders Are Aware
Both government and healthcare leaders are joining to fight the stigma of shame and treat addiction as a disease.3 The 2016 U.S. Surgeon General’s report on the opioid epidemic concluded, “Well-supported scientific evidence shows that addiction to alcohol or drugs is a chronic brain disease that has potential for recurrence and recovery.”4
Healthcare professionals who know this and treat patients for the disease of addiction have become frustrated with the lack of compassion across society for their clients. Thomas McLellan, former deputy director of the White House Office of National Drug Control Policy complains that addiction is treated as a moral failing rather than a chronic disease. “Less than 10 percent of American medical schools have a course in addiction … So, contemporary physicians are not equipped to do it. Yet it’s those same kind of services, medications, behavioral therapies, monitoring and management, they now do routinely for diabetes, hypertension, chronic pain.”5
Hope for Compassion Found in Research
If you or a loved one struggles with addiction, there is hope in this new research about how the disease derails some essential and basic functions in the brain. The body can detox from an addictive substance so that it no longer needs it, but the brain has trouble letting go. Small triggers like a bottle of wine on a grocery store shelf can set off a powerful mental struggle.
National Geographic magazine published a detailed article about the internal workings of addiction in the human brain and described how neural pathways are rerouted by substances like opiates and alcohol.6 The article explains how the survival of human beings and other animals relies on a chemical reward system.
The brain tells us we feel hunger and reminds us there is food in the kitchen. Once we acquire the food and eat, this sets off a series of chemical rewards in our brain. For one out of seven people, addictive substances become part of that system of need and reward. The brain dishes out a chemical that rewards addictive substance seeking and using the same way it would for seeking food or warmth or companionship.6
“We are all exquisite reward detectors,” Anna Rose Childress, a neuroscientist at the University of Pennsylvania’s Center for Studies of Addiction, tells National Geographic. “It’s our evolutionary legacy.” But she cautions that our biological survival skills can be put to work for addiction instead of health: “By taking advantage of the brain’s marvelous plasticity, addiction re-molds neural circuits to assign supreme value to cocaine, or heroin or gin at the expense of other interests such as health, work, family or life itself.”6
We’re Headed the Right Way
Now that medical researchers have discovered how the neural system is hijacked by addiction, they are working on solutions to reset that system. Promising experiments include chemicals that replace addictive substances and electromagnetic waves that seem to reset the brain’s reward system.6
Research is turning to the kinds of medical treatment that are used for other diseases instead of criminalizing or marginalizing people with the disease of addiction. It’s a step in the right direction that holds out hope for everyone concerned.
By Pat Matuszak