It is rare today that we do not hear an opioid-related story in the media. The media attention has brought opioid abuse and drug treatment directly into political and public awareness. Some of this attention is much needed, but with all of the attention, the myths have also grown. These myths matter because myths perpetuate stigma, labels, and even harmful beliefs.
4 Things About Addiction and Recovery That You May Not Know
1. Repeated substance use causes rapid, observable changes in the brain
One of the greatest challenges to recovery is invisible. How we talk about the problem of addiction impacts all of us. It creates stigma and a belief that a person will never overcome their behavior.
Any rewarding activity that is repeated will change the brain. Substance use is often (at least at first) much more pleasurable and rewarding than other, more healthy behaviours.
Addiction is a learned response, the brain and body adapt to the presence of whatever substance a person is regularly using. This does not mean that substance use is not serious or difficult to change. Substance use can cause a person to become dependent and any change to the regular pattern of use can cause psychological anxiety, depression, panic, physical pain and in some cases potential death.
“Opioids flood the brain with pleasure-causing and pain-reducing chemical signals. This is what makes these drugs so effective for short-term pain relief. However, after repeated use, the brain adapts, reducing the amount of these chemicals it releases on its own. Consequently, a person who uses opioids repeatedly will need to take these drugs just to feel normal. Without opioids, the brain’s new balance is disrupted, and the agonizing symptoms of withdrawal and craving set in.” Kenneth Feder and Noa Krawczyk
2. There are highly effective treatments for addiction
Often media and popular websites, talk shows and publications will focus on stories of a person or family who fails to “beat” addiction. We about their inability to follow through (willpower), or the use of “interventions,” tough love, or “rehab.”
What we may not hear as often is that there are many evidenced based and compassionate treatments that support recovery. Examples include:
- Medication assisted recovery
- Motivational interviewing
- Communicating and maintaining healthy boundaries along with adequate support for when a person is not yet ready and when they are in early recovery
- Care-giver self-care
- Dealing with underlying trauma
- Securing housing/employment and other basic needs
- Supporting a person to address concurrent disorders (additional mental health challenges such as PTSD, depression, anxiety)
- Treating the person with dignity at any stage of use or recovery
- 12 Step programs
There are many stories of success and recovery, through a combination of treatment support and informal help. Recovery from addiction is not hopeless and it is not random. Many people face a treatment gap where services that fit their needs or stage of recovery have long wait lists, are too expensive, are judgmental or are simply not available.
“Although rarely mentioned in media articles, there is a clear scientific consensus that medication-assisted treatments with methadone or buprenorphine (the main ingredient of Suboxone) are the best existing treatments for opioid addiction, and they work pretty well. Studies repeatedly show that patients whose recovery is supported by these medications are more likely to adhere to a treatment regimen, less likely to relapse, and less likely to overdose than patients in traditional abstinence-based treatment. This is because these medications target the biological basis of opioid addiction.” Kenneth Feder and Noa Krawczyk
3. The goal of addiction treatment is to restore a person’s ability to lead a meaningful life, function productively, and stay alive
Most people who live with addiction also have other aspects of their character that they strive to live out. A person may lose trust, self-respect, dignity or self-compassion. But at the same time, they can behave in ways towards themselves and other people that are compassionate, respectful and dignifying.
When we see stories in the news, we will hear that a person needs to “gets clean” and stops using any and all drugs. The reality is that for many people, they will attempt to cut back or reduce their use. Sometimes they will try many times and will learn that they have to stop all substance use. Others may be able to plan their use and they may be able to maintain safe levels of one substance or another (ie: continue smoking marijuana while ceasing their use of Crystal Meth).
“Equating recovery and abstinence is counterproductive and dangerous because medication-assisted treatment for opioid addiction is most effective as a maintenance treatment taken over an indefinite period of time.” Kenneth Feder and Noa Krawczyk
Some people need to slowly quit one substance after another and it may take months or in some cases, years, to stabilize. For many people, they do not plan to stop all substance use and may not need to abstain. Moderate use may be possible but may take a considerable period of abstinence and in some cases even small levels of use will create instability and health risks.
Regardless of what a person decides, like any habit, lifestyle change takes time and support to make it work.
4. A person might have an addiction, but this does not make him or her “an addict.”
There are many stories of success and recovery, through a combination of treatment support and informal help. Recovery from addiction is not hopeless and it is not random.
One of the greatest challenges to recovery is invisible. How we talk about the problem of addiction impacts all of us. It creates stigma and a belief that a person will never overcome their behavior. Society has changed how we refer to people with with conditions like schizophrenia or leprosy and we no longer call them “schizophrenics” or “lepers.” They are people first, and are not identified by their illnesses.
People who use substances, and who are in recovery, have families, emotions, and aspirations. Continually referring to them using terms like “addict” conjurs up many negative, unhelpful and even damaging stories and ideas. It is also inaccurate. Most people who live with addiction also have other aspects of their character that they strive to live out. A person may lose trust, self-respect, dignity or self-compassion. But at the same time, they can behave in ways towards themselves and other people that are compassionate, respectful and dignifying. They can maintain jobs and even friendships.
Addiction is a challenging condition to work through and labels make the work of recovery even more difficult because a person needs to overcome habit, the psychological and physical dependence, build social support, re-enter the workforce and create a sense of a worthwhile life. They also must face their own thoughts, beliefs and stories that reinforce a sense of shame and repeated mistakes and failures.
They also must face shame, disbelief, stigma and judgment from some (or many) police, physicians, health care professionals, treatment providers, family and friends, along with the media and internet.
Consider a situation where one of your family members will not stop talking about negative stories or incidents from your history. They focus on your mistakes and failures but fail to discuss how you have improved or the ways that you have always tried to show compassion for others. They use labels and state emphatically that no matter what you do or how much you improve you will always be… “insecure,” “a failure,” an “average student with an average IQ,” “fat or ‘heavy,’ “ or “morally weak”?
It is the no different than calling a person with any other mental illness as crazy, unstable, insane, psychotic, psycho or other negative labels. They may experience difficult periods where they struggle to manage depression, anxiety, schizophrenia, PTSD, or other symptoms. And they will also have periods where they will experience stability and healthy behavior patterns.
Continually referring to someone as an “addict” is dehumanizing, shaming and can perpetuate the idea that they will never be able to improve, change or make any progress.
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I invite you to read some of my related articles:
Please Don’t Hate Me Because I Have a Mental Illness
Mental Illness Cannot be Treated With Just a Pill
What if Addiction is Not a Disease and Your Brain is Not Broken?
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Keep it Real
Article adapted from “Four facts every journalist should know when covering the opioid epidemic” by Kenneth Feder and Noa Krawczyk; AUGUST 15, 2017.