Is Drug Addiction a Disease?

No, but we often treated as a disease.  So what’s the disease?  The changes in our neurobiology that cry out for the disease.   What?  Addiction is not the disease; what it really is something we use to calm the disease;  a little help from our chemical friends.   Enter pain killers, alcohol,  sweets and on and on.  They step in to help the brain suppress the pain, the need and the agony.  And since we go on treating the wrong thing as The Disease, we never find a solution.  So Heroin use is not an addiction?  Of course it is, but addiction is not to be conflated with disease.  It is the poor man’s attempt at a solution; doing what he possibly can to soothe and calm.

What is the disease?  Thwarting of need, leaving it unfulfilled, to hang there gnawing away at so many of our systems, doing damage.  The system cannot develop properly with many biologic systems unfulfilled and so it accommodates, and alternates, and deviates until  we may have too much or too little cortisol, serotonin,  immune cells, etc.  There is where the disease lodgers itself well hidden and out of the way.   So what do we do?  We treat the symptoms of the disease and it is an endless task because so long as the real disease is untouched there will always be symptoms.   Unless, the “therapy” is successful, and the drugs the doctor give us drive down the symptom and make it disappear.   Herein lies the key difference between a symptom of disease and its origin.  Why do we keep on treating the wrong thing, year after year, hoping and praying for a different outcome?.....a cure.  And why is it so elusive?  We are chasing the wrong dog.   And that is why all those helpful ploys offered by so many experts give therapies that make us come back over again.  Out of sight out of mind?   No.  Out of sight held captive by the mind.

I read many scientific journals and recent one is about addiction, (Science News, March 2014.  The Addiction Paradox).  They state that drug addiction has 2 faces;  chronic disease, and a temporary failure to cope.   Bruce Bower, the author, claims that addiction is a “solvable coping problem rather than a chronic, recurring disease.   Really?  So I take heroin because the boss is putting pressure on me or my wife wants to go out dancing more often?   All this is put forth by those who have never see the pain below addiction, who have not seen how long it lasts and the damage it does.   Yes, we can take a drink or a few Prozac when we have a deadline for a paper to write but that is not the addiction we therapists treat.  We treat a deranged neuro-biologic system forcing us  to find solutions while the experts try to find ways to stop us.  When we break a leg they might give us a few pills because they can see the damage. But what about the damage that happened before we had verbal memory?   The damage that lies in less oxytocin or serotonin?   That cannot be seen; therefore it must not be important.   And what happens when we treat rats and pigds and humans with touch and kindness and warmth?  All have their oxytocin levels rise significantly.   Does that means they were lacking something?  And when we offer pain killers to those deprived animals and they take to it with alacrity what does that mean?   It means that they need it; they hurt!  Is that so difficult to understand? Why is there this war against drugs?  Yes drugs do damage but they are an attempt at damage control.
Of course the other choice for the scientists is to call addiction a brain disease.  And then we spend years examining the minutia of the brain to find answers.   We need to see how experience affects the brain; that is what we need.  Then if we fail we can call it a brain disease.   But I have seen hundreds of addicts mainly travel back and down to the first months of life, continuing on to their infancy, and there we see the terrible hurt those individuals have suffered.    If there is no access to those deep-lying biologic memories then there is no choice but to think it is because of a defective brain.  When my patients overcome addiction they have no brain damage, unless, unless years of use, even of seemingly benign drugs, finally disrupt function.

The author agrees that addicts never really get rid of addiction?  Why is that?  Because they never get rid of the need which still lingers in its neural cave forcing the tendency to use soothing devices.  Warmth and caring in the present does help; witness the good the 12-step program does.   The problem is that you have to recognize that there is a higher power than you and you must accede to it.  Wait a minute; we are the higher power, and we have control given the right circumstances.    As long as need lives on in encapsulated form we will require weekly visits for reassurance and help.  But when basic primal need is extirpated, we don’t need a surplus any more of constant human reassurance.  .  I am writing about deep early need but that also encompasses early childhood where love means so much;  guidance, protection and warmth.    These count but they build on a structure already partly in place.   But believe me they count a lot.

In a self satisfied piece, one expert on addiction assures us not to worry because many addicts  mature out of addiction by their thirties.   Do they also mature out of their pain or is it better hidden?    This is an  age-old saying told us by our doctors in the forties and fifties; don’t worry your child will grow out of it.  By some magic?  We never grow out of need.  It is in place to stay. It must be experienced for us to grow and mature.   And its pain is a warning system that says, pay attention, there is something lacking.  Do not push it away except at your peril because it will always, always, come back to bite you.

And there are others, many others in the Behavioral Cognitive School, who think addiction is a decision, a choice both in and out of it.  Make a good decision and voila, all is well. Only people who live in their head could think that.  They have not seem the great pain addicts are dealing it.  Yes, we can make a decision to stop, and suffer thereafter.  Is that what we want?  More pain? The problem is, how can I get strong enough to make a decision to make a decision?

All experts agree that the addict cannot go it alone; cannot be cured without continuous psychotherapy.  I suggest that they cannot get well so long as they are in therapy because the doctor is now the calming influence.  He cares.  He has warmth.  He guides, and above all  he is totally interested in you.  Who can disagree with that?  As long as we keep going we have exchanged one addiction for another; both designed to ease our pain, insecurity and low self esteem, especially when the doctor approves of us, is happy to see us and hopes to see us again and again for years……..for our fix.

After the war I was a mess, so I looked up some shrinks for help.   They all wanted me to pay in order to be better motivated.  I just got out of the navy and was already well motivated, so I call the Veterans Administration for help.  I got an Analyst who spent msot of our time analyzing my dreams.   We never went into why I was such a mess.  I learned something there; beware the ides of March.