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Experts tackling addiction as a disease, rather than a moral issue

Enid News & Eagle - 11/16/2020

Nov. 16--ENID, Okla. -- "I had my first beer, probably at the age of 7, and I liked that feeling it gave me."

David, who was identified only by first name by the treatment center that arranged his interview with the News & Eagle, went from that first beer to become one of an estimated 19.7 million Americans battling a substance abuse disorder, according to the 2017 National Survey on Drug Use and Health.

It's estimated 1 out of every 10 American adults struggle with alcohol or drug abuse, according to the National Institutes of Health.

Tackling those statistics has required a change in thinking on addiction, and over the last three decades doctors and clinicians have come to see addiction as a medical and mental health issue, and not simply the result of "poor choices."

That transformation, based on research that shows both genetic predispositions to addiction, and real ways substance abuse changes the brain, "acknowledges that addiction is a chronic but treatable medical condition involving changes to circuits involved in reward, stress and self-control," according to a 2018 article published by the National Institute on Drug Abuse (NIDA).

Dr. Nora Volkow, director of NIDA, said in that same article that "informed Americans no longer view addiction as a moral failing," and that rather than a simple matter of individual choices, addiction is a disease stemming from "complex interactions between biology, behavior and environment."

?I didn't like anything about my life?

David's story bears out those "complex interactions."

Born in North Carolina and raised in Norman and Oklahoma City, David said his home life as a child was designed to land him on the path to addiction.

"I came from a very dysfunctional family," he said. "My father was a chronic alcoholic, my mother was an alcoholic, my sisters are chronic alcoholics and drug addicts. It is a disease, and that disease was around me my whole life."

David started drinking heavily as a teenager. He said, initially, it was an escape from his home life, and from a learning disorder that was still misunderstood when he was a child.

"I didn't like who I was," he said. "I didn't like that I had dyslexia, I didn't like that I came from a dysfunctional family. I didn't like anything about my life."

Alcohol became a regular escape for David.

"I got the taste for it, I got the feeling for it, and that disease that's passed on is aggressive -- it just gets worse and worse and worse," he said.

Even as he sank deeper into drinking, it didn't hold him back from working. Despite having only an eighth-grade education, David went on to build two successful companies in construction and remodeling.

But, behind the successful façade, David was slowly drinking himself to death.

?I hated myself?

It wasn't that David didn't realize there was a problem. Between 1989 and 2019, he was in and out of treatment programs, and went into residential treatment four times.

The worst came in 2009, after the housing market crash brought his business to a standstill, followed by his mother's death and a divorce.

David said he "just gave up." He started selling off his business, one piece at a time, and drank the proceeds.

"I had enough money to drink myself to death for 10 years, and that's exactly what I did," David said.

He still bounced in and out of treatment, but by the last five years of his drinking, that transitioned to repeated hospital stays for the damage the alcohol was doing to his body.

"In the very end I was dying," he said. "The alcohol got in my bone marrow and it was eating my liver up."

Finally, a simple cut on his leg led to gangrene. But, even after his leg was almost amputated, he went back to drinking again.

"I hated myself and I hated everything and everyone around me. All I wanted to do was die," David said. "I could not quit. I could not stop. It was just self-pity, fear, anger and resentments."

Finally, his sisters, who had overcome their own addictions, intervened in David's life.

"My sisters said, 'We're done with you David. We're not going to watch you die anymore,'" he said. They took him from a round of detox at the hospital to Catalyst Behavioral Services, in Enid.

?I found power greater?

David, now 61, successfully completed the inpatient treatment program at Catalyst, and now is living a life without alcohol. But, it wasn't, and isn't, an easy battle.

"This is an aggressive, aggressive disease," David said. "It's one of the hardest ones to overcome, and you never really overcome it. You will always be an alcoholic.

"It's through the grace of God that I am still alive and I have another chance," he said. "I was dying. I should have been dead a long time ago."

What made that program different than previous attempts at rehabilitation, David said, was that he finally learned to accept something bigger than himself.

"I sat in that last treatment center I'll ever go in. I sat in there as miserable as anyone in this world, and my sisters not wanting anything to do with me, and I asked God for help, and I just kept praying," David said. "I found God. I found a power greater than David."

?A belief system?

Tanya Kennedy, program director at Catalyst Behavioral Services Enid, said accepting some form of spirituality bigger than oneself is often what makes the difference between success or failure in overcoming addiction.

She said overcoming the changes in brain chemistry caused by addiction often requires finding something that takes away the inward focus on those rewired reward centers in the brain.

"Those I've seen recover and stay recovered are those who find some kind of spiritual peace, some form of spiritual belief system," Kennedy said. "They have to have a belief system in something other than themselves. Addiction by itself makes us very self-centered. With a spiritual system in place, we focus on others, and become givers instead of takers.

"Those who learn how to give -- those are the ones who get clean and sober and stay that way," Kennedy said, "and that's tied into that spiritual belief system, in my opinion."

But, she stressed, addiction, for most, is not a collection of choices that can be easily put aside. It is a brain disease, she said, and on average, addicts may have to make 14 failed attempts at treatment before they gain control over that disease.

"It's pretty rare to just do it, once and out," Kennedy said. "That's pretty rare."

?Not something you can just stop?

Jason Zwink LPC, director of Lighthouse Substance Abuse Services in Woodward, a service of Northwest Center for Behavioral Health, said public perceptions of addiction, and understanding of its nature as a brain disease, have improved considerably over the last two decades.

But, he said, "some of that old-school way of thinking still lingers -- that addicts should 'just stop.'"

"If we're talking about a biological change in the brain, I think we have to understand it's not something you can just stop," Zwink said.

Zwink likened addiction to other diseases, such as diabetes, which change the body's chemistry and processes.

"For addicts, the brain's rewards centers are hijacked, so it's not as simple as saying, 'This is bad for me, so I shouldn't do it,'" Zwink said. "They feel the need to do it, and do more of it, even though everything in front of their face in their life is falling apart."

?How we help each other?

As communities consider how to handle addiction, Zwink advised thinking of it as a health crisis, and not simply a moral failing.

"I would hope for empathy, and a level of understanding that what we're seeing with this disease is a lot like other medical diseases," Zwink said. "If you had a loved one with diabetes, you'd want them to get treatment and help."

And, said Kennedy, reframing that approach to addiction requires open and honest conversations about substance abuse and its treatment.

"Open up the dialogue about it," Kennedy said. "Don't keep it in a closet. Talk about it. That's how we learn, and that's how we help each other."

Neal is health, military affairs and religion reporter and columnist for the Enid News & Eagle. Follow him on Twitter, @jamesnealwriter, and online at jamesrneal.com.

Have a question about this story? Do you see something we missed? Do you have a story idea for James? Send an email to jneal@enidnews.com.

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