ADDICTION:  A CHOICE OR A DISEASE

by Art Christie

“No one understands the disease that doesn’t have to.”  When a loved one becomes addicted to alcohol or another mind/mood altering drug, then everyday logic and loving/helping actions by the family become part of the problem.  Rescuing and “enabling” by the family deprive the addict of the consequences that are so necessary to motivate recovery.  The addicted individual goes through a series of “normal” but ineffective attempts to deal with the increasingly out of control behaviors (increasing use and decreasing life skills).  The dynamics of the disease deprive the affected individual of any clear knowledge of the truth about the disease.

Meanwhile, those who don’t understand the disease (most of society at large), interpret the deteriorating behaviors as those of one whose moral character is “bad” (such as lying, cheating, stealing, philandering, embezzling, forging prescriptions, driving under the influence, and so on).

As the addiction advances, the individual eventually gets to the point where he “can’t not drink (use drugs)”.  This loss of choice is the center of the public’s misunderstanding.  Normal problem solving and reactions to consequences are no longer operating.  When the offending behaviors get the individual into the criminal or civil justice system (as they inevitably will), the problem escalates.

If the individual, the family, or the system can hold to a plan which allows the addict to choose treatment, then the problem is headed toward a solution.  If the addict has committed crimes in the course of the disease, then there must be consequences for that addict.  If the community is aware of this need, then treatment in-lieu-of incarceration is the hands-down winner in the choice of options for everyone.

This paradox (choice or disease) was best taught this writer by a 5^th grader and her teacher.  As a presenter of a “drug free schools” substance abuse prevention program, I was in the midst of explaining the disease of alcoholism to a class of 5^th graders in the Guthrie elementary school.  When a little girl, hairline scars still visible around her dark piercing eyes (it’s a small community and I knew she was the victim of physical abuse by an alcoholic step-father), arms folded in defiance, said, “How can you call this ‘alcoholism’ a disease when you have a choice whether or not to drink?”  This trained communicator was, for possibly the first time, rendered speechless.  During this pregnant pause, the teacher’s voice came from the back of the room to the rescue.  “Well, honey, when you have a choice whether to drink or not, you don’t have the disease; alcoholism is when you lose the choice, you can no longer choose not to drink.”

As a community, we must work together to communicate this reality, that addiction is a disease, not a choice.  Initiatives offering treatment instead of incarceration, such as Drug Court, Community Sentencing, and an informed judiciary aided by well trained and well paid treatment professionals move us in the direction of a solution to this most pervasive public health problem.  Do you “choose” to be part of the problem or the solution?

Art Christie, MA, LADC, LPC is Coordinator of Substance Abuse Studies at the Sociology Department of the University of Central Oklahoma.  Art previously worked as a Counselor and Clinical Director for A Chance to Change.

IS YOUR CHILD USING?
THE SIGNS AND SYMPTOMS YOU NEED TO KNOW
 

For more information about the topics discussed in this article, including the signs and symptoms of substance abuse, please visit www.theantidrug.com.
 

Prescription Medicine Misuse and Abuse:  A Growing Problem
Source:  Partnership for a Drug-Free America
12/7/2004

Prescription medication misuse and abuse by teens is a growing problem in the United States. The 2002 National Survey on Drug Use and Health, conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), found that 14 percent of teens (aged 12 to 17) reported ever abusing a prescription medication. Teens were asked if they had taken prescription medicine without a doctor's prescription or had taken prescription medicine only for the experience or feeling it caused.  Read on to learn about teens' misuse of medicine  —  and what you can do about it.

 PARENTS' QUESTIONS & ANSWERS

Q: What age are teens abusing prescription medications?

A: Kids as young as 12 are trying or using prescription medications non-medically.
Pharmaceuticals are often more available to 12 year olds than illicit drugs because they can be taken from the medicine cabinet at home, rather than marijuana which necessitates knowing someone who uses or sells the drug. Also, pills may have a perception of safety because they are easier to take than smoking pot or drinking alcohol and are professionally manufactured in a lab.

Q: What types of prescription medications are teens abusing?

A: The National Survey on Drug Use and Health identifies 4 types of prescription medications that are commonly abused  —  pain relievers, stimulants, sedatives and tranquilizers. Eleven percent of teens (aged 12-17) reported lifetime non-medical use of pain relievers and four percent reported lifetime non-medical use of stimulants.

Q: Do different groups abuse different types of medications?

A: Yes. Painkillers are the most common pharmaceutical abused by teens, especially by younger teens. Stimulant abuse is more common among older teens and college students than younger teens. Girls are more likely to be current (past month) abusers of prescription medications than boys (4.3 vs. 3.6 percent). [Source: 2002 National Survey on Drug Use and Health. ]

Q: What can I do to help to prevent my child from misusing prescription medications?

A: One easy way to prevent is to keep all prescription medication hidden: Parents and family members whose homes teens visit should keep prescription medications out of teens reach, rather than in the medicine cabinet. You should also talk to your teen and warn them that taking prescription medications without a doctor’s supervision can be just as dangerous and as potentially lethal as taking illicit drugs. For example, pain killers are made from opioids, the same substance as in heroin.

Q: How can I talk to my kids about pharmaceutical medication abuse?

A: Starting a conversation about drugs with your kids is never easy — but it's also not as difficult as you may think. Take advantage of everyday "teachable moments" and, in no time at all, you'll have developed an ongoing dialogue with your child. Teachable moments refer to using every day events in your life to point out things you'd like your child you'd like to know about.  When you talk to your kids about drugs make a special point to tell kids how dangerous prescription medication abuse is.

 
WHAT TO TELL YOUR CHILD ABOUT PRESCRIPTION MEDICATIONS

° Pharmaceuticals taken without a prescription or a doctor's supervision can be just as dangerous as taking illicit drugs or alcohol. 

° Abusing painkillers is like abusing heroin because their ingredients (both are opiods) are very similar. 

° Prescription medications are powerful substances. While sick people taking medication under a doctor's care can benefit enormously, prescription medication can have a very different impact on a well person. 

° Many pills look pretty much the same, but depending on the drug and the dosage the
effects can vary greatly from mild to lethal. Prescription medications, as all drugs, can cause dangerous interactions with other drugs or chemicals in the body.

° Prescription medications, as all drugs, can cause dangerous interactions with other drugs or chemicals in the body.

NIDA Article: Non-medical Use of Prescription Drugs Among Youth 2003
 

INHALANT USE – THE SILENT EPIDEMIC

According to the National Inhalant Prevention Coalition, more than a million people used inhalants to get high just last year and by the time a student reaches the 8th grade, one in five will have used inhalants. The abuse of inhalants is called a “silent” epidemic because the significance is not widely known. Inhalant abuse is intentionally inhaling or sniffing a product to get high. Inhalant highs are the result of toxic chemicals getting into the brain tissue where they are capable of causing irreversible damage and sometimes death. Because the chemicals in inhalants enter the lungs in such high levels and go directly to the brain, they are very dangerous.

Inhalants are cheap, readily available, usually legal, and widely perceived to be harmless fun. Kids do them out of boredom or as an escape from loneliness. According to National Survey on Drug Use and Health, the inhalants most often used were glue, shoe polish, or toluene, followed by gasoline or lighter fluid, and then spray paints. It is estimated that there are over 1,000 products that can be abused as inhalants.

The highest incidence of use is among 10-12 years old children with rates of use declining with age. According to the National Survey on Drug Use and Health, during 2003, almost 23 million (9.7%) persons ages 12 and older reported using an inhalant at least once in their lifetime. The 2003 Monitoring the Future Study from the University of Michigan reported that 8.7% of 8th graders, 5.4 percent of 10th graders, and 3.9 percent of 12th graders used inhalants in the past year. Parents worry about alcohol, tobacco, and drug use but many are unaware of this silent epidemic on inhalant use.

Some helpful resources are:

National Institute on Drug Abuse at www.drugabuse.gov
National Inhalant Prevention Coalition www.inhalants.org
New England Inhalant Abuse Prevention Coalition www.inhalantprevention.org