In and around the world of addictions treatment and recovery support, you’d be correct in suggesting the title of this post is something of a million-dollar question (or GBP £830288.95 if you prefer).
But first… what do we actually mean by the word – addiction?
According to the American Society of Addiction Medicine (ASAM): “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”
The above (in-part) tends to fuel the often vociferous arguments around the question being posed here. Firstly, not insignificant amounts of cash change hands during addiction ‘treatment’ in the USA, it’s almost a guaranteed cash cow, given the levels of apparent addiction in the american population. Secondly, many people choose to fixate on the “chronic disease of brain” aspect of the definition because, if addiction is a disease it can be treated… caching! Too often the psychological factors that led to that “…individual pathologically pursuing reward and/or relief…” are ignored.
As I’ve written before (see here); the ’causes’ of addiction are as many as they are varied. Each individual impacted by a substance or behaviour, will often have experienced one or more of those causes at some point in their life.
The NHS in the UK say: “There are lots of reasons why addictions begin. In the case of drugs, alcohol and nicotine, these substances affect the way you feel, both physically and mentally. These feelings can be enjoyable and create a powerful urge to use the substances again.”
In the case of substance abuse (for example, drugs and alcohol), an addiction can have serious psychological and physical effects. Some studies suggest addiction can be genetic, but environmental factors, such as being around other people with addictions, are also thought to increase the risk…(NHS-Addictions)
Today, many in our society hold a predominant belief which says; “my ‘medication’ will make me feel better than I do now” – irrespective of that substance being a prescribed medication or an illicit one.
I don’t usually subscribe to conspiracy theories however; in so many ways and for decades, we’ve vigorously been sold the ‘magic pill’ by Big Pharma. Or, told by the drinks industry that a cool beer or glass of wine will help us to relax. Society’s overt commercialism has conditioned our thinking to always search out the ‘cure-all’ medication. Something that will, for every given set of physical and psychological ills, provide us with a level of relief from the circumstances we find ourselves experiencing. The problem is that the ‘medication’ merely props us up in difficult times or, serves to blot out or disguise what we are experiencing.
We need to learn that it’s not the actual events that make us feel crap per se, it has more to do with what we’re actually thinking about those events. Our feelings and consequently our emotions are built on the beliefs we hold, or believe we should have. In turn those thoughts fuel our emotions and reactions. And subsequently, they eventually dictate how we react to what we hear, see or physically experience.
From whichever side of the addictions causation divide you come from, for yourself or anyone you are treating / supporting into recovery, the incessant [cause] debate also presents significant negative impacts for the individual who is searching for recovery. These arguments serve only to build greater clinical, therapeutic and social barriers to recovery. As big if not bigger than the social stigma ones that sadly but so clearly already exist.
These are all barriers that we should be working to dismantle, assuming we truly want to support sustained and long-term recovery from addiction!