Drug addiction: moral failing or illness or a combination of both?

[Stinky The Clown]

This is in light of the Corey Haim story, but asked in the far larger context of drug addiction as a national/worldwide matter.

Please comment as you see fit.

[nadinbrzezinski]

1. Genetic predisposition

hence disease... with some social components.

But moral failing... none whatsoever. I don't care what the religious inclined like to say about it. Reams upon reams upon reams of studies that show that indeed it is a disease.

[Donnachaidh]

16. total agreement.

How the hell could it be a moral failing when it's practically shoved down our throats daily? Not the *illegal* drugs, but I dare you to turn on a radio or TV anywhere and go an hour without some advert offering *relief* in pill form.
Constipated - take a pill.
Can't get it up - take a pill.
Don't have time in your busy day to stop and take a piss more than once - take a pill.

When you have generation problems with genetic predisposition to addiction -- you have problems. And we have Big Pharma which sends out it's pharmacological pimp messages DAILY.

[Mari333]

2. not moral failing

a lot of people become addicted to legal drugs from their doctors. it happens all the time. xanax, valium, vicodin...its very easy to become addicted, and if you are in terrible pain, and with no other alternatives, you take them.
it happens to a lot of people. we do not have enough facilities in this country to help people get off a lot of these substances.
I have seen this happen in my family, someone in horrible horrible pain become addicted to painkillers.
its a nightmare. but it happens.

[John Q. Citizen]

19. Here a facinating presentation on some research on pain relief. This is revolutionary.

Check it out. The presenter is a highly published scientist with funding from NIDA (National Institute of Drug Addiction

http://www.youtube.com/watch?v=JRFnGS1XPe4

[Mari333]

25. thanks for that

I recently helped a good friend of mine purchase that for her fibromyalgia..even tho we have new laws in michigan for medical marijuana, the waiting list is 5 YEARS. so she is in so much pain, I took a chance. I never did that before. but what can you do when you see someone writhing in so much pain??

[Kitty Herder]

71. In 2008, I lost a both a cousin and an aunt to drug overdoses.

My aunt overdosed on prescription pain medication; my cousin overdosed on heroin. One's drug was legal, the other's was illegal, but they're both gone. My aunt was medicating her physical pain; my cousin was medicating his emotional pain. I would love to see the development of better methods of dealing with both types of pain. I think we could start with legalization of marijuana for pain control. It might decrease the need for highly addictive opiates in at least some patients.

We also need to start taking mental illness seriously and making sure that those who need treatment can get it. That would require an acknowledgment that those with mental illness often are desperately poor, can't hold a job and therefore can't afford treatment. The state has an interest in making sure that treatment is available to them.

[John Q. Citizen]

3. Genetics plays a role. Some people are far more suceptable than other people.

Some people need a lot more Novocaine at the dentist to numb a tooth than other people do.

Everyone isn't the same physiologically speaking. So drugs interact differently and to different degrees in diffent people.

Even the placebo effect seems to be variable, both within the same individuals and in people as a whole.


Yours isn't a simple question, but I suspect you will get some very simple answers.

[randr]

4. Addiction can involve many forms of behavior

A combination of poor self esteem, poor role models, and at times a genetic trigger.
Addiction is not a criminal issue! We need to see people who are struggling with substance abuse as in need of medical or psychological help. The "war on drugs" is a big business reliant on the failings of the human condition and preys on these people just like a loan shark.

[mudplanet]

37. I work with substance abusers and I agree.

I'm on the fence whether it's an addiction or a disease. If you're sober when you wake up in the morning and drunk at noon, somewhere along the line you made a decision to take a drink (same applies for any substance). There isn't any little worm in your head controlling your behavior.

In the 1970s the mental health field decided it was a disease and, if it's a disease, it's a mental illness. Thus hundreds of thousands of alcoholics filed for disability benefits and got them. Social Security then decided that they were enabling drunks and made substance abuse virtually a disqualification for receiving benefits, despite the fact that many, if not the majority of the mentally ill fall into substance abuse in an attempt to cope with their illness.

What it clearly isn't is a criminal issue.

[TwilightGardener]

5. Illness--I always see addiction of any kind as a manifestation of

an underlying mental or emotional problem. Excepting, of course, those in physical pain who become dependent on pain relief.

[Happyhippychick]

6. My personal experience? Undiagnosed issue such as bipolar, depression or similar.

The bulk of my patients with addictions issues have co-morbid syndromes which they have been self-medicating for years. Mostly depression and bipolar but borderlines, anxiety and OCD have a part as well.

I don't even begin to understand moral failings so I can't comment on that.

[CoffeeCat]

49. And aren't most "mental illnesses"...

...simply responses to trauma or pain? I was diagnosed with PTSD due
to childhood trauma. I'm actually proud of the way my mind coped and
helped me to survive. I love my PTSD symptoms and how they got me
through years of pain.

I became hypervigilant--to steady my body and brain for the next bad
thing that would happen. Without that hypervigilance, I surely would
have had no emotional protection. Every abuse incident would have
been more shocking to my system. I also was depressed as a child--my
body and mind were slowing--to deaden the pain. I tend to look at the
depression as a safe cocoon. The nightmares were the truth leaking
out--as I got stronger. The mistrust of everyone and the control
issues were learned responses.

In my mind--mental illness is not an "illness" but a series of incredibly
resourceful coping mechanisms. I'm thankful that I coped that way! I'd
probably be a pile of mush if my mind hadn't coped the way it did.

The trick is---shedding those coping mechanisms from childhood-->adulthood.
Hypervigilance, depression and always having to be in control become roadblocks.
My therapy and recovery has always been about thanking those parts of me that
were so resourceful and smart--and convincing myself that it's ok to drop those
coping mechanisms.

I really have a problem with calling a lot of this "illness" or "mental illness".

I see so many others who have endured childhood trauma, and I listen to their stories
and their diagnoses. I wish society could look at depression, bipolar disorder, etc.
as wise adaptations, and not as sickness or illness. It suggests that something is
very wrong with that person, when quite possibly, the adjustments that the person made
were necessary and quite smart.

I wasn't "ill"...I was dealt a pretty heavy hand and I "coped".

Just my take on it... :)

[Happyhippychick]

60. Kudos to you, I honor your resilience and outlook!

It is such a rich topic, the question of whether these challenges are brain chemistry, response to circumstance or combinations of possibilities. One thing that I do in my practice (since my opinion on this topic is so fluid) is to choose to practice a strength-based model and not a disease-based model. That coupled with my assertion that all of us deserve compassion and empathy helps me to inspire my patients to believe in themselves as much as I believe in them. So many did not receive that kind of acceptance in childhood.

[Ozymanithrax]

7. Addictions are not a moral failing...

An addiction results in the addict being abnormally tolerant to and dependent on something that is psychologically or physically habit-forming. In physical addictions, such as drug addictions, the body will go through extreme biochemical changes that result in both pain and various types of acute mental trauma without the drug. Some drugs require multiple uses to develop a physical addiction, but there are others that after only one use the user will physically crave and go through withdrawal.

Addictions, even psychological addictions, result in changes in brain chemistry, so that the addict requires the addictive substance to function in a normal manner.

Addiction can happen to anyone, though there are genetic predispositions. Alcoholism, addiction to alcohol, appears to have a genetic component.

Addiction is an illness. Morality has nothing to do with it.

[BlueIris]

8. Genetics are a part of it, but the social environment one is raised in is relevant,

as is one's personality. No, I don't think "personality" is the culprit, but I don't think recovering addicts can blame everything about their terrible choices on the disease, either.

[Mari333]

11. elaborate

[Stinky The Clown]

15. You're getting into an area worth some discussion. Can you elaborate on your views?

For example, do you think it more likely an addict fresh out of rehab is less likely to relapse in a nice suburban environment than back in the inner city?

[Mari333]

18. an addict fresh out of rehab can relapse no matter where they live

because drugs are in every burg and small town in the world.

rehab is never enough. there has to be a consistent follow up, therapy, etc.

[Stinky The Clown]

21. I know that painfully clearly. My question was posed to the other poster.

[John Q. Citizen]

26. As a friend of mine who successfully kicked heroin addiction said,

"You don't need to find drugs. When you are an addict, drugs find you."


He's been clean and sober for the last 12 years.

[Mari333]

29. good for him.

:)

[Stinky The Clown]

35. I also agree with you that drugs are, literally, everywhere

And of late, around here, heroin is potent and dirt cheap.

[Ozymanithrax]

43. There is no one answer. Genetics may play a part...

Why do some people drink responsibly all their lives and others become alchoholics? My father and stepfather were alchoholics. I am extremely carefull about drinking anything with alchohol in it. Maybe I'd never develop the disease, but who know.

A lot of people use drugs in an experimental phase and then leave them behind. Others become adicts and drugs destroy their lives? The issue is complex.

[mitchum]

9. Illness and a desire to transcend the mess of life

[southern_belle]

10. Addiction is not a moral failing n/t

[L0oniX]

12. Addictive nature genetics, education, moral failing and mental illness ...bipolar?

Moral failing IMO is the choices made as to who you would choose for friends. If you want to stray away from drugs then don't hang with druggies. Do I have to point out that many addicts become hookers? Maybe it would be more correct to say that the moral failing comes after the addiction.

[Echo In Light]

13. Greed is the worst addiction of all. Funny how there's no 'war' on that.

[L0oniX]

17. Class warfare.

[Better Today]

14. Moral failing? Have you ever investigated the early childhoods of

many drug addicts. I can't say for everyone, but my brother was/is a junkie. We lived the upper mid class life with parents, a doc and a teach, who were two of the most abusive people on the planet, physically, emotionally, and psychologically devastating people to live with.

I have no question that my brother ended up with some "moral failings" after starting on the drug route, but it began as simply a manner to avoid feeling, to avoid thinking, to avoid hearing the constant repetitive degrading dialog that ran through his head, that had been beaten into him (and me) on a cruel and daily basis.

And before you or anyone points out that I went through the same parents and didn't do drugs (and I didn't do drugs), I nonetheless had my issues with a severe disassociative mental illness well into my 30s before I looked around and realized that I either had to get squared up or I had to let someone else raise my children. I chose the former.

There are many reasons why folks become drug addicts, it cannot be whittled down to an either/or question.

[Stinky The Clown]

20. What *I* have or have not investigated isn't germain to your point, is it?

Not being argumentative, but all I did was pose a discussion topic inspired by the apparent OD death of a former actor.

I have my own very current, very up close, and very personal addiction observations.

[Better Today]

28. After reading your entire response, I would say it is germaine because

if you have personal addiction observations, then your question seems even more careless and thoughtless than it did when I thought you had no personal experience with addiction observations.

[Stinky The Clown]

32. How so? How is my OP careless?

Those are the generally accepted views of addiction. One is mostly true. One is mostly false, and one is some of both. The question was posed to see how people feel about the issue and the wrong view was specifically to give permission for those who see it that way to so say and even defend their view.

You were saying ...... ?

[Better Today]

33. Generally accepted by whom? You? Certainly not anyone with

any actual experience directly or near directly (such as friends and family of addicts).

If you don't see how it is thoughtless and careless, then you've shown a lot about yourself and your ability to think in fully and analytically.

[Stinky The Clown]

34. So it is your view that drug additction is a moral failing?

I can only conclude that by the fact that you seem to feel the need to argue with me on my views - which, by the way, I purposely haven't clearly stated.

Or pretty much as likely, you started to argue and now, in the light of an internet audience, have to try to stick to your point.

[Better Today]

54. Then you conclude incorrectly. Have a lovely day!

[Turbineguy]

24. +1

[Johonny]

45. morals are set by society

It's pretty clear that modern American (and most of the world) society views drug abuse as a moral failing. The same goes for drink alcohol and even smoking. Heck even prescription drugs are set up as to try to prevent you from abusing them. Most(many) of our religions consider the abuse of these things a sin. Many laws are written to prevent or discourage their use. So it's hard to argue that it is not a moral failing considering modern morality. There is the morality we pretend to have and the actual morality of society. Clearly for the amount of negative things American society says about drug use, it's still very popular. However morality of society does not need to be set in reality.

It's hard to argue people are also not ill that are addicted. My uncle has/had a horrible drug addiction most of his adult life. No one in the family would call him well.

So the answer is both but the answers don't really tell you anything interesting. I mean the op ed has little value because of you last statement (the reason people use these drugs is the real interesting question).

[The2ndWheel]

22. It's the availability of X, Y, or Z that makes it such an issue

It's easy to get drunk, or high, or whatever. There are some hoops you may have to jump through to acquire it, but obviously it's possible to get. If there wasn't as much food available, you're not going to gain the weight. If there wasn't as much alcohol/liquor available, you couldn't become an alcoholic. Porn, drugs, information, work, isolation, everything, it's all so available, and easy. How could we not get immersed in it? That's the world we've chosen. It's what we want. The creating of that world could be thought of as an addiction. It's becoming easier and easier to create that world, that world is more available to us. For good or bad, we want easy and affordable access to whatever we choose to want. We have to live with it then.

[LynneSin]

23. There has always been some preverse idea of getting the teens partying was a good thing in Hollywood

Look at the lives of Drew Barrymore, Tatum O'Neill, Corey Feldman, Robert Downey Jr, Lindsey Lohan, Britney Spears - all of them made it big and all of them started partying when they were very young. ANd for some reason Hollywood accepted this as normal.

And every once in awhile you get a Drew Barrymore who managed to survive her stint of drug abuse (which if I recall started when she was 8 years old) to clean up before she was 21 and lead a productive life. Sometimes it's a Robert Downey Jr that takes a few attempts to make a clean break. But I worry about the Lindsay Lohan's - why has no one intervened with this girl and get her real help. Even Brittney's father stepped in and essentially took ownership of Britt's life in order to clean up her act.

Then you can get an Anna Paquin or Natalie Portman who both seem to have adjusted fine from being a talented child actress moving into a viable Hollywood star in their adult years. I don't think either of those gals ever got too mixed up in the drug culture.

[Stinky The Clown]

39. Add to your list ......

.... Jody Foster.

Some make it and some don't and some overcome it. Just like kids from everywhere.

[LynneSin]

47. Jody has done well for herself but she does seem the bit of a recluse

But I think that has more to do with the John Hinckley thing than her being a child actress.

[Laura902]

27. You can't just encompass all addicts into a category

especially into the category of having a moral failing, who walks along the streets at the 25 yr old guy smoking and thinks about the persons morals? For every addict, who happens to be a human being, the circumstances are different, the substances used are different and how/when they grew up is different. Corey Haim, just like many who were child stars may have grown up in an environment that was stressful and caused some lasting damage.

[Stinky The Clown]

30. I didn't think I was trying to 'encompass' any group into any category ..... was I?

[Uben]

31. No, it's not a disease......

... it is what it is....an addiction. I'm addicted to cigarettes...my brain craves the chemicals in them. I don't have a disease. If I quit, I am not cured, I will just be disciplined. The same goes for drugs, which I have used in the past, but no longer do. You can call it a disease if it makes you feel better, but it is really just a matter of self-discipline. My proof is the millions who have quit smoking permanently. I have quit, for years at a time, but one lapse of discipline, and the cravings return.

Alcoholism is not a disease, either. It falls under the same heading of discipline. Alcoholics crave alcohol because their brains tell them they need it, just like over-eaters crave food.

Some diseases can be cured by simply taking a pill or other types of medication. Drug addiction can only be alleviated by self-discipline. Yeah, there are some things that can help that occur, but ultimately, it is self-discipline.

I don't care if you agree or not. That's my opinion, and really, that's all it is.

[Stinky The Clown]

38. I want to thank you for a honest, easy to understand, straightforward post

No snark intended.

We disagree, but as you say, it is opinion, and that's all.

I don't see it as you do and disagree with you pretty much point by point. But I expect your mind won't be changed by my stating my opinions and mine won't be changed by yours. And that's okay.

[Uben]

40. I take most all posts as opinions...

...except for news items. Too many here take things too seriously. We all have opinions, and most all of those are biased to some degree. You are right in assuming your opinion will not change mine.
And, I am quite certain mine won't change anyone else's. It is what it is.

I usually take the "realistic approach" on things based on my own logic and knowledge. I'm not always right, but then again, who is? Now, if we could just get these bastards in congress to do the same, maybe we could get single-payer passed! To me, it is the most logical approach to solving HCR. The one fatal flaw in it is that it does not increase profits for the insurance industry, who we all know heavily funds campaigns for re-election. That's where a politician's logic is swayed by their political survival. Wouldn't it be nice if they could just do what is right for a change, without regard to what it would do to them politically?

[RaleighNCDUer]

61. I, also, believe it is not a disease but a symptom.

You don't 'catch' addiction by being around addicts. You can't cure addiction by taking a pill or having an operation (both approaches have been tried).

If you are able to root out the underlying cause for the addictive behavior, then you have a chance of a 'cure' - but depending on the substance you may or may not eventually be free of the cravings.

Self-discipline can set you on the right path, but it can't do it alone - that tends to put it back in the 'moral failing' column, because you remain addicted because of your lack of self-discipline, and I don't believe that. I don't know if other drugs have equivalents to 'dry drunk', but with alcohol addiction you can have splendid self-discipline and never take a drink, yet still do insanely crazy shit - the same stuff you might do while drinking - because the underlying cause for the addiction was not addressed.

IMO.

[Lilith Velkor]

63. If you still do insanely crazy shit, then your self-discipline is not splendid.

Hate to break it to you, but the 'dry drunk' concept is a superstition invented to justify bigotry against honest atheists.

[RaleighNCDUer]

66. Huh?

What on earth does substance abuse have to do with atheism?

And the self-discipline I was referring to was, in keeping with the thread, only about not partaking of that drug. If you are not drinking or drugging, but engaging in the same self-destructive behaviors you did WHILE drinking or drugging, there is obviously something more wrong with you than the infusion of that drug. I was saying that having the self-discipline to keep away from that substance is NOT the be-all and end-all of the problem. It is merely a path to addressing the problem.

[Lilith Velkor]

68. I was saying that selective self-discipline is not really self-discipline.

As for your question, are you familiar with the prevailing "treatment" for substance abuse? Your use of the jargon led me to believe you were, but perhaps not.

[RaleighNCDUer]

70. OK, I get it. And I agree - selective self-discipline is not real self-discipline.

And I've known plenty of people who were so proud of staying dry, even in AA, who continued to be appallingly self-destructive. I also believe that AA (and its ilk) is closet evangelism, and there are other ways other than depending on invisible beings. I can see how AA can work for believing Christians, but being told I had to get on my knees for the third step prayer rankled.

But that leads the discussion in a different direction, in which I would rather not take it.

Suffice it to say, self-discipline is only effective with understanding the core of the problem - without that understanding there is no solution that mere self-discipline can effect. You just wind up repressing and getting crazier.

I think we are in agreement, essentially, as my contention is that 'dry drunk' is a result of not addressing the underlying issues, not a matter of 'surrender to a higher power'.

[galileoreloaded]

36. Usually a disease of excess...............n/t

[Deep13]

41. It's a medical condition caused by ones biochemistry...

...becoming adapted to a foreign, chemical agent. When that chemical is suddenly missing, the body craves it like it would crave water, glucose or salt, but often much worse. In some cases the withdrawal itself can be fatal.

Nevertheless, using addictive chemicals remains a voluntary action that cannot happen unless one decides to do it. And since one is always responsible for his actions, there are aspects of addiction that can fairly be described as immoral and egocentric.

[CoffeeCat]

42. When I was in a support group for...

...trauma I suffered during childhood, there were about 20 others in the group.

I was truly shocked at what I saw and heard--but not judgmental. Most of them
were addicted to drugs and/or alcohol and many of them were food addicts--eating
to soothe and lessen the pain.

My experience is my experience--but I feel that a lot of addiction is an attempt
to numb reality or abuse/trauma/pain from the past. When abuse happens in childhood--you
learn to numb out and you never learn how to cope with basic feelings and emotions. These
kids are forced to deal with an inordinate amount of feelings and pain that would be
an almost-impossible burden for any adult. Numbing out and stuffing feelings becomes
essential for day-to-day survival.

As they grow older, these kids continue to stuff their feelings--and when they are exposed to
drugs and alcohol--as all kids are--they find even greater relief. Then the addiction
begins. Physical addiction and psychological addiction.

Some kids may be more genetically prone to addiction, but there are those who may not
be genetically prone--but find enormous emotional relief from the escape that drugs
and alcohol provides. Emotional addiction can be even more powerful than physical
addiction.

Not every drug addict or alcoholic was abused as a child. However, many abused children
grow up to be addicts to numb their pain. Society doesn't want to deal with child
abuse, especially sex abuse. So, victims feel that they must hide and be ashamed. Most
of those in my support group were addicts and very few could hold down a job. They
were shattered.

I see the bulk of addictions as a response to unimaginable pain inside people who had
their development derailed--leaving them ill-equipped to manage stress, feelings and life
in general. These people have my utmost respect and empathy.

[RainDog]

44. Medical Issue

the moral failure thinking comes from the same line of thought that bred creationism.

[Stinky The Clown]

55. +1

[Lyric]

46. It has nothing to do with "morality". I think it's a combination of genetics and trauma.

People who are already genetically-predisposed to physical dependency, and who are trying to self-medicate to deal with trauma or pain that is otherwise ignored or untreated. More often than we realize or care to admit, it's about real, physical pain that's left untreated due to a lack of access to healthcare and/or proper pain management. That's not the case for EVERY addict, but like I said--it's more common than you think.

Example scenario: A young man has severe, chronic back pain. He can't afford insurance and he can't get Medicaid because he has no dependents. He can't hope to be able to pay for physical therapy and/or surgery to actually FIX the problem, so he tries to get the medicine he needs to cope with something he can't fix. He tries to get pain relief at local emergency rooms so he can keep working, but is soon labeled as "drug-seeking" (which he IS...but not in the way they think.) Since back pain is often very hard to verify via medical testing, the doctors assume that he's just looking to get high. The "drug-seeking" label goes into his permanent medical records. That label effectively brands him forever; no ER doctor will EVER prescribe narcotics to someone with a history of "drug-seeking"...at least not unless he shows up with a bullet in his leg, a major broken bone, or a kidney stone (verified on CT) the size of a nickel (and even then, only very small prescriptions for weak pills.) This young man has been effectively shut off from any hope of the healthcare he needs. Health insurance is way out of his affordability range, but he can get Vicodin pills for $4 each on the street for less than half the cost of a crappy insurance plan; unlike a "recreational" druggie, he doesn't need fifteen of them a day to maintain a "high", so his drug costs tend to be pretty stable. However, eventually even THAT amount begins to strain his finances. In order to afford the street Vicodin, he turns to boosting cat stereos and video game systems that can be resold to fund his self-medication, without which he wouldn't be able to function. Voila--another drug criminal is born.

Everyone like to assume that drug addicts are just a bunch of weak-willed idiots who only care about getting "high," but that is not always the case. I can't speak for the rest of the nation, but in my *personal* experience with friends and family members, using just to "get high" is incredibly rare. Almost every addict I've ever known was a narcotics/marijuana addict looking to treat pain because they were shut out of the legitimate healthcare system. The saddest irony is that BECAUSE so many of these people are trying to self-medicate, and BECAUSE a handful of college idiots keep OD'ing at frat parties every year, local doctors get more and more paranoid about treating pain patients and the pills become harder and harder to legitimately obtain--thus continuing and intensifying the cycle.

I'd bet you dollars to doughnuts that if you did a nationwide sweep of all drug addicts over the age of 25 years old, you'd find that most of them are poor people suffering from chronic, painful conditions that they can't get proper treatment for. If a poor Medicaid recipient and an upper-middle class executive walk into the same doctor's office with the exact same complaints about a painful back problem, chances are that the Medicaid recipient will go home with a useless script for Naproxen, and the well-dressed exec will go home with Percocet or Vicodin. I know this for a fact, because that last part happened to ME when *I* was younger. I was in the waiting room for the orthopedic doctor because of a herniated disc that had me crying in agony and half-paralyzed. The lady beside me was an older, well-off woman with the same complaint. I could hear what went on in her room--she was right next to me. She had an L5-S1 herniation with spinal nerve root damage, same as I did. She got a cortisone shot and a prescription for Oxycontin. I got sent home with a prescription for physical therapy I couldn't afford (because I had no childcare) and Naproxen.

I spent eight months recovering my ability to walk and dealing with the worst agony of my entire life, and I did it without any help from a doctor because after I begged them for help and they treated me like a druggie, I didn't TRUST them anymore. It took me YEARS to heal enough to be able to fully function again. I am the bitterest person you could ever imagine when it comes to doctors who think that "poor" equals "untrustworthy". I've made a lot of friends over the years who had similar experiences--people like me, from poor backgrounds, who were discriminated against and treated as "high-risk" for drug abuse because they were poor and on Medicaid. You have no idea how many times this has happened to me. The herniated disc was just the first time. I could write a book about my horror stories with the medical establishment and their automatic suspicion of (and lower-quality treatment of) people who are obviously poor. And it's not just the lack of access to decent pain management. It's EVERYTHING. Less access to Open MRI procedures. Less concern about proper anesthesia (happened to me.) Being treated like an uneducated idiot instead of having the doctor fully explain what the hell is going on (at least until I prove my intelligence and demand more than that.) Being treated like a potential criminal. Being talked-down to in a way that no doctor would ever do with a well-off patient. Over and over again, it happens. It's dehumanizing. It's traumatizing. It's a nightmare.

I've managed to hurt my back again, and in about an hour, I'm on my way to the doctor to have it checked out because after three days of bed rest, ice, heat, and ibuprofen, it's still no better. In order to try and avoid receiving the "poor person" treatment, I'm actually dressing up for my doctor appointment in order to try and "pass" as someone in the middle class...even though I can hardly walk right now and wearing anything more complicated than sweats and a t-shirt is going to be hell. But I've learned the hard way--you walk in LOOKING poor, and they're going to treat you like you're either a druggie or a criminal looking to score pills and resell them.

Yeah, I'm a little emotional about this subject today. Pain tends to do that, and I don't have much hope of any relief. I just need to find out whether this is another bulging disc about to herniate, a torn/strained set of muscles, or something else entirely--like my kidneys. I have zero hope of pain relief. I know better by now. Rule #1 for poor people seeking temporary pain relief: don't bother asking unless you're broken in two and bleeding on the floor, 'cause it ain't gonna happen.

[Mari333]

52. +10000000000000000

[old mark]

48. Many addicts - probaly most-see themselves as having a "moral failing", adding

to the misery of the addiction. Distain by the righteous of society does no one any good. When I worked in rehabs and counselling, I found most seriously recovering addicts are very good people once they are able to drop that baggage....many of us use a 12 step program to help with that.

FWIW, I have 22 years today - 3-10-10.

mark

[Mari333]

50. yay

hugs

[EFerrari]

51. Happy birthday, mark.

:party:

[mochajava666]

57. Haven't dropped all of the baggage yet.

I've been sober over 10 years, but I'm still seeing a shrink every 2 weeks to continue my recovery. For me, the actual quitting of alcohol was easier than filling in the void left by the bottle...and the guilt of under performing as a father and husband.

As for the OP, it is NOT a moral failing. Genetics has a lot to do with it, since it runs in families. I think there is some biochemistry involved, too (seratonin, etc.). Previous trauma can also play a part.

I've also found it impossible to describe addiction to a non-addict. It like describing color to a blind person. Unless experienced first hand, it just can't be fully understood on an empathetic level.

For clinical modeling purposes, alcoholism defined as a disease works pretty well, but isn't a perfect model.

[old mark]

67. I think it's about as close as they can get....You are not alone, certainly

not here.
Keep going, friend.

All the best.

mark

[mochajava666]

69. Thanks. You, too.

[Winterblues]

53. Tobacco addiction is the leading cause of "Avoidable" Death in the USA

Drug addiction is very hard to overcome and tobacco is among the very worst..It is neither immoral nor a sickness, it is an addiction and it can be overcome..

[Tailormyst]

56. Mental illness

[ShortnFiery]

58. Mental Illness linked to a strong genetic predisposition. eom

[pitohui]

59. it seems to be an illness out of the person's control

you see some people who struggle who just never seem to get away from it, unfortunately, it's one of those illnesses that make you not want to be around the person -- one of my high school friends got away from drugs for 3 yrs and we all had great hope but eventually she was back smoking crack again -- crack is the worst in some ways, it never seems to kill the person, so they're around for decades draining all their family and friends of money and hope

at some point i made the decision to cut the drug addicts out of my life, it may seem harsh, but i can't help them, i'm only hurting myself by continuing to assoc. with them

i realize they don't choose to have a disease that affects the brain and makes them lie and steal from the people closest to them, on top of all the physical issues caused by the drugs, but i'm not qualified to do anything to cure their disease and getting involved in their drama needs to be left to the professionals

we need to find some kind of real cure -- the "treatments" we have such as AA work only for a small percentage

i can't believe some of the otherwise bright, funny, attractive people i knew (or at least they were bright, funny, attractive before the drug ate their head) made any kind of choice to be an addict, who the hell would CHOOSE that life? to be a "moral failing" i think there would have to be a deliberate choice to go down that road...

[robdogbucky]

62. Just wanted to add my opinion

I think there are multiple reasons for addiction, just as there are multiple arrays of brain chemistry, environment, genetics. We see drug addiction in all strata of society, so simple economics does not seem to be the reason for it, just maybe explains which drugs are used to fuel the addiction. Athletes get strung out from pain relief regimens, etc.

Please not with the moral failing thing.

I recalled a factoid that points to the pharmaceuticals and how increased use (imagine that when there are so many ads promising freedom from impotence, baldness, anxiety, weight gain, etc.) and that was in a news article someone posted here on DU within the last year but could not be found on a quick Google search here. I'm sure it can be dredged up on search engines. Point being that the story was about how in 7 states this year, the deaths from overdose of pharmaceutical drugs have outstripped the numbers of deaths in auto accidents for the first time. I don't think they made any distinction between accidental or intentional. This is the first time that has happened. I think it also was noted these deaths exceeded deaths by illegal drug overdose as well. Auto deaths is a benchmark used to compare to all sorts of things. There was included I recall, a chart of increased use coinciding with increased advdertising of pharmaceuticals in our media. This sheds a new light on the role of big pharma in this issue.

On a sociological note, I know from past research, that prior to the Viet Nam experience, heroin addiction was widely held to occur in men, mostly men with broken homes, in minority communities. These males were seen as weak, from homes without strong fathers, essentially mamas' boys. It was also held as gospel truth prior to the Viet Nam experience, that heroin addicts can never be cured. That they are permanently and hopelessly addicted, with only prison or death as a way out.

Then Viet Nam happened and a whole lot of middle class, working class white kids, all across the social strata, became heroin users while participating in that conflict in Asia. Well, the figures by professionals were turned on their heads. Many of these vets that had used junk while in country, kicked upon their return and never went back to it. This did not coincide with the medical beliefs of the day that addicts were hopelessly addicted, that it was a certain demographic that fell prey to addiction (namely minority boys from broken homes) as many of the kids that had used while under the stress of being there were able to leave it alone once they kicked, upon their return to the USA and resumption of their lives. Of course there were some that did not kick or stay away from it, but rather felt they had no hope of doing so, most likely due to the communities/homes/economic conditions they returned to.

But the medical community's thinking had to be permanantly changed because they saw thousands that used while under the stress of being over there, and were able to stay clean once back and removed from the stress and from the easy access to heroin. Believe me, one month of almost daily heroin use (these guys would snort the boy and go on patrol)would have anyone strung out, whether snorting it or shooting it. Why did they not resume the addiction once back stateside? Seems like a complicated set of data that definitely caused re-examination of their underlying theories of addiction to heroin.

People fall prey to it for a myriad of reasons, even those with lives of privilege. What has always been a more fascinating questions to me was why don't more become addicted, or how can some be addicted for a while, then walk away from it forever?

Whatever the reasons for it begininng, the cause for its ending are usually up to the user and their ability to resolve not to continue. If you don't have a reason, you won't be motivated to quit and stay quit.


Just my dos centavos


robdogbucky

[Heidi]

64. It's an illness. My ability to be compassionate doesn't hinge on the source of the illness.

And "moral failing" is a value judgment that shouldn't mitigate one's ability to be compassionate.

[NashVegas]

65. I'd Done Most of the Drugs That Were Out There By 1985

Never did heroin. Never did PCP. Pretty much everything else, recreational purposes. Never had a problem stopping when I chose to.

My dad was an alcoholic; my mom's mom was an alcoholic and she drummed the mortal fear of addiction into our heads but substance abuse, itself, not so much. Perhaps it was her cigarettes or the occasional glass of wine.

My best friend and I did once have a conversation based on the phrase, "drugs are a crutch for people who can't handle reality." "Yes, and thank goodness we had that crutch," we both agreed.

Our society is ever-increasingly rational. Hyper-rational, even. Handling reality (I call this, "owning your shit," as opposed to finding reasons for it) with aplomb, and thriving, takes emotional skills. Not having them isn't a moral failing, IMO.

[TheKentuckian]

72. I view it primarily as a misuse of government power issue by attempting to regulate such things by

use of the criminal code.

from the individual side I would tend toward a mix of illness and personal/genetic inclination.

[Kitty Herder]

73. Taking a substance into the body is morally neutral, in my opinion.

Foolish, perhaps, but morally neutral. It can lead to immoral behavior like stealing, but the act of using itself is not wrong.

I believe that drug addiction is an illness. And it's usually an illness that stems from other underlying illnesses. I lost two relatives to drug overdoses in 2008. One overdosed on heroin, the other on prescription pain medication. They were both medicating their pain--emotional in one case and physical in the other.

My father was a severe alcoholic. He tried and tried and tried to quit. I lost track of how many times he was in rehab. He could not quit, but at least he kept trying. He clearly had a illness. I'm not sure how much of the addiction was physical and how much was mental, but both are real, serious illnesses. He had underlying mental health problems. He had been abused as a child and had PTSD from Vietnam.

I think we need to get a whole lot better at treating the underlying conditions that seem to lead to drug addiction. We also need to stop judging people for using substances to treat their pain. Understanding and a willingness to help are needed.

[hunter]

74. Attributing drug addiction to "moral failing" is a moral failing.

Drug addiction itself is a complex medical and social problem. This wouldn't be a difficult problem to solve if we quit the "war on drugs" (which is a moral failure) and started addressing the medical and social problems of drug addiction.

For example, the real consequences of opiate addiction are things like constipation and accelerating use. There are plenty of old people with brittle bones taking high doses of opiates who are quite functional and not sharing dirty needles or breaking into peoples houses to steal video games and jewelry. Their neighborhood pharmacists are not out on the streets shooting at one another in bloody turf wars.

The problems we attribute to drug addiction -- AIDS, property crime, prostitution, gang violence, etc., are caused by our society's failure to address the actual problems of drug addiction.

We could end the "war on drugs" immediately if we treated every addict as an ordinary medical patient, not a moral failure, and we made the drugs they are dependent on easily available as they entered treatment for their addictions and addressed the mental health and social issues that caused them to become addicts.