Friday, August 26, 2011

Accepting that Alcoholism and Drug Addiction are Diseases


Peter Coleman, M.D.
It is becoming hard to remember just how much society has looked down on alcoholics and people with drug addiction problems. Since the beginning of recorded history, there have been references to the fact that, while most people are able to enjoy their alcohol, some people drink too much, make fools of themselves and hurt themselves and the people around them. It sure looks like these people are weak and immoral. It is actually very hard to conceive that they may be suffering from a disease, and that these behaviors are not their fault. Betty Ford helped to change all of that.
Until recently, even the medical establishment did not view alcoholism as an illness. There were some pioneers like Benjamin Rush who, in the 1700s, believed that alcoholism was a disease, but this was very much in opposition to the usual thinking of the day. It is easy to understand this because alcoholism and drug addiction involve the willful taking of substances. It absolutely seems that alcoholics are making willful choices that end up hurting themselves and hurting everyone around them. It certainly appears that alcoholics and drug addicts have a “weakness of character, poor willpower, poor ethics, and a general disregard for themselves and for others”. Society, in general, has had problems seeing things any other way. And the people with these problems have their own difficulty accepting that they have a disease. Who wants to admit that they are not in control of themselves? It is not surprising that the main support group for alcoholics determined that they needed to be anonymous. Early people in recovery had to meet completely anonymously. The reality was that being found out could have devastating consequences. I recently saw a photograph that now looks pretty comical. It is from the very first days of AA and shows early AA members talking and giving testimony on a radio show. They were standing in front of a microphone wearing Lone Ranger type masks, obviously because they felt the need to guard their anonymity. It is a pretty ironic photograph considering the fact that no one who was listening to the radio would be able to see them! In fact this is a powerful reminder that these men and women felt it was so necessary to be anonymous that they had to guard their identity even to the staff of the radio studio.

Things have changed a lot since those days. Those of us who are either in recovery ourselves or who are working in the addiction field have Betty Ford to thank for a big piece of that change. In the 1970s, while she was First Lady of the United States, Betty Ford was abusing alcohol and was addicted to pain medicines. In 1978 the Ford family found it necessary to deal with Betty's alcohol and drug addiction. They staged an intervention in order to convince her that she needed to stop drinking and stop taking the opiate pain pills that she had been prescribed for a pinched nerve in the early 1960s. This was radical stuff. The president's wife was not supposed to be an alcoholic, and she was certainly not supposed to be a drug addict. But the truth is she was. Fortunately for her she had people around her who loved her and cared enough about her to help her get the help she needed. She went to treatment. She stopped using alcohol and drugs. She got into recovery, and like many people in recovery she decided that it was important to help other people who suffer with alcoholism and drug problems. She announced to the world that she had been suffering from these problems, and she did it in a non-judgmental and an unapologetic way. She took responsibility for her recovery. In 1982, she helped establish the Betty Ford Center in California. This excellent treatment program remains one of the preeminent inpatient treatment programs in the nation and has literally helped thousands of alcoholics and drug addicts and their families.

Our understanding of what causes alcoholism and drug addiction has changed a lot since the 1970s. It is now more clear that there is really no difference between alcoholism and drug addiction - it is really one illness that we can call chemical dependency. Patients who drink alcohol heavily do not have a different disease from those who are addicted to drugs. Dr. Bob, one of the founders of Alcoholics Anonymous, was simultaneously addicted to alcohol and drugs - just like Betty Ford. The medical evidence makes it more clear that patients with addictive problems are genetically vulnerable to the addiction process. It is not their fault that they have an addiction. It is their responsibility to deal with it. Since 1978, medical research has clearly outlined the parts of the brain that are corrupted in the addiction process. The brains pleasure center, which is there to ensure we survive as a species, becomes damaged and drives people to continue to take their alcohol or drugs even though all of the evidence says they should stop. There is now a large field of genetic research that is beginning to outline the exact genetic differences between those who can drink safely and those who lose control.
It is an exciting time to be working as a physician in the field of addiction medicine. It is becoming easier to work with patients and to help them understand that they do not have to feel guilty for having the drug or alcohol problems. For many patients knowledge of this fact is very liberating. It helps them to accept their illness, move on and reclaim their lives. It helps them repair the damage from the past and become the people they want to be.
Many of us have Betty Ford to thank. While she was only one piece in the puzzle of helping society to accept alcoholism as a disease, she was an important piece.

4 comments:

  1. The model moral or religious

    This model puts forward the belief that addiction results from the moral weakness or lack of will. It is based on religious punitive approach, calling addiction a bad act, reprehensible, and the belief that the addict can not be treated only by resorting to religion and that being saved by it.

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  2. You're reference to Betty Ford Center as an excellent treatment program is incorrect and unfounded. The BFC has one of the worst rates of relapse in the industry. Also, the Ford family and their friends are no longer involved in the program because of the power-hungry executives that control the board.

    And Betty was a great woman, a veracious woman. She did a lot, but a lot more must be done.

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  3. Alcoholism and drug addiction should be stopped. Although this is somewhat impossible, however we can work on this to make it possible in the future. By supporting the campaigns for alcoholism and drug addiction, we can truly help.

    http://www.environmentaldiseases.com/

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  4. The effects of alcohol drinking and what should be necessary steps to be taken.In starting phase keep a small amount or no alcohol at home. Don't keep temptations around.

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