Sunday, July 24, 2011

The Mirror

There's controversy over whether addiction should be called a disease. Some people think about how they define the word "disease" and decide that addiction doesn't count.

For this post, I won't call addiction a disease, and this is not to imply it is or isn't, but only to keep that word from being a distraction from what I'm trying to say.

When a person becomes addicted to a substance, it's no longer a matter of willpower or choice. It's a matter of biology and chemistry.

Addiction means the person's body has re-calibrated itself and now considers the drug crucial to its survival. The person's mind--what they want, how they'd like to live their life--has become mostly irrelevant. Addicts truly do lose control of their actions.

I want to explain the science of what happens when a person becomes addicted to heroin, because I think heroin provides an analogy that makes it a bit easier--for a person who has never been addicted to anything--to understand how hard it is to kick a drug habit.

There are things in your bloodstream called sugar receptors that help you digest sugar. Heroin is chemically similar to a sugar your body metabolizes naturally--so much so, that heroin can latch onto your sugar receptors even though it doesn't quite fit them.

But heroin is chemically active. It alters your sugar receptor to make it effectively a heroin receptor. If enough receptors become altered, not only is your ability to process sugar impaired, but your body now considers heroin an essential nutrient--something it will die without.

Would you have enough willpower to starve yourself to death if you knew where to find food?

That's how much willpower a heroin addict needs to kick their habit. When they quit the drug, their body is convinced it's dying for lack of an essential nutrient. It uses every evolved response it has, every trick in its arsenal, to coerce the addict into getting more heroin.

So again--could you starve yourself to death? In the presence of food? Think how desperate you would feel, because that's the desperation a junkie feels; their body is using that same response on them, trying to drive them to take the drug.

If your answer is no, you couldn't voluntarily starve to death (or couldn't do it easily), then have empathy for addicts, because when you look at them, you're looking in a mirror. That person is you, if you'd had the bad luck, poor judgement, or youthful naivete to wind up addicted to a drug. Their body is designed the same way yours is; it could have been you.

And I'm not even done telling you about heroin.

Suppose a heroin addict kicks their habit, fixes their life, and goes on to live a clean and meaningful existence. Remember those altered sugar receptors? Those hang around in the body for years.

When a person kicks a heroin habit, their cravings decrease sharply in the first few weeks, and more slowly over the next few months, but they never go away. A person who has been sufficiently addicted to heroin will crave the drug for the rest of their life.

Also, because heroin is similar to a natural sugar, sweet foods can trigger withdrawal symptoms even years later. Imagine having successfully kicked a heroin habit at 20 years of age, then eating a candy bar at 40 years of age and going into withdrawal symptoms again. (And, by the way, heroin withdrawal is nasty.)

How abjectly unfair--and there's only biology and chemistry to blame for it. Same as for the original addiction.

Now, is addiction a disease?

A disease is something physically wrong with your body. Addiction is something physically wrong with your body.

Note I'm not talking about drug abuse, here. Drug abuse often leads to addiction, but addiction is a separate issue--addiction is the state of one's body physically craving a drug, regardless of what one's mind desires. Abuse, in the absence of addiction, is still a person's choice.

Addiction is certainly different than a disease like appendicitis, because appendicitis happens to people who have done nothing to increase their risk of getting it. Addiction requires conscious action, at least to begin with.

However, appendicitis doesn't make you feel worse when you're getting better. Addiction makes you feel horrible when you try to get better.

And appendicitis doesn't feel good when you're actively aggravating it. When an addict uses, they get a moment's relief--even though they're digging themselves in deeper. It's a heartbreaking Catch-22.

I'm not going to make a call on whether addiction should be called a disease because I have no expertise on this matter. I've never been addicted; no one I cherish has ever struggled with addiction (that I know of.)

But in general, if you want to know what something is like, you ask an expert, and in this case, that means an addict or a recovering addict.

And if they say addiction is a disease, then that's probably the truth, isn't it? They would know better than we who sit by the sidelines of dangerous living and wonder what it's like.

What makes us all human (and, in some cases, what makes us writers) is an ability to empathize and a willingness to understand someone else's struggle. Humanity has many strengths--intelligence, courage, artistry, athletic prowess--but the one attribute we have that the world always needs more of is kindness.

So please, always remember, when you see someone made pathetic, grotesque or even dangerous by their addiction, they're responding to it roughly the way you would if you had been unlucky or unwise enough to get yourself into that state. You're looking in a mirror to an alternate universe--one that shows you, if things had gone wrong.

Amy Winehouse was a beautiful woman who apparently felt ugly, a talented woman who thought she was worthless, an addict. Her body yearned for substances that eventually tore away everything her heart and mind had yearned for. Have empathy for her; what a terrible thing.

May she have peace now, and may her example give other addicts the will and courage to fight their way free. Amen.

Author website: J. J. DeBenedictis

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