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Thursday, Nov. 6, 2008 | 2 a.m.
Sun Topics
We don’t consider it a moral failure if a diabetic can’t control her blood sugar level.
And no one finds it shameful when someone with diarrhea can’t control his bowels.
So why do people blame addicts for taking their substance of choice?
The answer highlights one of the greatest myths and misunderstandings about addiction, according to medical experts.
People who think addicts are making willful decisions to ingest their substance of choice don’t know the science behind the disease of addiction, said Dr. Mel Pohl, a Las Vegas addiction expert and author of the book “A Day Without Pain.”
“It’s a medical disease,” Pohl said of addiction. “There isn’t any medical organization that doesn’t understand that. It really is a lack of information that commits people to believing that it’s a choice that’s related to self-will.”
And yet, the myth is propagated incessantly, evident by readers’ reactions to an ongoing investigation by the Las Vegas Sun that has identified a prescription narcotics crisis in Las Vegas. A Sun analysis of Drug Enforcement Administration data showed that Nevada ranks No. 1 among states for per capita consumption of hydrocodone, the drug in Lortab and Vicodin, and No. 4 for per capital consumption of methadone, morphine and oxycodone, the active ingredient in OxyContin.
Readers are quick to blame prescription drug users for their addictions.
One reader, claiming to be a pharmacy technician, wrote on the Sun’s Web site of one addict: “No one forced her to take so many meds that she OD’d. Addiction is a CHOICE. No one and nothing forces ANYONE to pop a pill, shoot a balloon of heroin, snort a line of coke, take a drink, etc. Regardless of ANY doctor’s actions, the ultimate responsibility lies with the patient.”
Pohl said he can understand why people hold such opinions, but they are wrong. Many people abuse substances without becoming addicted, but an estimated 15 percent of users — no one knows exactly how many — become addicted. Addicts have a genetic predisposition to a short circuit in their brain that allows their rewards system to be hijacked by certain substances.
The reward system of an addict’s brain drives the person to consume the drugs at the expense of anything else, even eating or sleeping, he said.
Dr. Jim Marx, a Las Vegas addiction and pain management specialist, said scientists have done addiction experiments in which animals will give themselves doses of medicine — and ignore the food by their side — until they starve to death.
“That’s the issue with addiction,” Marx said. “It will overpower any other urges you have. At that point, does the person have a choice? I guess they do have a choice to a certain extent, but the chemistry will override that.”
Pohl, who has worked with thousands of addicts, said it’s common for family members and friends to blame the drug addict because the behavior has had such a negative effect on so many people. Drug addiction destroys relationships, he said, because the addict will do anything — lie, steal, break laws — to get the drugs.
Addiction is a chronic disease that can’t be cured, Pohl said, because an addict still craves the drug when it’s absent.
When addicts overdose on prescription drugs the doctors who wrote the prescriptions don’t directly cause the death, but they are complicit in it, Pohl said. That’s why doctors must screen for addiction and survey patients to ensure they’re taking them in a manner that won’t cause harm, Pohl said. When prescribing potentially addictive and deadly drugs such as narcotics, he said, doctors should have a plan to ween the patient of the drugs.
“I don’t think most doctors do that,” Pohl said.
If addiction is a chronic disease that can't be cured, then why do rehab centers exist? Rehab obviously doesn't work. The majority of the centers that are proponents of the absurd 12-step programs survive on the premise that addicts are powerless and must turn their will and lives over to a "higher power." If that were true, then sufferers of diabetes, arthritis, epilepsy and all other chronic diseases should be lumped together in treatment centers where group meetings are mandatory and constant random testing is performed. It's all about the money. The rehab centers are expensive, relapses are expected, and without these programs, physician addicts, nurse addicts, etc., would have no jobs. Blame the "addiction specialists" on people not being able to control or live with their addictions - after all, addicts are told that they are powerless and have no control over their addiction. Before seeking help with an addiction "specialist", ask what their drug of choice was before they became a "specialist."
Yes certain doctors need a plan . If you are a primary care physcian and someone walks in with an addiction problem , and they don't have a clue what to do. Send them to a specialist who went to school to curb their addiction not feed them the drug of their choice. Someone has to be smart enough to save our children the future of America , before we lose more lives and destroy families .I do believe that rehab centers help the people that want to be helped.We just have to find the right educated people who know what they are doing . It is like physical therapy you must participate at the full amount , while your therapist is there to push you to get stronger . It really does work . The chemicals in the brain of an addict are screaming for more & more. When all they want is help !!!
Are we speaking of Dr. Buckwalter ??????
Your reporter committed an error by stating that "many people abuse substances without becoming addicted." Then why are you describing it as abuse? The government and the alcohol companies allow us to be told that we can "use alcohol responsibly," yet it is the most abused drug on earth. The reporter is putting forth the very tired prohibitionist view that anyone who touches any drug not sanctioned by the government, is "abusing" it. Every day, millions upon millions of people use drugs their governments do not approve of, without "abusing" them. If the US government would drop its hypocritical opposition to all neutral research, we would know a lot better what constitutes "use" and "abuse." But for your reporter to instantly qualify any drug use as "abuse" is both inaccurate and disingenuous.
Diabetics don't CHOOSE their illness - drug addicts, however, make the CHOICE to sue the drugs to start with and then get 'hooked'.....they have no one to blame but their own weak selves.
azsk8:
You don't even have a clue. Just what the heck are you talking about?
In response to the article asking "why people blame addicts for taking the substance of their choice"........choosing to take an addictive substance shouldn't even be mentioned in the same article as someone with a debilitating illness - how many people do you know who are diabetics, or perhaps they have cancer - I seriously doubt it was their choice and it's ludicrous to try to compare these two issues....substance abuse vs chronic illness....one is a persons own choice and one is not.
And btw, my brother CHOOSE to do Heroin and subsequently became an addict....then moved onto methodone and has been there for 25 yrs. He would be the first to tell you he put himself in this position.....
I don't buy this "everything is a disease" and people can't help it.
Maybe people are genetically preconditioned to be suseptable to certain drugs like alcohol but to call it a disease sounds like nonsense.
I'm addicted to Dr. Pepper, btw. Soon there will be some government funded medicine to help my non existant Dr. Pepper disease.
(Again this is the definition)
Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use despite harmful consequences to the individual that is addicted and to those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person's self control and ability to make sound decisions, and at the same time send intense impulses to take drugs.
It is because of these changes in the brain that it is so challenging for a person who is addicted to stop abusing drugs. Fortunately, there are treatments that help people to counteract addiction's powerful disruptive effects and regain control. Research shows that combining addiction treatment medications, if available, with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient's drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse
ask8 :
Please help your brother . I know its hard . You could be the one to make him chose to come clean . That would make you feel good
Drug abuse can not be cured but you can learn to deal with life without drugs. That does not mean you still dont want drugs, but it gives you tools to help you deal with the urge to use. I have meet Dr. Pohl at a rehab center and he has help save so many lives and a 12 step program is extremely important to getting sober. Your brother is not clean or sober, methodone is just a different drug. I know the difference it makes in the recovery of a drug addict to have people who want the best for them. A Dr should always be aware if they are prescribing drugs to their patient what effect it is having on them.. you don't just give large amounts of drugs and hope the patient does not become addictive.
First, who is defining "addiction?" An addiction specialist? Again, it only serves to support the 12-step approach. Secondly, 12-step programs DO NOT WORK. Read the studies. There are other programs out there, if one feels they are necessary, but the 12-step approach is a horrible, guilt-provoking journey.
KDR81... you will probably be a drain on health care when you get sick and fat from drinking all that dew. Not very responsible of you.
BTW, are you an expert on brain diseases now too?
Each person is different when it comes to addiction that is why it is important to work closely with that person on an individual case. Doctors take an oath to help the sick , never give up on anyone. It actually feels good to help someone even a stranger try it sometime. The definition of addiction came straight out of the dictionary .
I am a recovering addict of 8 years. I made the decision to take that first drug that sent me spiraling out of control for the next 15 years. Lie, cheat and steal are understatements. Do I blame the disease for everything I did, no. Do I blame the countless doctors who kept me in narcotics for years, no. Do I believe I have a disease, absolutely. Thank GOD for 12 step programs - my program has saved my life! I believe that the program works-IF YOU WORK IT!Much like a diabetic's medication, insulin only works if you take it. Never in my wildest dreams would I have dreamed of having the life I have today. 12 step programs DO WORK!
Those who think addiction is a choice, that an addict is "weak" for using drugs in the first place; you are forgiven. Since you clearly have not researched addiction in any form or manner, your comments are taken with a grain of salt. Please research and learn about addiction before you make ignorant allegations to an addict, possibly causing a relapse. 12-step does work, if it didn't, then it wouldn't exist... hmmm. If addiction were a choice, then people would just quit using, right? I mean, after all, our lives have become unmanageable.. and who wants an unmanageable life? Who signs up for that? If jails and institutions worked, then people would be flying in by every 747 to get recovery in our jail systems. So please, to us addicts, keep coming back, it works if you work it. We do recover!