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Wednesday, August 09, 2006

A Friend's Response to Yesterday's Post

My friend "Marcus" is a highly intelligent recovering alcoholic/addict. I respect him and value his friendship, and I think he deserves to be heard. He chose to discuss yesterday's post with me in private, via email. Here is his note to me, and my response is at the bottom:



Saur,

Suffice it to say that although I respect your opinion and the arguments you made in support of it, I disagree. I don’t have the time right now to research the equally impressive body of evidence in favor of the disease hypothesis (notice the terminology – I am not willing to call it a theory, that implies conclusive evidence). I will say this: The mere reality that so many medical professionals support the position does lend some credence, at least for me.

Beyond the scientific arguing, there is another reality that makes perhaps more sense, and that is perception. Alcoholism and addiction are obsessive/compulsive disorders – particularly nasty ones, but psychological disorders all the same. If one is will to grant disease “status” to the likes of bulimia, anorexia, obesity, compulsive shopping or shop-lifting, then addiction has to be included. If not, then the whole lot must be thrown out. But I’m ok with that.

As you know, I have dealt with addiction all my life. Even today, at two years clean and sober, it is a battle I must wage everyday. To me, you can call it what you want, at this point in my recovery it really doesn’t matter. Moral weakness? Perhaps it was. What is important is that when I first got into recovery – and it was a 12- step program that worked for me – it was functionally beneficial for me to view my addiction as a disease. It wasn’t to excuse my behavior to the rest of the world – it was a tool to get the footwork started.

Which brings me back to perception. In my mind, it was helpful to know (or think) that I had a condition that I was not responsible for. However, that is only the very start – immediately I must move beyond that to realize that although it may have been an inherited condition, the treatment is now my responsibility. That was the first time in a long time that I actually owned up to the fact that I must deal with a condition I am stuck with – like any other disease that demands treatment. Again, it was a necessary perception to get started.

From there I was able to take responsibility back in other areas of my life. I used to do things to get high that I would never do now - for any reason. I believe that I have high moral standards – always have. I was, for sure, taught them by my parents but also believe I was born with them as well. Regardless, I still crossed those imaginary lines repeatedly. I understand how these substances can overtake a person. However, I also believe there are bad people in the world and many of them are made worse by the dope – and are still bad if they get clean.

These are the ones that bring recovery, 12-step programs and other disorders a bad name. They go around doing shameful things and then say they can’t help it… they have a disease. They take what is a recovery tool and twist it into a perverse excuse to do as they please while whining to the many receptive co-dependants like Oprah that they are just as much a victim as the real victims. Spare me! Once an addict or alcoholic accepts the disease premise, he (or she) can no longer be a victim because proven treatment programs are available and they know it – but acceptance is the beginning. Accepting that one has a disease is one way of doing that. However – once I say that I have a disease – I no longer have an excuse for my behavior.

Which brings me to the strength vs. weakness argument. Something smacks of inconsistency when I am called weak for pursuing a lifestyle that is miserable, filthy, dangerous and painful. Indeed, it takes a fair amount of strength to maintain that lifestyle. I find it far easier to work and live in the daylight rather than the shadows. Why would anyone choose such a way of life? I can’t answer that question and I don’t know exactly what took me there – but I do know how I finally escaped - with my life. The sad fact is that the vast majority never make it back. My own brother is one – and I understand how the rest of the world feels because I often catch myself thinking the same of him – I have to stop and remember what it was like for me.

I don’t expect the rest of the world to stand up and applaud that I have found the help I need and can contribute to society in a meaningful way. In fact, I expect most to say “It’s about time,” and they’re right. However, for those who have never actually been there, it is impossible to relate – and I understand. My final point is this: If calling it a disease helps even one alcoholic or addict return to the world of the living, isn’t that worth it? Why not let them?

PS: I have no problem with you sharing this on your blog or elsewhere – I only ask that you leave my name out of it.

Thanks Saur…
You’re a good friend, and a very smart cookie!




Marcus,

Thank you SO very much. I greatly respect you and your opinion and (since I have your permission) I will post this tomorrow (anonymously of course). I think you are very correct to lump this in with bulimia, anorexia, obesity, compulsive shopping or shop-lifting as well.

However, studies DO show that anti-depressant therapy does significantly reduce the eating disorders. This is also true for addicts and alcoholics, for the most part. That's because some (or even most) of them have a chemical imbalance in their brain which causes clinical depression. The addictive behaviors are a way to self-medicate this. The problem with self-medicating is that it often is an unregulated, poor solution with bad side effects. So certainly the treatment for such problems is not JUST admitting to wrong behaviors and choices, and sucking it up. What I'm saying is that no one should hide behind the shield of the "disease" label.

I think it takes MORE strength to admit you're wrong, and take the steps to live an honest, hardworking life than to pursue the pleasures of addiction. Because, let's face it, addiction is a poor attempt to solve life issues that would be better solved by turning to a higher power, and being responsible in daily living. I think it's a LOT harder to live that way, and I mean it.

I was worried about hurting you, because I consider you to be my friend. I hope I didn't. And I meant what I said when I said that recovering addicts are to be applauded because it takes WORK, dedication, and determination to make the daily decision to fight off the easy solution.

*hugs* -Saur



There are a couple things I would like to add. In a sense this is merely semantics. Here's an exerpt of an exchange between Tracey and I yesterday:

Tracey: AA teaches that alcholism (or drug addiction for NA) is a condition (if you do not want to use the term disease) that is not curable,

Saur: Yes they do. And they're wrong. But the main reason they're not challenged is that everyone is relieved that what they're doing simply works! It doesn't mean they're right, though.

For instance, what if a savage discovers that penicillin cures venereal disease but mistakenly believes that the penicillin is something that forms on an orange that has been breathed on by an angel? Does it make the penicillin any less effective because the belief system is wrong? Still, if we know exactly what we are dealing with, we can treat it even MORE effectively than what we currently are doing.

Finally, even the concept of depression is simplified for the lay person. Often there are times that the question of when the chemical imbalance arose. Was it hereditary, or a result of poor choices which were made, that subsequently plunged the patient into the depression in the first place? In other words, alcoholics, addicts, bulimics, etc. may not have started out with depression but ended up with it as a result of their behaviors. Although this is beside the main point, it is interwoven with the "disease" concept.

13 comments:

Mike said...

I think any time there is a "choice" involved it's hard to describe it as a disease.

United We Lay said...

You know how I feel abotu this. Cancer is a disease. If you're an alcoholic or addict, you just lack discipline.

mckay said...

"Alcoholism and addiction are obsessive/compulsive disorders – particularly nasty ones, but psychological disorders all the same. If one is will to grant disease “status” to the likes of bulimia, anorexia, obesity, compulsive shopping or shop-lifting, then addiction has to be included. If not, then the whole lot must be thrown out. But I’m ok with that."

i agree with your friend on this point, saur. A disorder is different than a disease. please thank 'marcus' for his insightful comments. i'm not an addict so i can't fully relate to his struggle, but i do know that, right now, i lack the willpower to diet. i give up (or never start) every day. if i could use 1/100th of the willpower Marcus and others have used to overcome their addictions, perhaps i could be a skinny minnie. i just need to make the choice.

my mom died of cancer, and the cancer is a disease, but then again, isn't it sometimes a result of smoking, which is an addiction?

I also concede the point to marcus that if calling it a disease as a tool for the addict to understand and grasp the problem, makes the journey toward health a little easier, so be it. I just have issues with the mental health organizations classifying practically every deviance a disease. People need to stand up and take some personal responsibility, and look to themselves to fight their demons, myself included.

Badoozie said...

well, i think your friend is very articulate and spot on. i'm glad you posted his email because he weighs in somewhere in the middle ground where we can all sort of aggree? at least i think so. I also think that some of these "conditions" or "disorders" are a means of control. such as the mention of eating disorders. many of these start because it's a way for a person who has little or no control in their life, to control something. other times it starts because of faulty thinking that lends that person to believe that skinny looks good.

so each one of these things can be different, and it's hard to lump them all together. on depression, i hate to see that lumped in with addictions purely because there is an insinuation that a person who is afflicted with depression is somehow to blame, or somehow inferior?

i think that is a big reason it has taken years and years for people to be treated with respect who have depression. to tell someone to "snap out of it" is about the worst thing you can say. I have a strong will, and i'm very stubborn if i so chose to be. but no matter what i do i can't "control" my depression on my own. and i accept that. and I believe i'm every bit as valuable as the next person.

we're taught in social work that each and every person has inherent worth, and some sort of strength somewhere. although this is hard to swallow at times due to people who murder, rape and molest, i always hold fast to the idea that if you have never walked in the addicts shoes, you have very little to stand on.

so we must come to a conclusion that its okay to feel FOR the person (be empathetic) but we don't have to feel LIKE the person (sympathetic) and we don't have to aggree with behaviors but we do have to accept each person. not all of us can be on the straight and narrow, it takes all sorts to make the world go round.

one last thing, it makes more sense to call alcoholism a "condition" than it does a disease.

marcus said...

~mike & united,

Granted, it is hard indeed. One of the biggest obstacles to recovery is the perception by addicts themselves that there is something inherently wrong with them because they can't "just say no." If it were that easy, why would so many pursue their behavior all the way to the gates of Hell?

As I stated, for me I don't care - it really doesn't matter anymore - I have paid my debt and changed the way I think. However, I never asked my family or the court or anyone else to excuse my behavior because I was incapable of stopping. What do you say to the agoraphobic who can't get out of the house? "Just get up and leave - you just need the discipline." Or the severely depressed? "Just be happy... all you need is the discipline - look at all you have compared to the dying kids in Ethiopia."

Mental illness is still a dark science. It wasn't that long ago that frontal lobotomies were dolled out to those whose behavior we didn't understand. If you don't want to call addiction a disease - that's fine with me, but what's the harm in allowing those suffering from the inability to choose otherwise? How does it hurt you?

One last point and I'm done... this argument is akin to discussing abortion and capital punishment. I'll answer my own very rhetorical question - and then address the answer!! (I'm not all better yet!)

The "harm" in calling these afflictions diseases comes not from the everyday semantical ramifications of heated arguments and bruised egos, but rather in the legal ramifications. As I said, the disease label, as used in recovery, is not supposed to be an excuse, but a tool. Unfortunately, it is perverted into an excuse and not just on Oprah.

When it's used as a means to escape justice in a criminal case - there is harm there. Behavior is behavior and almost everyone, except in very extreme cases, is responsible for theirs and the consequences thereof. That goes for those that were abused as kids themselves. I’m sorry that had to happen to them, but it’s not an excuse.

The second area is somewhat more insidious. Using the "disease" terminology as a means to cash in. Unfortunately, it happens all the time. I think it is in the best interest of the taxpayers to provide treatment for those who need it - to a point. It is far more cost effective to help - if possible. I don’t think we should support those who don’t want to get help or refuse to acknowledge that is their behavior – disease or not – that is dolling out their consequences.

Although I was fortunate to get some financial help from my family, I also took advantage of the many grants and loans available to a student, any student, who can show need. True, my need was produce by my “choices,” but I can say that for myself and many others that I know personally – your dollars were well spent as I am now contributing to the tax based rather than sitting in some county jail feeding on it.

I don’t want a pat on the back or any kind of congratulations – I get that from my family and support group. I am only trying to get those who have no way of understanding from their own experience to understand a little from mine. Indeed, if you still can’t understand why someone would do all that to themselves – then you are truly blessed. If you get nothing else – perhaps you can take a little gratitude with you.

marcus said...

PS: Thank you Saur

You are a good friend and I have nothing but respect for you!

"Marcus"

Valerie - Riding Solo said...

I have mixed feelings on this issue. The best documentation I could find was a little too technical for most people. I found this - http://www.hopenetworks.org/pdf/intro.pdf - which is a little better.
"Tenth Special Report. Today we
know that approximately 50 to 60 percent of the risk for developing alcoholism is
genetic. Genes direct the synthesis of proteins, and it is the proteins that drive and
regulate critical chemical reactions throughout the human body. Genetics, therefore,
affects virtually every facet of alcohol research, from neuroscience to Fetal Alcohol
Syndrome."

Yes, most people can control self destructive behaviors - I believe some really can't.

While this may not make it a disease it still makes it a physical condition you are born with and must deal with in your life. Not all of us do that well.

Just because my dad quite smoking cold turkey does not mean that I can. He was an alcholic and I am not. My sister is, however.

And I might be if I indulged more, which is a lot of why I don't.

I can't find it in my heart to be so hard on someone who's shoes I might have been wearing...

The fact that the government is handling it wrongly is no surprise to me. They seem to get most things wrong lately.

My two cents.

Miss Cellania said...

I haven't decided exactly where I stand on this, because its kinda complicated, but you've given me a lot to think about.

Kathleen said...

Thanks Marcus. Like cellania, I have more to think about. I do agree that having a strong, good family can make a big difference in if someone recovers or not.

Senor Caiman said...

Saur,

Interesting post.

If I was in a fist fight I'd rather it be with a black than a white suffering from depression.

That's just me.

KristieD said...

i think that addiction is a disorder we create for ourselves by the choices we make. the disease is not there until we have put it there ourselves. once it is there, some sort of treatment is necessary and then the addiction takes on the qualities of a disease, in that it has symptoms and treatments. but, in my opinion, it is not the same as OCD. most people dont decide they are going to be a little ocd today and then it just gets out of control, like with drinking or drug use. ocd just kind of develops over time as basically a messed up coping mechanism. something gets tripped up the brain and the output is ocd.(i know this is not the greatest definition of ocd, but i am keeping it simple). As far as heredity is concerned, they have only been able to prove a "tendency" towards being an alcoholic. but they cant say for sure if it is genetically inhererited or if it is the environment they grew up in. from what learned in my drug abuse class, the evidence is not clear cut on this one.

I think people who kick whatever habit they have should be applauded. it is sad they had to go to such lows, but the fact that they stood up and walked away from it and have the strength to stay away deserves admiration. addiction is a crazy thing. i have a few close people in my life who battle it constantly. and its a battle that will last a lifetime. props to anyone who has taken the sober path.

michelle said...

Alchohol and drug addiction can be the symptom a medical/mental health condition such as depression. The thing with symptoms is they may kill you long before the original medical conditon. If the person with the, let's say depression, would or could get treatment then perhaps the alchohol or drug addiction would never happen. Problem is that mental health care is not covered the same as medical by insurances. Just when you get to the bottom of things your benefits fun out and you are right back where you started.

Ellen said...

I applaud Marcus for his comments, as well as achievements. Life is tough enough without the addictions he bravely fights everyday. What impressd me the most was that he stepped up to the plate and owned up to it, sought help, and didn't use the crutch of disease to stop him. I've met too many people that can't get that far in their thinking.

Bravo Marcus!