As I See It 2... By: Liz Lucey
Over 24 million Americans 12 and older suffer from alcohol or substance abuse, or both. Triple this number (at least) if you consider their loved ones who suffer right along with us. Of this 24 million, only about 2 million are admitted into treatment each year. This means there are over 20 million untreated people with a substance abuse disorder in the United States now. Many of those untreated are incarcerated, and the remainder are dying. There is no other option besides recovery, jail, or death. There seriously is no other option, as there is no such thing as a “functioning addict.” It is significantly easier for an addict to get a bag of dope than to get help. We are at a critical point in our history as a country, and treatment and recovery is going to be determined by our collective voices or our collective silence. Those that have found a solution need to use their voice and speak up. Although it is considered progress that substance abuse is recognized as a treatable medical disease, it also made the field of addiction treatment a “business.” When this happened, managed health care recognized the profits of this new “industry” and the business of recovery and treatment fell into their hands. And they have no idea how to treat us, so people continue to use, continue to die, and the stigma emerges that we do not comply with treatment and do not want the help they are providing. The recovering community is their only resource for a viable solution. Unlike other diseases, they must go to the ones with the problem to find their solution. If we remain silent, we are contributing to the problem. De-stigmatizing and reducing the shame of addiction is possible by showing our faces and using our voices. Those that are ignorant and judge the addict are justified if they do not see that there are millions living a life of recovery and productivity alongside them.
Statistically, heart disease, hypertension, and asthma are diseases that have a 50-70% relapse rate. This rate would significantly decline if patients were compliant to lifestyle changes, diet, and medication adherence. This non-compliance costs the taxpayer’s money, increases healthcare costs, and frustrates their families. Half of asthma patient’s prescriptions are never even filled.
Treatment could be successful and relapse dramatically decreased if only the victims of these diseases would comply. Unfortunately, that is not the case and everyone pays the price, both financially and emotionally.
How is addiction different from these other common diseases? I believe, personally, that it is because the addict’s disease targets the part of the brain that attacks the “pleasure” or “reward” area and floods this area with dopamine. Society sees the initial response to our disease as fun, pleasurable, and satisfying. No other disease that I know of creates a sense of euphoria to the victim, the likes of which he/she has never known. For us, the substance IS our medication, solution, treatment, etc. to the symptoms that are already present. We find in the substance relief from our symptoms and finally feel “normal,” in a way that most people already know. Eventually, brain functioning is impaired and that is when tolerance, cravings, and addiction sets in and the damage is already done. Becoming desperate, impulsive, sick from withdrawal, and physically addicted, we act out in drug seeking ways that, although often criminal, are desperate acts of self-preservation.
Consider this: If diabetics were forced to line up like cattle outside of clinics every single day to receive their insulin, what do you think the public reaction would be? Or medication for high blood pressure was limited to a specific number of doctors to prescribe, and patients were put on a waiting list to receive it (to prove their willingness to live), what do you think society would say? Or if a smoker was diagnosed with lung cancer and was told they did it to themselves. I do not believe there is any other disease that tricks their victims in such a way as this; the substance presenting itself as the medication, or cure, to their symptoms, ultimately becoming the major symptom of the actual disease of addiction itself. I know of addicts and/or alcoholics who waited hours to be admitted to a detox, only to be told they had no beds available for them because it had to be held for an addict on a different drug. An alcoholic turned away because he didn’t drink enough, went out and drank more, and was again turned away and directed to a hospital. We are not drug seeking at this point, we are medication seeking! There is no pleasure seeking at this point, we are seeking treatment and until we can find another solution, we do whatever it takes to get the only solution we know that works – our substance. Just like any individual with a chronic disease, we will die without it, yet are shamed and humiliated trying to get it.
I remember being locked in an “isolation” cell in prison for several days going through withdrawal from alcohol. I was vomiting and dry heaving so severely I believed I was going to have a heart attack. I was drinking toilet water because I was dehydrated and my lips were cracked and bleeding. It was the only water available and I can still feel the humiliation. Laying with my head against the cold floor, I begged the nurse that showed up once a day to please give me Librium so I wouldn’t die. When she returned later with my chart, I was berated because she found out I had a history of bulimia and that I needed to stop acting out. I could only stare at her with blank, hollow eyes. I will never forget that experience, which was one of many to come.
As an alcoholic, I would be too ashamed to go to the same liquor stores every day, several times a day. I would sometimes travel miles out of the way just to get a bottle, because I was so afraid of being judged by the clerk at the liquor store (all of them). I would sometimes buy more than one bottle (if I could afford it) and have to explain that I was NOT drinking by myself, that I was having a few friends over. The extremes that I went to in my addiction in order to hide it is somewhat understandable. What is not understandable is that I had to do the exact same thing when it came to seeking treatment. I was transported by ambulance weekly about eleven years ago. The drivers got to know me, and the staff at the surrounding hospitals did as well. I repeated the same behaviors with them as I did with the liquor stores, alternating my frequent visits equally so it would appear that I was not really as sick as I was. The only time I would allow them to transport me to the same one was when I would be having a seizure, and not able to direct them. I wonder if these drivers had many emergency transport victims as embarrassed to see the hospital staff as I was. I wonder how many of us that have died from this disease have actually died of shame. It would not be far-fetched to read that in an addict’s obituary, that she “died of the shame that prevented her from getting help.” “She had seen one eye-roll too many and heard the last tsk-tsk of the tongue that she decided to die at home, finally in peace.” For most people, shame passes. But for addicts it is always present, leading to painful feelings, destructive behaviors, and eventually self-sabotage. I believe that this is why people living in recovery have to speak up and reach out to those twenty million or more addicts still suffering; empathy and identification suffocate shame. Shame cannot exist with or survive empathy. Shame wants you to believe you are alone, but empathy wants you to be understood. Only another addict can best understand and help another addict.
So my point to all of this is that there is occurring among us right now a social movement in the area of addiction recovery and treatment. Social movements focus on specific political or social issues that a group of people with a shared interest attempt to change, resist, or undo. Usually originating from a crisis or event (or chain of events), this is not the first time alcoholics and/or addicts have attempted a social movement. The rise of twelve step programs such as Alcoholics Anonymous were a result of the critical mass of individuals being institutionalized and abandoned into psychiatric hospitals, drunk tanks, and “foul wards” of city hospitals. Attempting to prohibit alcohol did not work, just as attempting to stop the drug supply does not work today. What did work was a group of drunks that advocated for a change in society’s thinking, treating, and stigmatizing of who they were and how to help them. Presently, a generation of young people are dying in epidemic proportions and silence and anonymity are killing them as much as ignorance. The collective voices of those of us who are living a life free from active addiction need to advocate and speak up. Give back and pay forward. Educate the educated ones on how to treat addiction. Speak up and speak out. Our voices are loud and our voices are necessary. There are way too many of us to be ignored. The issue is political, economic, medical, and social and the only ones that understand the generation that is dying are the ones that are living in recovery. A free rider is one who is silent during a social movement that involves them and allows others to advocate while reaping the benefits after the work is done. Don’t be a Free Rider.