Sadly, There is No Magic Bullet
Addiction is not solely a disease of the brain. The case for holistic treatment.
Drugs—we love them. We've come to believe in a prescription for every condition and a pill for every ill. Industry advertising tells us what doctors should prescribe for a catalog of ailments, real or imaginary. And this pharmacological boom has proven particularly creative and bountiful in the treatment of addiction.
Advances in brain science have given us a new understanding of addiction and its neurological basis. They have made possible a spectrum of anti-drug drugs. The latest of these, now in development, are vaccines that may be able not just to treat addiction but to prevent it as well. These vaccines would train the immune system to recognize psychoactive substances that now slip unidentified into the bloodstream (cocaine, for example) but, when identified, can be destroyed before they can reach the brain.
It sounds great. And the new medications will have their place as treatment protocols evolve. In our passion for the prescription quick fix and pharmacological solution, however, we should recognize that drugs alone are not the answer to addiction.
The law of unintended consequences warns us that there's a downside to just about every advance. So discovering that addiction involves profound changes in the brain has led to a widespread assumption that addicts are powerless over their condition—that drugs have hijacked their brains. This, in essence, rules out free will and the possibility that some addictive behavior may be voluntary. It is a seductive proposition, for it suggests that the addict is incapable of self-control, and hence cannot be responsible for his or her behavior.
It is clearly true that addicts become increasingly incapable of controlling their behavior, for the compulsive nature of their drug use is the defining characteristic of their addiction. Moreover, addiction is far from an equal opportunity affliction. Certain individuals—by heredity, mental illness or age—are far more vulnerable than others. There appears to be a genetic component to addiction, and a substantial proportion of addicts suffer from co-occurring mental illness. As parents and policymakers, the vulnerability of teens rightly concerns us most, for the adolescent brain is a work in progress. While the brain's pleasure- and sensation-seeking center is up and running strong at puberty, that portion of the brain exercising control over impulsive and irrational behavior isn't yet fully hooked into the mental communication system until the mid-20s. Lives can be destroyed before they even begin.
My work—I founded Phoenix House, the drug and alcohol treatment program, 40 years ago—and the work of my colleagues would be much easier if the brain were the sole culprit in addiction. As jarring as it can be to say this in a milieu constantly shaped by reports of new scientific insights, it must be said: biology is not necessarily destiny. To accept the proposition of an addict's powerlessness is to eliminate volition from the equation, for we know from hard evidence that addicts can and do kick the habit. And, no matter how difficult it eventually becomes to exercise choice, there is always a period at the outset when choice is not only possible but relatively easy.
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Member Comments
Posted By: Gicomeng @ 03/26/2008 6:50:31 AM
Comment: Life for me began at 19 when I was prescribed Desoxyn (methamphetamine) for narcolepsy. My 2.0 GPA doubled in one semester. For the first time, I had direction. I went on to manage the International Space Station C&TS for the NASA. Because of my persistence for continuous communications, the ISS program saves about $35 billion/ year. After 14 years on Dexoxyn, I discovered a health food store product that turned out to be gamma-hydroxybutyrate (GHB) which allows for the most natural REM sleep and I switched over. By 2001, GHB was taken from the shelves of health food stores and by 2002, I was terminated from employment. I came to California hoping to jumpstart my career. A physician thought that narcolepsy was a narcotics disorder and prescribed Trazadone that did nothing to stop the daytime sleep attacks. The medical records he produced contained the diagnosis of "SPEED ABUSE" because our lawmakers have indoctrinated everyone to fear certain drugs. Incidentally, Desoxyn is prescribed for children as young as 6 years old. A health educator offered to refer me to his drug dealer for a solution because physicians are afraid to write prescriptions for controlled substances. Today, I'm disabled because I can???t get treated for narcolepsy. I dream of the day that the drug war will be over and I can get back to work. Last December, I delivered a presentation at the 2007 International Conference on Drug Policy Reform, pointing out that we live in the Electro-Chemical Age in which drug use is normal human behavior. Drug abuse is a teaching disorder and anti-drug disorder is a societal phobia that defines our world. The solution is Drug Use Education (DUE). Rather than a drug war that has crippled our nation and our economy we need to establish an educational program that teaches medicine... I've encountered a vast number of people who depend on illicit street drugs because they can't afford healthcare. Meth has been used to spike CD4 cells in HIV/AIDS patients and save lives when used responsibly. We need to look at the bigger picture. Addiction is one of many problems that can be prevented through education. Drug abuse is a quantitative issue. It is the foundation for chemical dependency (ie: addiction). The fear and ignorance spawned by the drug war is causing our society to regress. There are reasons we don't even know yet why people are using drugs. We can???t administer experimental blockers and then realize it was a total mistake... In January 2006, 34.5 years into a drug war costing over $2 trillion, the US Congress stated: "Too little is known about drug abuse, especially the causes, ways to treat and prevent drug abuse." Now I ask you: Why are 30% of our prisoners in the US serving 20-40 year sentences for something that Congress knows "little" about!? We need to stop destroying and start healing. Please visit my website (http://www.gicomeng.com/). Thank you...
Posted By: stickville @ 03/03/2008 11:43:29 PM
Comment: Dr Rosenthall is obviously not an addict. It is so easy for the non-addict to theroize on the condition of the addict and the possible cures and just as easily entirely miss the mark. The good Doctor writes like someon who's livelihood depends on constantly formulating new approaches to "curing" addiction. Sadly, each new one is a much of a miserable failure as the pne before it.
I am an Addict. My problem is not drugs. Drugs were the solution to my problems. I used drugs to mask my problems, to hide my problems, to run away from my problems. I am powerless over my addiction.But, that does not mean I am helpless. I can, with help, live a life of recovery. It's called the 12-step program. I know that many professionals, possibly even the good Doctor, look down their nose at 12-step programs. Most like it's because they can't make any money off of them.
Here's a quarter. Buy a clue.
Posted By: C. MacLean @ 02/26/2008 10:40:41 PM
Comment: "Families can make the road to recovery shorter."
Families can also make the road to recovery longer if they are not willing to work at their own recovery from codependency. If your "child" is old enough to be addicted to heroin, s/he is old enough to make decisions about releasing information.
Addicts who don't agree to programs are not a family responsibility, although they certainly cause a lot of family sorrow. As long as the family keeps assuming responsibility, the addict has little incentive to change. As painful as this may be to hear, if the addict in the family is a child, this is almost always a symptom of much more severe problems within the family . We in the treatment community have a saying - the sickest person in the family is not always the one who presents for treatment.
As a parent, I feel your pain, but as a substance abuse professional, after reading your comments I heartily recommend Al-anon or Nar-anon, and starting to focus on your own issues. This is the best way to help a child caught in the spiral of addiction.