Regardless of whether addiction is a brain disease or a learning disorder, addicts are compelled to use ever increasing amounts of drugs and then one day they accidentally take too much or combine with other drugs and die. This is the tragedy of addiction. Is it true?
Hardly! In fact, overdose is only loosely coupled with addiction. Most people who overdose are just experimenting or dabbling in drugs and most drug addicts never overdose and are always well aware of how much drugs they are doing and what amount is safe, despite what is shown in movies and told in stories. In fact, most overdoses are intentional suicides. Usually the drug user is going through a tough time in life (as many of us do) and then one day decides to play ‘Russian Roulette’ with whatever drugs they have on hand. Often it is a deadly combination of opiates, alcohol, benzodiazepines, and even huffing drugs. The goal is usually a ‘cry for help’ though sometimes the outcome is fatal.
Once we understand overdose as a suicide attempt and not a symptom of ‘addiction’, we can see how a policy of ‘addiction treatment’ is not only ineffective but harmful: it targets the wrong population, since most overdoses are by people who are just experimenting and cannot possibly be considered ‘addicted’, and so are missed. And much ‘addiction treatment’ is 12 Step based and teaches that the user is ‘powerless’ to the drug. As a result, they may mistakenly believe they are powerless to their cravings, and then find themselves unable to resist the urge to overdo it the next time they are faced with one of life’s unavoidable frustrations or disappointments. Actors especially are vulnerable to this dynamic, and many have died soon after attending AA (e.g. Philip Seymour Hoffman and Corey Monteith).
Opiates are implicated in many overdoses, and so politicians are now urging a crackdown on the doctors who prescribe them (or the drug companies that make them) in order to prevent the development of addictions. But will that help? In fact, crackdowns only push people into the heroin market, which is cheap and plentiful in many areas. Also, one doesn’t need much of the drug in order to overdose, if it is mixed with other drugs or alcohol. So a crackdown probably wouldn’t prevent the dabbler from accessing a lethal dosage, even if it limited the accessibility for addicts. (As addictions go, opiates are the least harmful, and cause no damage to the brain or body even after long term use, with the exception of complications from dirty needles, so the addiction itself doesn’t cause death.)
More importantly, there are many people in chronic pain. Crackdowns only make life more miserable for these people who need the drugs to function. It’s simply wrong to characterize someone in pain as ‘addicted’ to opiates even if they are dependent on them, if their life would be miserable without it. Are these people at greater risk of suicide? Of course, as anyone in constant pain can attest the thought is never far away. Kurt Cobain had chronic stomach pain for which he took opiates, and killed himself soon after an intervention in which he was told he would have to stop.
Suicides by people in chronic pain should be in a separate category and should not be held up as evidence for the severity of the ‘disease’ of addiction — the tragedy of which is that it afflicts otherwise healthy people.
The addiction treatment industry (whether disease theory, spiritual malady, or learning disorder) is always ringing the alarm bell: “People are dying of this disease!” But this statement is simply false. In fact if you go to an NA or AA meeting generally you find fairly healthy people who complain about pretty mundane problems and rarely about uncontrollable cravings. The old timers when reciting their drunkalogs generally talk much more about their conquests than their cravings, and one gets the impression that their life was never at serious risk. In fact, the claim of craving is simply a lie (Craving Lie) that is foisted upon the general public, and to vulnerable newcomers: “I almost died from my disease.” This is followed by a testimony for the cult: “AA helped me and it was the only thing that ever helped. Now I am happy, joyous, and free.™”
But this is just Big Book propaganda. These people were generally having too much fun drinking and drugging to ever seriously consider suicide except perhaps as a manipulation ploy. But now they can try to convince newcomers that they are in fact powerless. In fact if the newcomer denies it, they will accuse them of lying and being in ‘denial’. They may be told: “You are full of resentments that are deadly for the addict. If you don’t believe it, go home and keep drinking/drugging!” Sometimes people actually follow the advice, and the morbidity is promoted as evidence of the disease. I believe the evidence will show that AA attendance greatly increases overdose rates. Anyone who is depressed should seek professional help and avoid AA at all costs.
Parents of children who died of an overdose are quick to blame ‘addiction’ even if there is little evidence of long term drug use, and in fact often have to concoct a story that they were unaware or in denial of the extent of the ‘addiction’. This fits in perfectly with the 12 Step disease model and such parents are often persuasive apostles for the group, even teaching other children about the dangers of the ‘disease’ or testifying before Congress. But the simple truth is that the child was only dabbling in drugs, and one day experienced an insult, failure, or disappointment and decided to overdo it. The parent much prefers the disease theory over the possibility that they inadequately prepared their child for the vicissitudes of life. The truth would be obvious in many cases simply by reviewing the child’s social network feed.
Every time the news shows a story about the high rate of overdose, they attribute it to ‘addiction’. However, this connection is simply unjustified. Most of these people are intentional suicides. Often people start using drugs and alcohol because they are unhappy and having suicidal thoughts, and it is easy to see how this could quickly lead to a regrettable action. Also many people claim ‘addiction’ to conceal a slow motion suicide, especially if they are approaching the age when ‘doing whatever you want’ just won’t cut it (and ‘growing up’ has little appeal). If excessive drug use is seen as a symptom of unhappiness instead of a disorder on its own, we have a better chance of being able to intervene more quickly and offer help — help for unhappiness, not ‘substance abuse’.