My Views on Substance Abuse Have Evolved

Joseph M. Bowers

In December of 2015 I wrote a blog complaining about the federal government lumping together substance abuse and mental illness in the creation of SAMHSA. At the time, although opposed to the war on drugs and favoring treatment over criminalization, I tended to have a condescending attitude toward those with a substance abuse problem. After all, one chooses to use a drug at least initially.  No one chooses a mental illness.

Since that time I have talked with professional addiction councilors and taken more than 60 hours of classroom training for recovery coaching. I learned that most often addiction is accompanied by mental illness issues. Choices to use are often  made by people whose prefrontal lobes responsible for awareness of consequences are not yet fully developed and now we have an epidemic, caused in large part by false advertising and over utilization of opioids for painkilling. This information made me somewhat less judgmental.

Recently I have been visiting a young man whose mother in another state contacted the local NAMI chapter to which I belong. He will soon be released from a substance abuse treatment center. The center allows two hours of visitation one day a week. During the first hour professional councilors would talk with us visitors and play a TED talk on the subject of addiction of which I have now seen two. I learned a great deal from them.

The original idea of punishing people with addictions and rehabbing them by imposing severe consequences was based on a flawed lab study. Rats were placed in a cage containing only two containers containing liquids-one water and the other water with heroin. The rats almost all preferred  the container with heroin and most would continue going to that container enough to overdose. It was concluded that one use would almost always result in addiction. Only forced abstinence could possibly help.

Some years later another scientist wondered if the cage might be as big a problem as the heroin. He put the two containers in a cage that provided wonderful living conditions for rats-plentiful cheese, tunnels-everything a rat could want. In this cage almost no rats became addicted to heroin. They almost all stuck to the container with just water.

Then there was the Vietnam conflict. During our involvement more than 20% of our soldiers were heavily using opium and heroin. It was thought that our society would have a huge addict problem when they returned home, but a strange thing happened. Upon returning home, most of these people quit using right away. From this one might conclude that addiction happens not because of the addictive quality of the substance but when someone’s life sucks. When one’s life sucks, a person takes things that ease the pain at least temporarily. When things are going well, addiction is unlikely and uncommon. This TED Talk concluded: “The opposite of addiction is not sobriety. It is connection.”

At the end of a session one of the staff told a story I liked: Someone in a group of people held up a new, clean, shiny one hundred dollar bill and asked everyone who wanted it to raise their hand. Everyone did. Then he crinkled it up, threw up in the dirt and mud and just made a mess of it. Then he held it up again and asked everyone who wanted it to raise their hand. Again everyone did because they knew that whatever it looked like, it still had value. People with substance abuse and/or mental illness problems may be a mess, but they still have value. They are still worthy of love.




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