She asks an innocent question, “Is addiction a disease or is it more of a choice?” She watched her husband suffer the throes of addiction for years and ultimately it took his life. I tell her it’s both. Her husband lived with a disease and he had a choice every day of his life as to whether he would be in remission. That’s a lot to wrap your head around if you’ve never been addicted.
There are many ways in which the disease of addiction is unique. Nobody intends to have it. No one consciously chooses addiction. They choose a drink or a drug. They choose them because they are pain killers – or more accurately pain blockers. Their choices perpetuate living in insanity over having a manageable life. Nobody chooses in the full light of day to become an alcoholic or addict of any kind.
You will meet those who say in retrospect, “I was an alcoholic from the first drink” and this is true. Millions of us are predisposed to addiction. We were raised in it. We inherited the genes for it. We found something that made “first times” possible: the first time we felt happy, the first time we felt comfortable in public, the first time we felt at ease with ourselves, the first time we felt unafraid.
The disease of addiction is in many ways similar to cancer, ALS, and heart disease. We can’t just look at a person and know they have it. One can have the disease and not know it. The disease is often subtle, then progressive, then destructive. We believe that people who have these diseases are deserving of treatment and we do not judge a person for having them. We have attached a moral judgment to the disease of addiction. We want to believe that only bad people become addicts and alcoholics. We perpetuate the myth of the skid row addict/alcoholic while ignoring the obvious truth that the disease of addiction is alive and thriving in board rooms, operating rooms, and living rooms.
The stigma attached to the disease of addiction blocks two obvious truths. First, addiction is widespread and pervasive in our society and second, recovery from addiction can and does happen every day. Social stigma further endangers the afflicted and gives the non-addicted user the illusions of safety and control. In this manner both addiction and recovery get driven underground and to the outskirts of society.
How is it that drinking is celebrated as a right and a desirable past time but being an alcoholic is morally wrong? We are encouraged to live on the edge but are damned for falling off of it. Getting prescribed Xanax, Klonopin, or Valium for your nerves is normative in a stressed out society but becoming addicted to these substances makes one “weak” or seen as having “no will power.” We see it as perfectly reasonable that people be prescribed Percocet, Oxy Contin, or Morphine if they are injured but condemn them when they admit dependence. The list goes on and on. Do what you will – but do it covertly – bring it out into the open and you will be judged harshly.
Some of the most hopeless cases we have seen do not support the mythology of addiction. Instead they bolster our claim that addiction is most destructive when well hidden. We have sat with doctors, lawyers, and school teachers who are loved by their communities and drowning in the sea of alcoholic self loathing. We have counseled judges, political leaders, and wealthy business people who cannot resist the temptation of a drug.
I sat with such an individual last week and advised them that I expect they will be dead by spring with continued drinking. Like so many they have defied every medical journal and every probability.
They should be dead a hundred times over and incredibly their body tolerates further abuse. They have reached a critical juncture. Their mind can no longer rebound from the affects of alcohol. This is a person of means, wealth, and influence and yet they are powerless to remain abstinent. They have chosen sobriety a thousand times only to see their resolve crumble when faced with disappointment, pain, loss, and fear. Can there be any question that this person is dying of a disease?
Our friend Al refers to what he saw as the “inevitability of drinking.” Despite countless attempts at sobriety, he believed that each period of abstinence would end with an inevitable drink. Only when he came to believe that relapse was not inevitable did he allow himself to have hope for a different outcome. Al is a remarkably resilient individual and is easily one of the most intelligent men we have ever met and yet his intellect was not a boon to him in changing his outcomes. The process of rationalizing and justifying self destruction is in no way logical and thus intellect, professional resources, and wealth will in no way deter it.
The disease of addiction does not discriminate. It will afford equal opportunity for destruction to any person regardless of age, color, creed, gender, or socioeconomic status. It increases in isolation. It brings a private Hell to our homes. It endangers all of us even as we attempt to shun those it claims to the outskirts of the our society.
We are proud to declare ourselves “recovering alcoholics and addicts” because we are proof that people transform and become happy, joyous, and free. We are proud to declare ourselves “recovery allies” because we understand that there is hope for every person as long as they remain vertical and breathing. We know that addiction is a disease and that recovery is a daily choice that does not end until one is buried. We live by the words of Grandma Moses who said, “Pray for the dead and fight like Hell for the living.” Those in the grasp of addiction cannot be said to be truly living. They are surviving. Our brothers and sisters in the 12 step communities carry the message that a manageable life is attainable and we support them for we remember too well the loved ones we have lost to a disease whose validity continues to be unnecessarily debated.
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