Addiction is a highly controversial word that tends to stir up debate: ask 10 people their opinion on the matter and you’ll wind up with 10 contrasting answers. But despite differing opinions, people are finally talking about addiction instead of keeping it in the shadows. Addiction is a major public health crisis, and it needs to be talked about. The more we discuss it, the more awareness we create. And the more awareness we create, the more likely it is that we can bring an end to this devastating epidemic.
More people agree that people can be helped before they reach their lowest point. As David Sheff writes in his book Clean: Overcoming Addiction and Ending America’s Greatest Tragedy: “Many addicts are alive because their families didn’t wait for them to hit bottom. And for every person who hit bottom and wound up in treatment, many others kept falling further and further downward….For many, there’s no bottom—it’s a bottomless pit.”
Addiction afflicts people from all walks of life. It doesn’t matter where you live, what color your skin is, what you do for a living, or how much money you have or don’t have. No one is immune from addiction. Yes, there are homeless drug addicts. But there are also suburban soccer moms, bankers, and lawyers who are drug addicts. They took a taste of a mind-altering substance—oftentimes as prescribed by a doctor—and their brains sent the message that they must have more.
So, what aspects of addiction are people debating over?
These 5 are the most controversial thoughts about addiction.
Is addiction a disease or a choice?
This is one of the oldest (and most controversial) arguments surrounding addiction. People on the disease side of the argument cite groups like AMA, APA, and WHO, all of which have stated that addiction is a disease (ASAM, 2011).
From their viewpoint, people suffering from addiction have a chronic brain disorder: drugs change some of the interactions in the brain’s circuitry, which can lead to long-term side effects and harmful, self-destructive behaviors. But others say that addiction is a choice because nobody forced the addict to pick up a joint or a needle or a liquor bottle. This debate will no doubt continue for a very long time.
If you’re addicted to drugs, you’re a bad person.
There are many people who view addiction as a moral failing, something that only bad people suffer from. They are stuck in a world where addiction is only a problem for low-income or homeless people with long criminal records. But times have changed.
Should addicts be punished or treated?
Much of society still wants addicts to be put behind bars, because they’ve broken the law and that’s where they belong. But the tide has been turning recently. Take the city of Gloucester, Massachusetts, for example. In June of 2015, their police department enlisted a new, trailblazing policy: any addict who goes to the police station with the remainder of their drugs and/or paraphernalia and asks for help will not be charged. Instead they will be walked through the system toward detox and recovery.
The program has been so successful that other cities are now looking to adopt it. It is now very clear that incarceration alone is totally ineffective. Drug Treatment Courts (DTC) have been set up in many places under the judicial system to help non-violent drug offenders (Fulton Hora & Schma, 2009).
An addict has to hit “rock bottom” to get help.
“Rock bottom” happens when a person is brought to their knees by the horrible consequences of addiction: losing a job, a relationship, a home, getting arrested, overdosing, or getting into an accident. While “bottoming out” can certainly prompt someone to seek treatment, it can also be traumatic or life-threatening, and cause irreparable damage.
Are sober living homes a good or bad thing?
Sober living homes have generated controversy for years. Some state that the additional traffic and noise that come along with sober living homes disrupt the neighborhood, while others have no problem coming right out and saying they don’t want “those people” living near them. But proponents of sober living homes will tell you that these residences are absolutely vital to an addict’s recovery (Barthwell & Brown, 2009). The rules, structure, and sense of community they provide to those in recovery are key factors in successfully transitioning from treatment back into mainstream society. Without sober living homes to bridge that gap, substance abusers are much more prone to relapse.
American Society of Addiction Medicine (ASAM). (2011). News Release: ASAM Releases New Definition of Addiction. Chevy Chase, MD.
Barthwell, A.G., and Brown, L.S. (2009). The Treatment of Drug Addiction: An Overview. In Ries, R.K., et al., Editors. Principles of Addiction Medicine. Fourth Edition. Philadelphia, PA: Lippincott, Williams & Wilkins, pages 349-359.
Fulton Hora, P., and Schma, W.G. (2009). Drug Courts and the Treatment of Incarcerated Populations. In Ries et al. [previously cited], pages 1513-1518.
Sheff, D. (2013). Clean: Overcoming Addiction and Ending America’s Greatest Tragedy. New York, NY: Houghton Mifflin Harcourt.