You Do Know Who's An Addict, Don't You?

So, why do we continue to have addicts who willingly ingest, snort, and inject dangerous substances that will eventually kill them? Who are these people? The whole truth likely covers an endless ground of causes related to the effect; however, some very insightful research models have been formulated that give us a deeper view into the addictive personality.

We could argue to no end whether addiction fits the known definition of a disease, a disorder, or just a sinful decision. In my mind restricting addiction to definitions and connotative, argumentative terms that do nothing but create accusations while offering no major solutions to the epidemic does not meld efforts to get all local citizens “on the same page” for marked improvement.

The disease model of addiction proposes that biological factors (genetic and chemical changes from drug use) are the primary cause of addiction. Particularly, brain imaging and new drugs have shown that behaviors can and do change when brain chemistry is altered.

Criticism of a strict disease model believe there is evidence that, while addiction does have elements of a disease, it can be prevented and treated if other aspects of an addict’s life are taken into account. They point out cases where addicts have successfully quit drugs on their own – with no medication at all. Then, what kind of disease could it be if willpower and support are able to cure it?

I believe we must consider that addiction has roots in biology, in psychology, and in society. And, if we understand the truth of the matter, then the war against abuse must be simultaneously fought on many fronts to assure victory. As you read this model of addiction, please consider how many factors describe conditions in our sick, addicted county.

The Bio-Psycho-Social Model of Addiction

This model is supported by Leigh and Reiser, 1980; Keye and Trunnell, 1988; Kumpfer, 1987; and many others since then.

The bio-psycho-social model of addiction (BPS) is an attempt to explain how addiction occurs and is maintained. It is meant to give a framework of understanding so that treatment can be more effective. It involves acknowledging the complex interaction between the biological, psychological, and social aspects of addiction.

Therefore, the BPS model expands to include not only the physical causes of addiction (bio) but also the emotional (psycho) and the social parts as well. In other words, this model contends that without addressing the environment the addicts find themselves in (both psychological and social), we won’t do very well at treating it.

This model presents a holistic, systems approach and identifies the influence as well as interaction of various dimensions of the biological, social, psychological, spiritual, and cultural environment on the individual. According to the Addictions Foundations of Manitoba (AFM), the etiology of addiction is complex, variable, and multifactorial.

(James Bethea. “Biopsychosocial Model of Addiction.” Encyclopedia of Substance Abuse Prevention, Treatment, and Recovery. December 30, 2008)

Here are some of the factors that influence addiction in the BPS model:

Biological Factors:

• Genetic inheritance of genes associated with addiction.
  
• Damage to the individual before or during birth that makes him or her more susceptible to drug abuse.
  
• Physiological differences that are influenced by the environment within which one lives shortly after birth.
  
• Changes that occur within the brain: understanding that while an initial decision to use a drug is voluntary, the individual may continue to take the drugs involuntarily or on compulsion.

Psycho-Social Factors:

• Family variables such as positive and negative behaviors.
  
• Community or school variables in which drug use may be promoted or not.
  
• Peer and social variables which consist of the attitudes or behaviors of the peers concerning drug use.

1. Family variables include family attitudes and values, which interact with family stressors (i.e., conflict, poverty, parent, or sibling use of drugs), as buffered by positive family coping skills and resources (i.e., communication, problem solving skills, life skills, and external social and material support).

2. Community\school variables include community\school attitudes and values towards prosocial activities and alcohol or drug use, which interact with community\school stressors (i.e., poverty, high crime rates, high population density, impersonal climate, discrimination, conflict or noncooperation and support, pressures to use drugs), as buffered by coping skills and resources (i.e., positive leadership, good problem solving skills, education, prevention, and treatment resources).

3. Peer\Social variables include peer attitudes and values towards prosocial activities and alcohol and drug use, which interact with peer stressors (i.e., peer conformity pressure, developmental adjustment issues, poverty, lack of emotional or material support, depression and poor mental health, lack of opportunities, academic, job and social adjustment problems) as buffered by peer coping skills and resources (i.e., social support, effective group problem solving, conflict resolution and communication skills)

The Bottom Line

Many factors should be associated with an individual's drug dependence and eventual addiction. Besides believing that addicts just make a bad decision to take substances and abuse them because of their weak wills, the public must understand and address many underlying factors that contribute to drug abuse.

Even something as simple as recognizing that early aggressive behavior and poor social skills in children is a factor may lead to intervention before any abuse occurs. The school and the community must help those children who show certain tendencies toward addiction.

Yet, even more important, parents must model good behavior and dedicate themselves to proper parental supervision. Without strong family support, any child is a target for peer pressure and any of a myriad of other abuse stressors that surround him or her. I personally believe parents mistakenly consider teens, as they enter adolescence and progress through their high school years, are capable of living independently, thinking critically, and solving complex problems with less and less parental input.

I can assure you that a teenager may look like an adult, but he or she possesses a frontal cortex in need of years and years of more crucial development. Rules, promises, and wishful thinking that a teen will not take liberties to cross set boundaries that provide minimal risk are not guarantees that the youngster will maintain sobriety. Being enough of a “helicopter parent” without being too restrictive is a fine art. Suffice it to ask yourself: “Do I want to maintain my child's innocent, natural maturation while delaying any possible life-threatening independent choices?” Research proves not only abstinence but years of delay save teen lives.

In a environment like Scioto County, the relatively easy availability of drugs cannot be ignored as one of the most negative social causes of addiction. Schools, parents, neighbors must report all illegal drug activity to enforcement, no matter their fear of negative consequences. In turn, law enforcement must do everything possible to eradicate these criminals. Unless people stand up against poison in their midst, that substance will reek untold damage.

Another huge factor in play in our county is poverty. This community factor of poverty facilitates the abuse of drugs. In a county of less than 80,000 inhabitants, I believe more should be done inter-community. Wheelersburg, Sciotoville, Lucasville, West Portsmouth, South Webster, and all other areas should use our Appalachian ties to fuse countywide efforts to eliminate squalid conditions and to foster pride in the work ethic and furthering education. Indifference breeds problems, and it is evident many people here remain unsupportable bystanders.

The positive reinforcement one receives as a reward from the use of drugs represents a powerful enemy to resist. So many people claim getting high is the best method of avoiding pain. They experiment, then encounter dependency, and soon find the very “cure” to their pain is the beginning of a living hell known as full-blown addiction.

Finding all of the sources of pain and structuring strategies to change how we deal with it is the most difficult challenge to ending drug abuse. Reread the factors that contribute to addiction in the BPS model again. Is it any wonder we are inundated with drugs and with addiction? So much must be changed to have a significant effect on drug abuse, which is our biggest detriment because it directly affects so many major problems.

Lastly, I abhor this Scioto County (I call it Psych-Co.) class-structured attitude held by so many people here that the small minority of those they consider the “least of us” does 99.9% of the “worst damage.” These same people believe they and their near-perfect loved ones and friends are above reproach, and they definitely consider drug abuse is a problem perpetuated by the “least of us” and limited to that lowly group. This faulty judgment is stereotyping, pure and simple.

Somehow, some way, under the circumstances described above or in other unmentioned situations, people of every admirable human trait are being crippled and/or dying as slaves to drug addiction in Scioto County. Strangers, friends, family – all around us these people succumb to the ravages of substances that greedily consume their own hosts.

I can tell you this is true from first-hand knowledge. I can direct you to scores and scores of those who will also tell you the same. But, to many of you, that will not change your attitude on so-called “dirty drug addicts.” Those of you who blame without care feel bulletproof and confident in your judgment.

Only one image can change such a terrible misconception. Allow yourself to envision “them” as “you.” Think about your dearest loved one morphed into an unrecognizable stranger who cares nothing about family – a human sacrifice to substances so strong that nothing matters to him or her except getting another fix. The transformation wanders the neighborhoods of your county as you wonder what went wrong. But, no answer comes, only the final solution – bars of imprisonment or a cold casket.