Why is our understanding of addiction still stuck in the past?
We all experience stress and anxiety at times, and we know it’s not our fault. It’s also incredibly likely that we’ll all experience addiction at some point in our life — so why do we treat it so differently?
Ask just about any person over the age of 50 and they’ll tell you how different the attitudes and beliefs around mental health were when they were younger…
In past decades, it wasn’t ‘the done thing’ to share your struggles so openly. People tended towards suffering in silence and isolation.
This movement towards unashamed help-seeking, is in no small part down to technological advancements and greater information sharing. The internet gets a lot of slack but there’s a world wide web of knowledge that’s given us much greater insight into our mental and physical wellbeing.
Not too long ago, depression was described as “the last taboo”. Now, whilst that may have been a bit of an overshoot, we’ve definitely come a very long way from the ‘melancholia’ and ‘black bile’ days of old.
After years of public health campaigning, ongoing research funding, increased awareness, and health tech brands like Headspace and calm.com, the conversation has changed. It’s no longer about ‘just getting on with it’.
We have entered into this incredible age where we can talk about our physical health and mental health — we even have entire campaigns and days for it, like R U OK?.
The general understanding is that we all experience stress, we can all feel anxious and depressed, and that all of those things exist on a spectrum of experience. We’ve come to realise that it’s actually really human and there’s nothing taboo about it.
We’re even pretty used to athletes and other high profile figures talking about their experiences publicly.
As a species, we’re just far more aware of the importance of prioritising our own mental health and the risk of ignoring it. There’s more awareness around what to do and what help is available, whether it’s something you’re experiencing temporarily or chronically.
If you go to a GP now you’re infinitely more likely to be directed to a mental health plan, rather than being told to rub some dirt in it and get back to work.
Having said that…
Somehow our understanding of addiction is still so muddled.
This level of understanding and wokeness hasn’t been applied to the use of addictive substances and behaviours. Addiction is something you experience, not who you are. And yet, people still freely use derogatory and reductive terms like ‘junkie’, ‘problem drinker’, ‘drunk’, ‘addict’, ‘druggie’ and ‘alco’.
We don’t make a habit of labelling other conditions with such implicit and unjustified judgement. Could you ever imagine calling someone living with cancer “A cancer”?
No one should ever be defined by the health challenge that they’re experiencing. What this does is push people further away from identifying what’s happening to them and accessing support; lest they be lumped in with the “boozers, users and losers”.
Addiction got left behind, and it got left behind because we don’t have the same widespread understanding of what it is. It continues to be associated with choice. But just like someone doesn’t choose to be anxious, no one chooses to develop an addiction.
Popular culture still reflects this idea that: to be addicted to something means to be broken somehow. There’s an assumption that anyone suffering is irredeemable and there’s an element of blame. Because in order to become addicted to alcohol, you have to have drunk alcohol, right?
In actual fact, though, addiction is a biologically driven process that happens to us all. Shout out to our brain’s reward circuit! It’s a rather important evolutionary system for survival, which creates our motivation for basic human needs, like eating and drinking.
When we experience a stimulus, our ventral tegmental area (VTA) releases dopamine, which then travels to different parts of the brain. From there it’s picked up by dopamine receptors, and you feel happiness, euphoria, nothing but good vibes.
At the same time, serotonin levels can drop, meaning we’re less likely to feel satiated or content. Your hippocampus will then step in and say ‘let’s remember how good this was so we know to keep doing it’.
Here’s a video explaining the process:
This is our natural response to pleasurable stimuli such as food, sex, social interactions, drugs…and, of course, different stimulants activate the circuit to different degrees. It’s why some substances are easier to become dependent on.
The annoying (/occasionally very cool) thing about us humans is that we’re very good at manufacturing dopamine; whether that be with pokie machines, social media or synthetic substances.
Where the reward circuit can be dangerous for us, is with drugs like heroin or methamphetamines. There’s no gradual build and the intensity of what it’s setting off in your brain is immediate.
The stories of someone trying a substance and becoming absolutely hooked have definitely been used as a form of scare tactic. But there is truth to the idea that a substance can completely take over your life after only one hit; or that you can start with weed and move to other drugs searching for the bigger ‘high’ that your brain is trained to crave.
Everyone is going to experience some form of addiction in their life; the only difference is in the substance or behaviour and what the consequences of that will be.
Think about where you sit on that spectrum. Are you feeling anxious? Or do you suffer from anxiety? Do you have a morning coffee habit that gets you through your day and that you feel lost without? Or has your life been absolutely destroyed by ice? The consequences and the acuteness can obviously be very different but what’s actually happening in your brain isn’t.
No one’s immune. And whether you choose to accept or believe it, everyone is doing something or consuming a lil’ somethin’ to cope with their day-to-day existence. We can call it routine but if you’re craving a drink, some chocolate, a particular person, your phone because it’s not in your hand…that’s an addiction.
We know that about one in four Australians will develop an alcohol, drug or gambling disorder during their lifetime, and about one in 20 will develop addiction.
We know that almost 21 million Americans have at least one addiction, yet only 10% of them receive treatment.
The World Health Organization has found that people delay seeking treatment for an average of 6 to 18 years for substance use disorders.
A huge part of that wait is the stigma born of a lack of understanding. Meanwhile, the research continues to show that feelings of shame and guilt related to drug and/or alcohol issues have been associated with poorer recovery and an increase in the likelihood of relapse.
In much the same way that you’d treat a physical issue, there are earlier stage options when you’re dealing with addiction. People shouldn’t have to wait until they are being checked-in to rehab, or until relationships with friends or family have completely deteriorated, to seek help.
We should all be exploring our relationship with addiction and the possibilities for change.
We all need to understand that moving past addiction requires slow changes over time, to readapt the brain and body. We’re done with guilt and blame. We all have to know that it’s not simply a matter of willpower and that reaching a stable recovery is possible.
It’s up to all of us to create a world where no one is waiting years or even decades to reach out and get the support they deserve; a world that makes our grandparents proud of how far we’ve come.
So let’s start sharing and listening and undoing the damage that silence has done.
Lived is helping people who want to quit, cut-back, or are considering a change with alcohol. In our app you’ll learn from people who have been in your shoes and know what really works.
