September is Recovery Month, established to recognize the struggle of the vast number of people in the United States who have fought the battle against the brain disease we commonly call addiction.
Professional circles now refer to addiction as a substance use disorder, due to the information we have learned through science about the nature of this powerful disease. Those that have worked their way through treatment to learn how to overcome the compulsion to use will attest to this power.
Indeed, strong, smart and accomplished people have had their lives turned upside down from substance use disorders, and some have died on the street because they didn’t get the help they needed.
Recovery from this illness is not a matter of will power, moral failing or station in life. It is not even about one's choice. Science tells us that the changes in the brain chemistry that drive this compulsion to drink, use drugs (or gambling, food, sex, gaming, etc.) is as powerful as our drive to eat food. Our body chemistry is very powerful. The person you know with a substance use disorder is fighting every day against the messaging being put out by their brain chemistry.
Diabetes, heart disease and breast cancer are diseases we often hear about or know someone who has these or other chronic illnesses. Twenty years ago we could hardly say breast cancer in a public space without everyone being a little embarrassed. Today, professional football players are wearing pink gloves with pink shoes to match, to support the fight against breast cancer. Breast cancer is being talked about in all media, has survivor marches, raises substantial money and is working its way toward lifesaving solutions.
It is not quite so comfortable for people with a substance problem to acknowledge their disease. In 1971, Congress passed a law establishing a privilege for people and organizations providing treatment for substance use disorders. The law required the service provider to keep confidential all information about the individual in treatment. The law stemmed from the fact that there was substantial discrimination against anyone that had a substance problem. Congress established the law so people could participate in treatment anonymously and have their information secured.
One of the primary support systems in a recovery program from substance use disorders is Alcoholics Anonymous or AA. Among its principles is that of anonymity. Early development of AA in 1935 recognized the high degree of shame people feel about having the illness and the societal stigma or discrimination that resulted from being identified as “alcoholic” (imagine if we referred to cancer patients as "cancerous," rather than as a person who has cancer).
After a person went through treatment, they had to return to society and the stigma associated with the disease. There was not an understanding of the disease or general support for those suffering from it. The anonymity rule also allowed for a leveling of the group, so no one person was more important than the next. But regardless of the person’s social status, once sober and sustaining a recovery program, the issue was still viewed as a weakness and moral failing, so it was not publicly discussed, and the secrets continued.
Science has told us how addiction changes the brain, that treatment is effective and recovery a real possibility. But we still put those who struggle with this illness in the position of keeping it a secret. The secrets must go if we hope to reduce the shame and stigma and promote recovery. One brave soul at a time must stand to forge the path by announcing they are in recovery and proud of it.
Everyone knows someone who has a substance use problem. It is that common. So, let’s get behind the person we know and understand their struggle to get healthy and promote an atmosphere of support and acceptance. We understand and support those with diabetes or heart disease who must change their diet, alter their lifestyle and get help from those around them to support them in these critical changes. So, too, with substance use disorders, we need to support a change in our own attitudes and our community approach, so we have marches down Main Street raising our placards in support of recovery and announcing individual pride at being in recovery.
Help the loved one you know who struggles with substance problems. Support them in getting the help they need and being in recovery. It isn’t easy. It takes work from everyone to sustain the recovery program for your loved one. But with recovery comes a vital, healthy person who can contribute and participate in the world.