Friday, August 9, 2013

Understanding the Disease - The Cold Facts

 A common way that people in the world of substance abuse have conceptualized addiction as a disease over the years, is to compare addiction to an established and accepted medical condition such as cancer. As the analogy goes, compared side by side, addiction is viewed as a disease the same way cancer is accepted as a disease because both Addiction and Cancer:
  • Have Diagnosable Symptoms
  • Are Progressive if not treated and therefore potentially Fatal
  • Are Chronic (long lasting)
  • Are influenced by Genetic Predisposition
  • Recovery is a process requiring lifestyle change
  • Relapse can be a major factor especially if proper self care does not take place.
This makes sense to most as the addiction-cancer analogy has been critical in explaining the rationale behind the Disease Concept of Addiction for decades. However, in my years of experience working with primarily less motivated people who are using/abusing substances, I have found that this analogy, although logical and reasonable, can still be extremely difficult to accept, particularly for young people. People in general, especially the younger generation, have an extremely hard time accepting the possibility that they may develop a condition that can be likened to something as ominous as cancer. (There are actually studies showing this to be true if you research the Optimism Bias). For example, have you ever tried to tell a drug abusing teenager that he has a disease? Get ready for an argument. If you are an adult in recovery, how would you have accepted early on, some counselor telling you that you have a disease? That conversation usually does not go very well. 

That is why I have evolved the way I open up a dialogue about the addiction-disease concept by instead comparing addiction to the common cold. The comparison between addiction and a "cold" as diseases still holds water similiar to the cancer analogy but there are some secondary benefits to using the cold analogy especially when considering young people and earlier stage users. For the most part, cancer is viewed as very "black and white" in that people generally view cancer as either you have it or you don't. In the addiction world, people often get unnecessarily hung up on the same black and white thinking- (Think of someone in a group pointing fingers saying "He has the disease, but that guy over there doesn't, and you have the disease too but you don't even realize it yet"). That kind of talk is rarely helpful and usually ends up more in debates and comparing rather than in insightful discussion. A cold on the other hand, is commonly viewed across a spectrum: A cold can start with the "sniffles" and if not cared for properly can progress all the way to deadly pneumonia. That simple reality makes it much easier for a younger person to grasp the possibility that if they keep going they way they are going with their substance use, than it could get worse with time. If someone abusing substances can at least grasp that possibility, then the door to a much more productive discussion is opened. 

I am not saying that this approach is going to open the eyes of all that hear it, or do anything miraculous like that. But still, it is a much better way to get people talking openly and with less defensiveness, and that in itself is an enormous step in the right direction. Try it.

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