Theraverse . August 6, 2024

What is the meaning of addiction and why is it seen negatively? Is it a moral problem, legal problem or a health problem? Is it an individual problem or a social problem? Is it a problem of choice or a problem of lack of choice? Is it a weakness of character or a biopsychosocial vulnerability?

We are often so busy creating answers that we forget what the questions are in the first place.

Everything in nature exists for a reason and similarly people also get addicted for a reason. Today I would like to talk more about reasons and causation rather than give the usual and superficial or rather moralistic lecture on why addiction is bad for health. Don’t we all already know that it is?

Use – abuse – addiction, all three lie on the same spectrum and are marked by gradual increase in harm and loss of control- that is, when we use something, we get its benefits. It solves a problem for us and since we are the ones using it, we are the ones in control. But as we use something more and more because we need more of its benefits, it solves some problems but creates others. This is where abuse begins.

The transition from abuse to addiction is a very slippery slope. As we use something more and more, we become dependent on it, and consequently lose control. That is, we are no longer able to choose – instead we feel compelled. Harm becomes much more than benefits and before one knows it, one is addicted. That is why I say addiction is not a disease of choice. In fact, it is defined by lack of choice.

In the words of Gabor Maté, a world-renowned expert on addiction, addiction is not just about drugs. He defines addiction manifested in any behaviour that a person finds temporary pleasure or relief in and therefore craves but suffers negative consequences in the long term as a result of, but does not give up despite negative consequences. So craving pleasure or relief, experiencing harm and inability to give it up is addiction. It could involve substances, some illegal like heroin, some even more toxic than heroin but legal like alcohol. This definition also includes people who are addicted to gambling, shopping, eating, working, the internet, pornography, sex, power, and a whole lot of other human behaviours. He therefore asks why are we negatively labelling some addictions when in this very stressful human culture, practically all of us, have or have had some addictive pattern or the other?

Are we as a society also not responsible for an individual’s addiction? As human beings, we are not solitary creatures, as the saying goes ‘No man is an island’. We need each other physiologically, psychologically, emotionally and spiritually. Physiology is linked to psychology and emotion which in turn is linked to the social environment.

How we feel about ourselves is determined by relationships from the time we are in the mother’s womb. The mother’s anxiety, depression and emotions can affect the brain of the baby. And what about the mother’s emotions, this depends on their own relationships, their social class, their childhood trauma, on the work they have to do and many other social factors. So, children of mothers who are stressed already have biological markers of stress as early as when they are born into the world. Can you imagine that? Worldwide statistics show an increase in anxiety, childhood ADHD and other mental health conditions along with obesity, autoimmune and metabolic conditions.

As per Maté in his book The Myth of Normal, qualities of the society are actually making people sick. In terms of physical health there is food, pollutants, contaminants. In terms of psychological and emotional qualities, there is ruthless competition that isolates us from each other. In Britain they had to appoint a minister of Loneliness! Our particular society and culture promotes illness.

Illness is a normal response to an unhealthy culture. Our culture takes us away from who we are and does not make it easy to become who we are meant to be. When homes are not only places of safety and belonging-  but also of domestic violence, parental addictions, sexual abuse and suicide, when playgrounds are places of bullying, when schools, colleges and workplaces are places of cutthroat competition and fight for survival, when society is a place of judgement, discrimination, exclusion and stigma, the individual suffers. And the individual seeks pleasure, relief and escape from that suffering.

Addiction is not a disease of choice and recovery from addiction cannot be individual responsibility but a collective responsibility.

Therefore, my appeal is less to the students and more towards the people in positions of power to make positive change namely parents, teachers and policy makers. Let us remember that only with the right understanding can we do the right problem solving!

By,

Dr Navina Suresh MD

Consultant Psychiatrist

Talk Therapy Clinic, Chennai