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Community & Behavioral Health | Recovery | Social Change


Changing the Conversation

Understanding Addiction as a Chronic Disease

10/20/16 09:42 AM | Justine Hanson | Recovery, Substance Use

I recently spent my day writing final project reports. I wrote about how our project helped one state place peer recovery coaches in hospital emergency rooms to support people recovering from opioid overdoses. Another state expanded supported employment opportunities for transition-age youth. Several states created training and credentialing programs for peer recovery support specialists to help people enter and sustain recovery from mental health conditions and substance use disorders. Another state is re-examining and re-engineering their entire behavioral health crisis response system. We helped a U.S. Territory experiencing a substance use crisis take steps to establish their first-ever recovery community organization. We brought together adults in recovery with family members of adults with behavioral health disorders to discuss ways to improve supports for people in crisis.

I could go on. There’s so much good work being done by dedicated and compassionate people committed to supporting recovery and working to fix our broken systems with innovative, collaborative, and evidence-based approaches.

Then, I flipped to the New York Times and skimmed an article about one of the sadder side effects of the opioid overdose crisis: the children who are left behind, either by active addiction or death. I didn’t watch the video; I don’t recommend you do either.

I braced myself before clicking on the comments. I knew they would be filled with blame, judgment, self-righteousness, and cruel comments that recycle stereotypes that haven’t changed since medieval times. When it comes to people struggling with addiction, the typical response in our society (or at least the segment that comments online) is “burn the witches!” It’s a response that shames and blames people with substance use disorders, holding them responsible for pretty much all of society’s ills.

I forced myself to read the comments, wading through the prejudice and vitriol to remind myself of this facet of our cultural reality. Then, to be one voice against the mob with pitchforks, I wrote a comment. It was selected as one of the “NYT Picks,” and since I can’t link to it directly, I’ll share what I wrote:

Addiction is a chronic disease. When are we going to start treating people with substance use disorders with compassion and empathy and effective wraparound treatment and recovery support, as we treat people with cancer? As a society, our beliefs about people struggling with addiction are medieval, based on damaging myths, folk tales, and misinformation. These cruel judgments only perpetuate the damage to our society and families, as we shame, blame, and dismiss people who are struggling with a chronic disease. The mothers of Magnolia New Beginnings are heroes. Will it take all of us losing a loved one to a substance use disorder before we change our ways and invest in effective prevention and recovery support programs?

I wrote this because I’m sick and tired of watching the general public blame and shame people with substance use disorders. It is treated like a moral failing, a character defect, and blame is placed on the individual who is judged harshly. As a nation, we are poorly educated when it comes to science-based understandings of addiction; prejudice and fear thrive in this dark space of ignorance.

According to the National Institute on Drug Abuse, “addiction is a chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences.” Drugs change the brain in ways that make it very difficult to simply stop using substances. It is not a question of willpower or morality. It’s a complex disease; teens, whose brains are still developing, are particularly at risk. To learn more, check out the great resources compiled by the folks at Overdose Lifeline. Read about a young woman's reflections about losing her father to addiction.

Like diabetes or asthma, substance use disorders can be managed successfully, with the right treatment and recovery supports. Instead of blaming and stigmatizing the victims, we need to treat people struggling with this disease with compassion, humanity, and understanding. We need to commit to making treatment and recovery supports available to all. We need to educate ourselves and our communities about what addiction is and what it isn’t. It’s time to put away the pitchforks.


Image by Trevor Hurlbut (CC BY 2.0).

Justine Hanson

Written by Justine Hanson

Justine Hanson is a Senior Associate at the Center for Social Innovation. She is part of the Bringing Recovery Supports to Scale Technical Assistance Center Strategy team and directs the project’s Policy Academy, supporting states, territories, and tribal organizations to implement recovery-oriented behavioral health system transformation initiatives. She is a sociocultural anthropologist with expertise in understanding the needs of diverse groups, multiple stakeholders, and vulnerable populations.