I’ve just got round to listening to ABC Radio National’s two part Health Report special on the drug and alcohol dependence and was pleasantly surprised about how well constructed and informative it was.

These sorts of programmes can be a little dry, if you’ll excuse the pun, but this two-parter in a compelling look into the effects of a number of substances, talks to some addicts in treatment, explores some residential services and discusses the evidence for various treatments.

The interviews are quite revealing and they’re a good demonstration that addiction is not solely about the drug. People who become seriously addicted change their lives to accommodate their addiction, and can live quite precariously as a result.

This often alters people’s behaviour, often in quite an adaptive way considering the unpredictable and dangerous circumstances, but not in a way that is best suited to mainstream life.

For example, one gentleman notes that he had to get out of the habit of lying to people as a short term fix to problems.

This is not a direct effect of the drug, but these sorts of maladaptive behaviours also need to be addressed during treatment for addiction for it to be successful.

Stopping the drug is only a part of the battle – stepping out of an ingrained lifestyle, mindset and pattern of behaviour can be the real challenge.

Addiction is more than just problem with taking too much of a chemical, it’s equally a social and emotional issue and we are often guilty of downplaying this aspect while clumsily trying to avoid the language of blame. The pure ‘disease model’, that says addiction is nothing more than a genetic brain disorder triggered by a particular substance, is a case in point.

It is, of course, possible to highlight individual responsibility without victimising people, but this is a difficult task for many in a society that has many double standards over the issue of drug taking.

The situation was wonderfully described in a 2003 article in the Journal of Applied Philosophy that noted that we often accuse addicts of self-deception while pushing our own self-deceptions about addiction as a substitute:

We frequently accuse heavy drinkers and drug users of self-deception if they refuse to admit that they are addicted. However, given the ways in which we usually conceptualize it, acknowledging addiction merely involves swapping one form of self-deception for another. We ask addicts to see themselves as in the grip of an irresistible desire, and to accept that addiction is an essentially physiological process. To the extent this is so, we, as much as the addicts, suffer from self-deception, and the responsibility for their state is in part ours. Conversely, since addicts are compelled to accept a self-deceptive image of themselves, they are at least partially excused from blame for their self-deception.

Parts one and two of ABC Health Report on drug dependence and treatment.

Link to ‘Self-Deception and Responsibility for Addiction’ article.

Link to DOI identifier for article.