Reducing stigma and shame of drug addiction: Addiction is a disease of free will

Together we can work hand in hand in reducing stigma and shame of addiction for a speedy treatment are eventual recovery. Reducing stigma is therefore a must if we have to win in this fight.

Over the last few decades of my practice as a medical professional I have come a cross so many patients from across the globe with different disturbing health conditions coming to my office for treatment which we have gladly offered to them to a resounding positive feedback. We have made it a routine in our facility (AWAREmed Health and Wellness Resource Center) to give our very best to all our clients irrespective of their limitations because we believe in offering lasting solutions to all health complications that we can professionally handle. This has made us to move from strength to strength over the years. However one problem of drug addiction keeps recurring owing to the nature of its effects to people differently. This one story disturbs me the most. It disturbs be because it came to my attention several years after I was first introduced to the couple. That story is going to form part of our discussion in this article even as we focus on reducing stigma and shame of drug addiction both internally and externally. But before we get there we want to assure all people reading this article now that drug addiction is a real problem and the sooner we deal with it the better. It is very painful seeing people losing hope and giving up on treatment because they keep relapsing every time they are about to have a break through. We are not taking more seriously the issue of relapse so that we can be on the front lane in defeating the beast of addiction. Therefore if you or anyone you know is struggling with any kind of addiction, our doors are always open at AWAREmed Health and Wellness Resource Center under the able leadership of doctor Dalal Akoury to help you recover from it professionally and with a lot of dignity. So don’t keep in hiding come up and purpose to regaining your life back with us professionally.

Reducing stigma and shame of drug addiction: Stigma and shame

Now back to the story about two or three decades ago a couple visited my office with an addiction problem. Actually the man was alcoholic while his wife only accompanied her to seek for help. Before we could even start the session, they excused themselves shortly and I felt that they were consulting on something then we could commence together without any further interruption. I was surprised several minutes and hours later that my client vanished never to return. Several years later one of my student narrated this story to me and I was astonished. The student said “when I was still very young may be five or six years old, my maternal grandfather died of what I was always told was complications of heart disease.” She believed that because that is what she was told. It was not until several years later, after she had graduated from a medical school in psychiatry, and had secured a job for a very long time using neuroimaging to study the addicted brain, that she learned the real reason for the death of her grandfather. One day her mother gave her the revelation of the shock of her life and this was also coming when her mother was near the end of her life and she told her that, “I need to tell you something I have never spoken to you about.” She disclosed to her that her grandfather had been an alcoholic, and that he took his own life in his distress at not being able to control his strong urges to drink.

“Oh Jesus I almost lost my grip.” Her mother had out of fear of stigma and shame kept the real reason for her grandfather’s death a secret from her that long. What surprised her is that even though she knew that in her whole professional life was devoted to trying to understand what drugs do to the brain, and that she had heard her speak of addiction as a disease of the brain, still she was not going to tell her the whole truth.” So she wondered how she had miscommunication, and how she had not made her realize that it was not a taboo to speak about addiction and that there should be no shame in it. This really troubled her and so she came to confide in me says doctor Akoury.

Reducing stigma and shame of drug addiction: Is addiction a chronic brain disease?

In her practice as a medical professional she continues, she has actually thought about this question so many times, and had realize that describing addiction as a “chronic brain disease” is a very theoretical and abstract concept she says. And so we continued to share and she used this illustration that “if you are a parent or guardian with a very sick child, and you took the child to the hospital for medication and the doctor said, “Your child is in a coma because he has diabetes,” and in an effort to help you understand, the doctor went on to explain that diabetes is a chronic disease of the pancreas, would that really help you to understand why your child was so severely ill? Certainly not, that is because what would explains it for further and better understanding is that, the cells in the pancreas can no longer produce insulin, and the body actually need insulin in order to be able to use glucose as an energy source and that without it, the cells in our body are energy deprived. That is what will help you understand and so that explains why your child is so sick.”

To explain the devastating changes in behavior of a person who is addicted, such that even the most severe threat of punishment is insufficient to keep them from taking drugs where they are willing to give up everything they care for in order to take a drug, it is not enough to say that addiction is a chronic brain disease. What we mean by that is something very specific and profound: that because of drug use, a person’s brain is no longer able to produce something needed for our functioning and that healthy people take for granted, the free will. 

Reducing stigma and shame of drug addiction: Dopamine

All drugs of abuse, whether legal or illegal, cause large surges of dopamine in brain areas crucial for motivating our behavior—both the reward regions (such as the nucleus accumbens) as well as prefrontal regions that control our higher functions like judgment, decision making, and self-control over our actions. These brain circuits adapt to these surges by becoming much less sensitive to dopamine, a process called receptor down regulation. The result is that ordinary healthy things in our lives like all the pleasurable social and physical behaviors necessary for our survival (which are rewarded by small bursts of dopamine throughout the day) no longer are enough to motivate a person; the person will therefore needs a big surge of dopamine from the drug just to feel temporarily okay and they must continually repeat this, in an endless vicious cycle.

Reducing the stigma and shame of addiction: Addiction and suicide

Back to the story doctor Akoury says that from the story you will notice that the shame was not just because the father had been an alcoholic, but because he committed suicide, out of hopelessness and helplessness at his inability to control the strong urges to drink. At this point I remembered that couple who visited my office and just walked out never to return. Now on digging deep I found out that the couples were actually the grand parents of my student. Now it pains me most that something that could be treated caused this great damage simply because of stigma, shame and fear. Dear reader if you’re following this story, let this be the last one, addiction is a treatable condition and stigma or shame are just perceptions that should not result in death. Come quickly for help today and together lets kick out of our lives the problem of drug addiction.

Reducing stigma and shame of drug addiction: Addiction is a disease of free will