This week I have been reflecting on addiction and the disease concept. The passing of Phillip Seymour Hoffman this week has thrust addiction into the main stream media. Many people outside of the scope of addiction appear concerned and “clueless” of how someone with 23 years of sobriety could relapse and ultimately die from the disease. And whether you respect Dr. Drew he got it “right’ all over my TV. Here is an excerpt from an interview
Dr. Drew: You can't kick addiction, it's 'lifelong'
By Amanda Sloane
Some people have been saying how sad it is that Hoffman died after 'kicking' his addiction two decades ago. How do you feel about that?
Dr. Drew: The idea that addiction is something that’s “kicked” or is a “demon” -- these are crazy notions in my world. The fact is, once the switch is thrown on addiction, it’s a chronic, lifelong condition that needs to be managed every day much the way a diabetic has to take insulin every day. And if they don’t take their insulin, their blood sugars go out of control and the same is true of addiction. If they’re not practicing their treatment and recovery and participating in that in a regular basis, they will use -- it’s inevitable.
The people who are actually in the recovering community say their disease is doing push-ups while they’re sober. It’s a brain disorder in them and it’s waiting and lurking and ready to take advantage of any opportunity it has to re-emerge. It’s a motivational disturbance where the usual motivational priorities like our loved ones, our work, our very survival, start to diminish in importance relative to this one overwhelming priority, which is using. And that takes over thinking and it takes over the emotional systems. It’s interesting to see a brain that’s under the influence of a distorted motivation.
What do you think when you hear that someone who was purportedly clean for so long has started using again?
Dr. Drew: Well, we don’t know if he was sober those 20 years. But it’s not unheard of for people to sort of diminish their participation in treatment or begin to think they don’t need to do all the work and the addiction will re-emerge when that happens. Let’s say he was sober all those years, the fact that somebody after two decades of sobriety relapses makes them an extremely difficult population to treat. They -- in a way -- sort of know too much and their addiction takes full advantage of that.
How common is relapse when it comes to addiction?
Dr. Drew: Relapse is a part of recovery. The people that do poorly, though, are the ones that relapse and then relinquish their participation in recovery. If somebody slips, it’s a slip. But a full-blown relapse is when people dismiss recovery, they don’t participate in any more treatment. That’s when they die.
We normally hear of celebrities overdosing on prescription medications. Is heroin having a comeback?
Dr. Drew: It’s always been around. It’s not that it’s having a comeback. It’s that the pills are so massive now that when people can’t get pills or can’t afford pills -- that’s when they switch over to heroin. It’s cheaper, more intense and very available. The extraordinary thing about Philip Seymour Hoffman is that he died of heroin and not pills. Typically, what happens these days is that pills get people. Although we don’t know yet, we may find that he had pills in his system, also. That may be the issue here. Maybe that’s what finally took him.
What’s one important thing people should know about others who struggle with addiction?
Dr. Drew: The one thing that I always want to emphasize is to separate the person and the disease -- the career and the disease. This is a wonderful person by every account, a wonderful father and clearly a magnificent artist who left us a glorious body of work. That is not in any way diminished by him having a chronic medical problem we call addiction -- any more than if he had cancer.
What can we learn from this tragic event?
Dr. Drew: More people will die of opiate addiction in the next 30 days than died in the 9/11 tragedy. This is something to remember. Also celebrities have a tendency to get special care. They want special care from special people. I would just remind them that Conrad Murray [the former doctor who treated and was convicted in the death of pop star Michael Jackson] is a perfect example of a special treating physician and what kind of special outcomes are in store for people who seek special care.
“DISEASE”, “CHRONIC, LIFE LONG CONDITION”, “BRAIN DISORDER”
I am a subscriber to pure abstinence, something I believe is part of the maintenance of my disease. I was at the Dr.’s office yesterday and made it very clear, I am a person in recovery and I will not accept and habit forming medications. I am scared of the “what ifs”. Developing healthy boundaries with myself is of upmost importance to keep my condition in check.
Thank you Phillip Seymour Hoffman, you died so I can examine your life and for one more day I can live.
Rest in Peace.
B