Monday, May 1, 2017

Opening our eyes to addiction

Unsplash: Dmitry Ratushny
I've said it myself, many times.

"Addicts will lie, cheat, manipulate, and abuse, whatever, to get their fix."

It's frustrating when it comes to the public costs addicts incur in our health care, criminal justice, and/or child welfare systems, and we have to pay for them.

Moreso, it's heartbreaking when the addict is a loved one of your family and they're robbing you blind to fund their highs, or feeding you the lines of the most ridiculous bullsh*t to explain their behaviors.

Because you get so damned angry. Rightfully so.

And the hurts feel so personally aimed.

But they're not.



Addiction knows no family loyalties, no sense of decency or morality, no empathy or obligations. No laws or rules will enforce abstinence or sobriety.

To be sure, these manipulations are betrayals of epic proportions, hurled out at friends and family to hit them where they're weakest, most tender and vulnerable, so that they just might cave and help that desperate need to numb. Other times, the manipulations serve to confirm the lies their addiction has provided them - "You're no good," "No one could love you," - and make us cut ties with them.

Permanently.

It's easy to vilify addicts because of such behavior and the heinous offenses they commit.

Again, I've caught myself doing it.

How can I give so much grace to people struggling with addiction in my work and yet be so hard on her, especially knowing what I do about addictions?

I'm pretty sure it has to do with the degrees of separation. Just like a doctor might not give the most sound advice to a relative, a social worker can't put their skills to work on a loved one - it's just too close to home.
Last fall, voters in Larimer County rejected a ballot initiative that would fund the opening and operations of a local, public substance abuse and mental health treatment facility. Currently all publicly funded substance abuse and mental health treatment options available locally are outpatient only. The nearest in-patient, acute care facilities are available in Weld County.

The need is great.

And while analysts are saying that it wasn't what the initiative was that got it rejected as much as it was the mechanism for how the initiative would be carried out (tax increase), I think there's more to it.

Yes, the ballot initiative came after as many as 4 other measures that required substantial tax increases that were defeated (proposals for increased tobacco taxes, taxes to fund statewide universal healthcare, Thompson School District mill levy and bond issue, and creation of a Downtown Development Authority in Loveland). That the treatment facility was just one more item on a list of costs the taxpayers didn't want to pay for is oversimplifying it in my mind.

People don't understand addiction.

For Pete's sake, some people still don't accept mental illnesses as organic brain disorders, and instead believe that if people just think differently or do a lot of hard work to cognitively re-wire their brain, they can choose whether they are happy or not.

And if people can't understand that - then they sure as hell aren't going to want to spend their hard-earned dollars to fund treatment options for "horrible people who steal, cheat, lie, and participate in other amoral activities just to live as a junkie."

You know what people do understand, though?

That child abuse is bad and wrong and Justice. Must. Be. Served.

Right on - I couldn't agree more.

But our systems fail children daily.

Yearly.

For decades, until they are no longer children and suddenly stand before us as adult addicts.

They've somehow lost their appeal to our societal savior complex.

Because now they're grown and should've made better choices?

Because they're living in the past and need to just "get over" their childhood traumas?



Studies show that Adverse Childhood Experiences (ACE) directly relate to adult rates of substance abuse

Put another way, of all the addicts in treatment (and who knows for those not engaged in treatment):


2 in 3 adults and more than 3 in 4 teens
have a history of childhood trauma

How do we reason that these people don't still need our help? 

They obviously didn't get the help they needed as children. 

How many cases of physical and/or sexual abuse go unreported/undetected each year?

How many children hide severe neglect well enough to fly under the radar?

How many placements do children in foster care have to experience, never really having a stable home or someone who cares about them permanently?

We fail our children, despite our best efforts, and continue to throw them away when they find themselves addicted.

I think we are better than that, America. Colorado. Larimer County. And it starts with us.

In addition to the link between addiction and childhood trauma, we also have a rampant opioid epidemic raging across our nation. Opiate addictions are created by and large, through legitimate and innocent means:
Four out of five people who become addicted to heroin start out with a legal prescription from a physician – a result of injury, post-operative care or a medical procedure.
Substance-abuse disorders affect 20.8 million people in the United States — as many as those with diabetes and 1½ times as many as those with cancer. 

Yet, only 1 in 10 people receives treatment.

We must do better.

To educate about addictions, so we can understand more and judge less.

To provide accessible, public safety net care options instead of allowing addicted people to clog our jails and emergency rooms with things that could be addressed in treatment.

To try new, innovative approaches to addictions treatment that garner higher, longer lasting rates of recovery. (Link is to NPR report about a promising new treatment model in Connecticut, repeated in quote below.)

Saying "and" instead of "or" - as in, we need better approaches for in-patient "and" out-patient care.

Quit looking at addiction as a matter of choice and willpower and seeing addiction "as a chronic illness — it doesn't disappear just because symptoms are temporarily under control."

Give a little more grace, and extend a lot more encouragement.

Show up at the polls and make the vote that supports all of this.

Put your dollars to good work, helping fund awareness efforts, like this indie documentary on legal marijuana and heroin use in Steamboat Springs, CO.

Need more research? 

Got it:

http://imgur.com/gallery/A3Rtd

http://www.choosehelp.com/topics/trauma-therapy/how-adverse-childhood-experiences-lead-to-adult-addiction-4

https://www.samhsa.gov/capt/sites/default/files/resources/aces-behavioral-health-problems.pdf

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