Addicts: dying for love?
Has anyone noticed that we're only kind to addicts when they're dead?
In the press reports about singer Amy Winehouse before her death a year ago, there's a meticulous documentation of every foot she put wrong. Each lurch or stagger – snap! – someone was ready to record it. Even her 'pot belly'– in reality, a teensy bump visible above low slung jeans as she left a London restaurant – created spiteful headlines.
But flash forward to the days after her death a year ago and it's all warm tributes and mourning the loss of her talent. The same public mood swing followed Whitney Houston's death in February. After years of condemnation disguised as newsgathering ('Whitney Houston leaves club stumbling and bleeding'; 'Whitney Houston will always love crack,'), there was the same outpouring of sorrow when she died. So why can't we show the same compassion for drug dependent people when they're alive?
Because we're still stuck in the idea that people bring addiction on themselves, says psychiatrist Dr Glenys Dore, clinical director of the Northern Sydney Drug and Alcohol Service.
"The perception is that it's all about lack of self control. Yet no one sets out to become addicted. Every patient has said to me 'I never imagined this could happen'," says Dore who's worked in addiction medicine for over 20 years.
To understand why quitting drugs isn't as simple as pulling yourself together, we need more education on the biology of addiction. Drug use might start out as personal choice but once dependence develops, there are changes in the brain that amp up the drive to use and override willpower.
Let's start with the brain's reward system. To make sure humans survive, nature has wired us to feel pleasure when we do things like eating or reproducing that are essential to our species' survival. The trouble with alcohol or drugs like cocaine, heroin and cannabis is that they can excite the brain even more than sex, says Dore. That's why the priorities in the brain change so that the drive to have the drug eclipses the drive to eat.
"On top of that, the brain becomes more reactive to stress so people become less able to deal with pressure – and are driven to use a drug more as a result. The more problems mount up, the more people feel driven to use the drug."
This explains what the rest of us don't get - why people continue using or drinking even when the fallout from their habit is destroying their lives.
Drug dependence is a complex mix of biology and environment, according to Dore who says there are genetic differences that can influence our susceptibility, including how we respond to a particular drug.
"If I have three or four drinks I get a headache and feel nauseous so I've got inbuilt protection against drinking too much, but we find that people who get into trouble with alcohol don't get the same cues that they've gone too far," she says. "It's similar with other drugs – one person can smoke cannabis and have a panic attack and never touch it again, while others feel relaxed and more sociable."
Having anxiety or other mental health problems can also make you more vulnerable and although the 'addictive personality' is a myth, personality traits like being very impulsive or a risk taker can make some of us easier targets for addiction, Dore says.
You can't shame someone out of a drug or alcohol habit because stigma only makes things worse. Just as telling people they're fat doesn't make them thin, calling people junkies doesn't make them clean.
"The shame generated by stigma is a critical part of addiction. Not only can it act as a barrier to getting help, but hurtful reactions from other people can drive more drug use. I say to medical students 'you should treat people with addictions just as you would any other patient – or as you'd like your own family members or yourself to be treated,' " she adds.
"We need to see symptoms of drug addiction not just as bad behaviour but as a health problem – if Amy Winehouse's symptoms had been caused by epilepsy, we'd be more sympathetic.
"There's also a huge paradox in the way we promote food, alcohol and gambling in our society – yet when someone develops a problem with any of these things they become vilified."