portfolio_2023_Martin_M

Addiction?
Excerpts from the books In The Realm of Hungry Ghosts (2008) by Gabor Maté M.D ,
and Inside Rehab: The Surprising Truth About Addiction Treatment – And How to Get
Help That Works (2013) By Anne M. Fletcher.
I found it interesting how the term
addiction is defined: Both resources
originated differently: “The term’s
original root comes from the Latin
addicere, “assign to.””, while the other
explains “The word “addiction” comes
from a Roman law having to do with
“surrender to a master.” Today, which
basically means since the last century,
the definition of addiction is “Any repeated
behaviour, substance-related or
not, in which a person feels compelled
to persist, regardless of its negative impact
on his life and the lives of others.”
While in the time of Shakespeare it
meant “addiction referred simply to an
activity that one was passionate about
or committed to, gave one’s time to.”
As in the module was also mentioned,
addiction is classified as a disease, but
even AA cofounder Bill W. shied away
from the notion that alcoholism is a
disease. And seemingly many professors
follows: Dr. Vincent Felitti (Clinical
Professor of Medicine at the University
of California) wrote that “The current
concept of addiction is ill-founded.” He
was the chief investigator in a landmark
study of over seventeen thousand middle-class
Americans for Kaiser Permanente
and the [U.S.] Centre for Disease
Control, where he concluded that “The
basic cause of addiction is predominantly
experience-dependent during childhood,
and not substance-dependent.”
Lance Dodes (psychiatrist at the Harvard
Medical School Division on Addictions)
seems to be on the same page: “Addiction
is a human problem that resides in
people, not in the drug or in the drug’s
capacity to produce physical effects (...)”
Gabor Mate argues that “Addiction is a
complex condition, a complex interaction
between human beings and their environment.
We need to view it simultaneously
from many angles—or, at least,
while examining it from one angle, we
need to keep the others in mind. Addiction
has biological, chemical, neurological,
psychological, medical, emotional,
social, political, economic and spiritual
underpinnings”. And John Cacciola,
PhD (Associate Professor of Psychology
in Psychiatry at the University of Pennsylvania)
also mentioned: “The issue is
one of getting a multidimensional assessment.
In other words, if the questions
are all about drugs and alcohol
(how much you used and what you’re
going to do to stop using) and that’s it—
but you’re not asked about your family,
work, and psychiatric problems—that’s a
bad assessment.”
It doesn’t always turn out why one has
an e.g. a drinking problem: Is it because
of excessive stress at home or at work?
Whatever the cause is, the problem
probably stems from a traumatic experience
in the past. It turned out that she
had been in a treatment program and
had after-care, which had ended recently,
though it’s unclear which program
she had taken (12 steps or something
alternative). But maybe it doesn’t matter,
as Anne M. Fletcher mentions in her
book: A number of studies have shown
little or no difference between programs
implementing such “evidence-based
approaches” and those that do standard
“treatment as usual.” (According
to John Kelly, PhD, of Harvard Medical
School’s Center for Addiction Medicine
at Massachusetts General Hospital, the
term “treatment as usual” typically refers
to what goes on in addiction programs
when “counsellors choose what
they implement”, as they see fit, without
following a manual or sticking to
established clinical guidelines.”
[End of excerpt]
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