Your Mind on Drugs

05.10.14

Coming Out of the Addiction Closet

Imagine using cancer to try and ruin someone’s career. Or diabetes. As Chiara de Blasio and Zac Efron go public with their struggles, why are we so close-minded about drug addiction?

As frowned-upon offenses in America go, addiction falls alarmingly close to violent crime.

The law deems illicit drug abusers criminals, so we treat them as such. The substances themselves are dangerous, powerful—sometimes, lethal. But the drugs alone are not the problem. The people aren’t either.

Contrary to what’s portrayed on movies like Wolf of Wall Street, those suffering from serious substance dependence aren’t getting high, drunk, or stoned, for fun. They’re sick, suffering from a disease that’s stolen their ability to choose. We’ve gotten better at understanding addiction, but there is a ways to go.

Take the two public displays of addiction that came out this week as examples.

New York Mayor Bill de Blasio’s daughter Chiara spoke out about her depression and substance abuse for the second time while accepting an award from the Substance Abuse and Mental Health Services Administration (SAMSHA). As she did, the Internet all but jumped through the screen to hug her. Former Health and Human Services Secretary Kathleen Sebelius smiled with pride as she handed her the trophy.

In a speech to the crowd, the smiling 19-year-old called her journey to sobriety “a miracle.” But on an accompanying post on XOJane, she detailed the daily battle she still fights. “It is remarkable how I’ve learned to change my natural state, as every morning I awaken a nervous and depressed wreck, before slowly putting myself back together again.”

Her decision to go public through a video in December, while—by all appearances—voluntary and miraculously scandal-free, was met with rumors of an impending smear campaign. Released just three days before her dad announced his mayoral candidacy, it may have been a brilliantly timed evasion of just that.

These rumors, of course, say nothing of the inarguably authentic and immensely brave message delivered by Chiara. Nor do they speak to the infinite number of teens to whom she’ll undoubtedly bring hope.

But they do say something of her audience.

“For too long there has been this perception that someone suffering could just stop. If only they flipped a switch, or tried harder, or lifted themselves up by their bootstraps, they could stop.”

The sheer fact that the discovery of an addiction, in the de Blasio case or otherwise, can be used successfully as a weapon in America captures everything that’s wrong with the way we view it. Imagine someone using cancer to try and ruin someone’s career. Or diabetes.

Addiction, unlike the other medical conditions to which it bears resemblance, is somehow—almost always—the person’s fault. If they could just stop, everything would be fine. After all, we’ve stopped, haven’t we? There’s a no-addicts-allowed club in America, and getting kicked out can cost you everything.

Or—could have.

In a statement equally courageous as de Blasio’s daughter’s, and even more well received, 26-year-old High School Musical star Zac Efron dodged expulsion when he opened up about his struggles with alcohol and drug addiction. Speaking with Matt Lauer on Today , the bright-faced brunette nearly glowed as he uttered, “I think it’s changed my life.” But later in the segment, the shame of addiction reared its ugly head once more. “It’s impossible to lead an honest and fulfilling life as a man and not make mistakes and ’fess up to them when you need to,” Efron said. “I’m a human being, and I’ve made a lot of mistakes. I’ve learned from each one.”

A mistake. Dishonest. His fault—and his alone. An idea that’s hard to believe he planted in his own mind.

Still, in many ways, Efron and de Blasio’s public testimonies are a triumph. One step closer to turning the tide of the addiction taboo that operates like well-oiled spin machine. But while the veil of privacy—for better or worse—has been lifted, the stigma still remains. Corey Monteith, Philip Seymour Hoffman, Whitney Houston, and Amy Winehouse. All four died of drug overdoses, all four alone. Because of fame, their stories made news. Each year, there are roughly 40,000 more that don’t.

“If one of us dies of an overdose, probably 10 people who were about to won’t,” Philip Seymour Hoffman uttered to Aaron Sorkin years before the imaginary became real. “[Hoffman] didn’t die because he was partying too hard or because he was depressed,” Sorkin continues in a tribute to the actor he wrote for Time. “He died because he was an addict on a day of the week with a y in it.”

The families, friends, neighbors, loved ones of the 100 people who die from drug overdoses every day in the U.S. know the meaning of this statement all too well.

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In it lives the key to our undoing: assuming that addiction is, always, someone’s fault.

“[It’s] not a moral failing on the part of the individual,” Rafael Lemaitre, communications director for the Office of National Drug Control Policy tells me. “For too long there has been this perception that someone suffering could just stop. If only they flipped a switch, or tried harder, or lifted themselves up by their bootstraps, they could stop.” But with the “wealth of research” that’s proved that statement false for almost a decade, it’s hard to comprehend why our own minds are so far behind.

The people, Lemaitre says, aren’t some distant creatures in dope land—they’re people you know. “These are people, not bad people. Coworkers, neighbors, soldiers, family members—people we know and work with and see every day. We want to encourage them to tell their stories.”

“The impairments we find in specific neural circuits (e.g., in charge of processing things like reward, conditioned learning, habits, decision making) help explain many of the typical (maladaptive) behaviors we observe in addicted individuals,” a spokesperson from the National Institute on Drug Abuse (NIDA) tells The Daily Beast. “The field of neuroimaging of the brain has been producing compelling evidence, for the past decade at least, of the structural and functional disruptions that emerge in the brains of chronic drug-abusing individuals.”

For those at NIDA, most specifically the director and doctor behind the science, Dr. Nora Volkow, not treating addiction as a medical disorder, given this knowledge, is borderline insane. “A person using drugs cannot properly execute their free will. They cannot stop taking the drug even though they may consciously want to,” Volkow says during an explainer video on addiction posted on WhiteHouse.gov. “And when you compare it to other diseases like asthma, diabetes, hypertension—the relapse rate you see with addiction is not any different than what you see with these other chronic conditions—classic medical illnesses.”

For years, though, we’ve been headed for a fall.

Drug use in America hit its peak in 1979, when an estimated 14.1 percent of the population was considered a “current” (in the past month) user. Since then, there has been a significant decline overall, with that same number landing somewhere around 8.7 percent of the population in 2013.

But left behind in the wake of decades of drug abuse are the survivors. The Office of the National Drug Control Policy estimates there are 20 million Americans living in recovery today. But if those in recovery continue to hide in plain sight, teens like Efron and de Blasio will continue to suffer in silence for years before finding help.

It’s the end of Chiara’s post, one of the final lines, that ushers in a new era of hope. A line in which there is no apology. No talk of mistakes. No claim that she’s repented—or even that she needs to. “Today, I’m in recovery,” she writes.

There’s nowhere better for a sick person to be.