Disease of Addiction | Disease of Free Will – Dr. Nora Volkow
For those who may not know, Dr. Nora Volkow is the Director of the National Institute on Drug Abuse (NIDA). I have long admired her work and found her recent article, “Addiction Is a Disease of Free Will,” another in a long list of her compelling research publications and articles. As she explains in this one:
“We can do much to reduce the shame and the stigma of drug addiction, once medical professionals, and we as a society, understand that addiction is not just ‘a disease of the brain,’ but one in which the circuits that enable us to exert free will no longer function as they should. Drugs disrupt these circuits. The person who is addicted does not choose to be addicted; it’s no longer a choice to take the drug. Addicted people in my laboratory often say it’s not even pleasurable. ‘I just cannot control it.’ Or they’ll say, ‘I have to take the drug because the distress of not taking the drug is too difficult to bear.'” Dr. Nora Volkow, Addiction Is a Disease of Free Will
Disease of Addiction | Disease of Free Will – Addiction Publications developed by NIDA under Dr. Volkow’s direction:
After assuming the Director’s position in 2003, Dr. Volkow has pioneered the use of brain imaging to investigate the toxic effects and addictive properties of abusable drugs, leading the NIDA in its support of most of the world’s research on the health aspects of drug abuse and addiction.
Below you will find three publications, with explanations quoted from the linked site, that I most frequently reference in my work to help my readers better understand this complicated disease – how it develops, how it can be prevented by understanding how it develops, and how it can be effectively treated, thereby allowing a person to live their lives in recovery.
Dr. Nora Volkow’s, Director of the National Institute on Drug Abuse, helps us uderstand the disease of addiction | disease of free will concept in her latest article, “Addiciton is a Disease of Free Will”
- Drugs, Brains, and Behavior: The Science of Addiction – “For much of the past century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When scientists began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punishment rather than prevention and treatment. Today, thanks to science, our views and our responses to addiction and other substance use disorders have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of compulsive drug use, enabling us to respond effectively to the problem.”
- Drugs of Abuse – “Learn the facts about the most commonly abused drugs. Each drug page includes a brief overview, street and clinical names, the effects of the drug on the brain and body, statistics and trends, and relevant publications and articles written by NIDA researchers and scientists.”
- Principles of Drug Addiction Treatment: a Research Based Guide (Third Edition) – “Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual’s life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences. Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work, and in society. Because addiction is a disease, most people cannot simply stop using drugs for a few days and be cured. Patients typically require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives. Indeed, scientific research and clinical practice demonstrate the value of continuing care in treating addiction, with a variety of approaches having been tested and integrated in residential and community settings. This resource is designed to serve as a resource for healthcare providers, family members, and other stakeholders trying to address the myriad problems faced by patients in need of treatment for drug abuse or addiction.”Note: as previously stated, the above explanations are quoted from the sections linked on the NIDA website.
Disease of Addiction | Disease of Free Will — sometimes it’s just hearing the same message a different way. Thank you Dr. Volkow!
Lisa Frederiksen
Latest posts by Lisa Frederiksen (see all)
- Does a Loved One Have to Hit Bottom? - November 20, 2022
- Resources for Parents of Children with Substance Use and Mental Disorders - October 18, 2022
- 4 Things to Support Brain Health and Function for Recovery - August 30, 2022
Thanks for sharing the articles by Dr. Nora Volkow. I too have admired her work. NIDA is full of resources that can help with understanding and the latest research on addiction. I’ve heard that addiction takes away a person’s power to decide which sound similar to Dr. Volkow’s point. The brain simply cannot function properly and thus cannot control the drug use. The research can helpl so much with understanding the issues that our loved ones are struggling with.
I so agree, Cathy – I forgot to mention that I will be hearing her at City Arts and Lectures June 30 – can’t wait!
Diseased or Deceived?
The Root Debate
I am firmly convinced that a common thread between addicted men and women is, they share dangerously high opinions of what ‘they perceive to be’ their strengths and terribly critical judgements against what ‘they perceive to be’ their weaknesses. I am therefore left convinced that the essential character attributes of emotional/relational Stability and Vulnerability have been excluded from the familial examples.
The World Health Organizations approach in treating addiction as a disease stems from the following conclusions:
1. It responds to treatment
2. It gets progressively worse if ignored
3. It eventually kills
I believe this ‘disease’ diagnosis to be a deadly stigmatic myth. Whilst acknowledging it to be born in sincerity, it has to be recognised that it is still merely of man, and as was once said, ‘the best of men are men at best’.
All too often in addiction treatment circles parents can be heard; “I just don’t understand”. Family members stare into an abyss of hopelessness as loved ones slowly die before their eyes. Various doctors desperately come up with various medications in attempts to offer temporary chemical solutions. We see repeated attempts to offer shattered families a degree control, whilst in reality the true image of ‘the child that was’ increasingly darkens under a continued destructive influence of an addiction and/or the satiated effect of mood stabilisers and anti-depressants.
Going to prison for the first time due to heroin addiction related crimes, I repeatedly rang the alarm bell in my cell in an attempt to get a sleeping pill, almost crying, convinced I was dying. Eventually I was told by two very angry night-shift prison officers; ‘if you ring this bell once more you will need more you will end up in intensive care’. From the moment the atmosphere was set where medication help was not going to happen, I resigned myself to ‘getting on with it’ and many of my symptoms went away. My anxiety levels decreased, I stopped pacing my cell, I was able to lie with quite a high degree of stillness, and eventually, after 16 days, I started to sleep.
During the addiction hopelessness increases as the (perceived) destruction progresses. In the darkness of late nights and the twilight of early mornings, young addicts lie awake in one room, overwhelmed by a pre-occupation of where the next hit is coming from, whilst parents lie awake in the next room, overwhelmed with confusion, uncertainty and powerlessness.
But hopelessness, fear, confusion, uncertainty and powerlessness are consequences of active addiction, not symptoms.
In their ‘Social Disease paper of 1976 Professors Stanton Peele and Archie Brodsky wrote:
We now know that heroin withdrawal symptoms can be suppressed or minimized in social settings which do not nurture their expression, as in certain iconoclastically tough-minded rehabilitation centres. On the other hand, among individuals or groups of people who consider it reasonable and permissible to fall apart upon being jilted by a lover, something analogous to extreme heroin withdrawal can be observed, with alternating inertia and uncontrollable restiveness, physical reactions, and an overwhelming feeling of emptiness. To understand why someone could find the absence of a drug—or a lover, or anything—so unbearable, we have to ask why that person found its presence so valuable. And this brings us to the basic hopelessness the addict feels about his prospects in life—a hopelessness which leads him to become addicted, which is intensified as he gets deeper into the addiction and further loses contact with life, and which looms all the larger upon withdrawal.
The deepest need of everyone concerned is an empowering explanation of exactly what is taking place which simultaneously illuminates and steers towards hope and peace of mind. Illumination needs to take place within the often distorted perceptions of addicts, families and professionals about the spiritual link to addictions. Because we struggle to understand the spiritual side of our make-up, we tend to dismiss it. In my own ‘Biblical Link to Addiction’ the primary focus of my argument are aimed at the spiritual root and the corresponding fruits which we know call ‘active addiction’. In my opinion, the primary need of everyone concerned is the arrest and reversal of various processes that the various players find themselves trapped in.
· The addict will be in a process of trying and failing
· The family will be in a process of judging and blaming
A neutral ground needs to be established where everyone involved can make a start towards the removal of desires to blame and a joint attainment of acceptance, compassion and direction. Looking for someone or something to blame will not offer us a solution. The addicted individual does not necessarily make their initial choice to use or booze because of bad parenting or hidden abuse issues. For many, in simply exploring the options of ‘something more’, they follow a still developing logic and decide to simply try drugs. Invariably however, there is one deadly common denominator between all who eventually become addicted. Years of counseling hundreds of addicts, in prisons, in hospitals, on street corners, in Churches in cardboard boxes and in 12-bed roomed mansions, no matter the colour creed or background, at root level they each believed the same fundamental deception; “I will not become addicted”. However, if for a moment we explore that particular logic a little further, we see it quickly cancels itself out; there are probably millions of other individuals with the same belief, who also experiment with and recreationally use various forms of mind and mood altering chemicals, who do not go on to become addicted.
If the addicted individuals are actually under a ‘spiritually deceptive government’ as opposed to ‘deadly diseased design’, trying to combat an inaccurately diagnosed ‘disease’ with ‘deception’ flavoured solution, no matter how philosophically or psychologically fine sounding, can only ever lead to a temporary hope and an inevitable increase of despair.
The truth is simple, people can start taking drugs for any one of a variety of reasons, but then find themselves unable to stop for an accumulation of other reasons.
Taking this argument one step further, I would suggest the ‘deception’ principle to be in active application within the foundational ethos of many of the worlds most sought after Addiction Treatment Clinics, mainly those who conform to the Disease Concept. Addicts voicelessly settle for a fragile second-hand identity from 12-Step membership, based on a their personal lack of obvious chaos and what look like signs of ‘development’ and ‘change’ which naturally takes place as a result being chemical free. It is true, a process of emotional development does begin at the removal of the chemicals, but we must take into consideration the condition of the person when their developmental process stopped, and not fall into the trap of thinking abstinence from the chemicals equates to being clean and sober. Whether deceived or diseased, this much we know; there is a propensity within the ‘addicted type’ to make sure that they become like the people they mix with in order to establish an identity. Likewise, members of the 12-Step Recovery Community have their own way of talking and greeting, socializing and watching out for each other. I want to suggest that individuals coming out of chemical dependencies do not have to settle for this 12 Step self-help second-hand identity in order to stay clean and sober. I would in fact warn those in early recovery against resigning themselves to 12 Step membership for the rest of their life’s and to set targets of independence from the day they start to develop.
I am firmly convinced that a sensitive a courageous nurture of emotional/relational Stability and Vulnerability can, over substance free time, can and will provide a footpath to normal living.
From My Boss and CEO of Bethesda Addiction Treatment Center, Colin Garnett
Very informative. I guess it is easy to recover a person from initial stages of addiction than those who have been addicted for years. Symptoms like bad temper, poor focus, a feeling of being depressed and empty,frustration, anger, bitterness and resentment. There may be a sudden increase in apetite. Social and/or recreational sacrifices all are symptoms of drug or any kind of wrong addiction. In such situations talking to the person is necessary. Even before taking him/her to rehab centers there are cases where we can make the urges to stop. I found a similarly interesting blog on how to control urges by yourself http://www.canadarehabreviews.com/blog/general-category/5-ways-to-control-your-urges/
Thank you for sharing your views and this resource.