Friday, April 9, 2010

Re-hab Nation and Carrie Nation

Substance abuse is nothing new. Despite what one might think from public handwringing by politicians and talk show guests, it isn’t even any more prevalent today than a century ago. Every attempt to eliminate the problem by attacking supplies has been as unsuccessful as was, in the end, Carrie Nation’s hatchet. There always are and will be people who can’t tolerate life without getting high. They will pay to accomplish it, and others will sell to them.

These days addiction is classified and treated as a disease, and this may be appropriate. However, there is a distinction between substance abuse and, say, heart disease or Parkinson’s. A sufferer of one of the latter cannot choose to stop the symptoms. Addicts can, and most eventually do.

In 1992 the National Institute on Alcohol Abuse and Alcoholism conducted a study known as the National Longitudinal Alcohol Epidemiologic Survey. Of the more than 4,500 interviewees were or had been dependent on alcohol, 27 percent sought some sort of formal treatment, whether AA or rehab. At the end of the study, one-quarter of those who never had any treatment, were still alcohol abusers; one third of those who received treatment were still abusing alcohol. Those without treatment actually had better recovery rates. The point is not that treatment is harmful – those in treatment may be harder cases – but that it isn’t the necessary element in ending abuse. The necessary element is personal choice; when a person finally chooses to be sober the rehabs and support groups may well help. Without that choice they don’t.

It is not an agreeable conclusion that we can’t do much to cure someone else’s addiction. However, a lot of conclusions are disagreeable and no less correct for that. All we can do is offer help, and we often make matters worse for them and for us when we try too hard to force the issue.

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