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Vince Mercuri: Understanding is needed to free nation from addiction

Tribune-Review
| Tuesday, December 11, 2018 7:03 p.m

In 1784, Dr. Benjamin Rush published a pamphlet titled “An Enquiry into the Effects of Spirituous Liquors Upon the Human Body and Their Influence Upon Happiness of Society.”

Rush, who was a member of the Continental Congress, a signer of the Declaration of Independence and a physician of the Continental Army, has often been called the father of American psychiatry and is the first American authority on alcohol and alcoholism. His writings proclaimed that “spirituous liquors,” meaning hard liquor, hurt people, especially their health and work productivity. His claim was that a nation corrupted by alcohol can never be free.

His writings stand as the first proclaiming the disease concept of addiction by an American. However, his claims were met with resistance and ridicule, being described as ludicrous and impractical.

Throughout history there have been many diverse concepts, opinions, movements, theories and reasons given for addiction. Many are steeped in misconceptions, stigma, stereotypes and the belief that individuals who are addicted are weak-willed or morally adrift.

The denial, resistance and lack of acceptance of the disease model of addiction is prevalent throughout our culture. Intolerance and misunderstanding have their roots in lack of information and awareness.

Since 1956, the American Medical Association has established and accepted the disease concept, recognizing that addicted, as an illness, means several things:

• The illness can be described. The condition is defined by specific, unique symptoms that can be diagnosed by medical professionals.

• The course of the illness is predictable and progressive. It will get worse, resulting in deterioration physically, emotionally, mentally and spiritually.

• The disease is primary. It is not just a symptom of some other underlying disorder.

• The disease is permanent — you have it even if you are in recovery or abstinent.

• The disease is terminal. If left untreated, its progressive nature will result in premature death.

The most common rebuttal and response to the disease concept is that an individual chooses to use chemicals, and therefore it was his or her choice to become a person with a substance use disorder.

This stigma is not informed on the progressive nature of the illness. No one sets out to be addicted. There is a predictable pattern with chemical dependency that begins with the experimental stage, where an individual learns about the mood swings resulting from use, and progresses over time to the addictive stage, when the drug becomes the most important thing in the user’s life and disrupts family, work, school and health, even leading to illegal activities.

Having this disease does not mean people are not accountable and/or responsible for their actions. It does mean they have the knowledge of their past behaviors and choices that can be a springboard to change. The cornerstone of recovery/wellness is acceptance, surrender, commitment and a hope that a new sober lifestyle is possible.

It has been 234 years since Rush published his works on the disease of addiction. Much has been gained to confront the stigma associated with this illness, but more understanding and acceptance is needed for our nation to be truly freed from its grip.

Vince Mercuri, executive director of the Open Door Alcohol/Drug Treatment Center and Crisis Intervention Program in Indiana, Pa., is a member of the Valley News Dispatch Editorial Board.

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