What Kind of People go to Rehab?
Drug and alcohol use have long had a complicated history in the United States.
In the golden age of Hollywood alone there are countless stories of actors and actresses being given pills like they were candy: To stay awake through a long day. To steal a few hours of sleep. To drop a few pounds.
Then there was Prohibition throughout the 1920s and early 1930s. History’s shown that banning the problem didn’t exactly make it disappear. Far from it, in fact.
Drug use was popular in the 1960s. The counterculture turned on, tuned in, and dropped out, mostly with LSD and marijuana. It shocked the mainstream — never mind that it was acceptable to have a scotch at the office or for a housewife to rely on “Mother’s Little Helper” (more than likely Miltown) to get through the day.
Speed, cocaine, acid, quaaludes, dope — it all was mostly reviled by the general populace.
In between President Nixon declared war on drugs and Nancy Reagan urged kids to just say no.
More recently cannabis has gradually been destigmatized while we’ve sounded the alarm on the opioid epidemic. Much of it hinges on medical value and the potential for abuse. Then there’s the drug scheduling system and the Controlled Substances Act. (Heroin, for example, is Schedule 1, with a high potential for abuse and no medical value. In contrast, some cough medicines with small amounts of codeine are Schedule 5, with medical value and little likelihood to be misused.)
That tension remains, however, over how drug and alcohol addiction is perceived.
Drugs Are Bad, Mmmkay?
Despite substance use disorder officially being categorized as a mental illness — because it changes a person’s behaviors and priorities, and interferes with their day-to-day lives (work, school relationships) — it’s still seen by many as some kind of moral defect.
That continues despite federal reports estimating that one in every seven Americans will struggle with a substance use disorder. Facing Addiction in America, the Surgeon General’s report on how drugs and alcohol impact the U.S, estimated drug and alcohol abuse and addiction costs the economy $442 billion every year. That’s more than diabetes.Vivek Murthy, former surgeon general, told USA Today that every dollar invested in sound treatment can save $4 in health care costs and $7 in criminal justice costs. Losing the stigma and changing how addiction is viewed and approached (including prevention programs and quality treatment) would put less strain on society, Murthy said..
He’s gone so far as to call for a “cultural shift” on how we regard addiction. By viewing it as some kind of moral failing, that adds shame and makes people with substance use disorders hesitate to seek treatment. A better approach would be to treat it like a chronic illness to be handled with compassion and skill. Like heart disease, diabetes, or cancer, it’s something that can be managed, but it will need long-term approaches.
A Health Issue, Not a Moral Failing
To make that shift happen means no more thinking of addiction as some kind of character defect. Instead, consider it a chronic brain disease that needs compassion, treatment, and maintenance like any other ongoing health condition.
It’s not that a person is “weak” and becomes addicted. A number of things factor in, including:
- Environment (lack of parental involvement, a home where family used, peer pressure, availability of substances)
- Beginning use at a young age
- Dual diagnosis (addiction and another mental disorder)
- The substance used (cocaine, methamphetamines and heroin tend to be more addictive)
- How a drug is taken (smoking or injecting a drug makes it enter the bloodstream faster, and increases risk of dependence)
In addition to the struggle with craving and addiction, people face a number of additional fears that may serve as barriers to getting help:
- How to pay for it
- Believing they can cure themselves
- Not knowing where to find help
- Fear word will get out and family, friends or employers will view them negatively
- Fear of being committed
- Fear of it not working
Bad News Sells Papers
Media coverage gets some blame as well, and not unreasonably so.
Cases that turn violent or tragic tend to get more play than the story of someone who achieves sobriety. For every Amy Winehouse story that ends tragically there are countless stories of people who stopped on their own, or who walked into an AA or SMART Recovery meeting, or who checked themselves into rehab with little ceremony and little incident, except that they wanted to get better, and they did.
That’s why it can be helpful when people in the public eye are open about their struggles with and successes overcoming addiction.
And lots of celebrities have struggled with addiction:
- British comedian and actor Russell Brand has been very open about his heroin addiction..
- Actor Robert Downey Jr. for many years made more headlines for his drug use (including slipping into a neighbor’s home undetected and passing out in one of their bedrooms) than his film roles before finally entering rehab. Then he became Iron Man.
- Actor Brad Pitt has admitted to attending AA meetings.
- Singer Elton John has gone to rehab and been sober for decades.
- Singer and actress Demi Lovato has also spoken up about her stays in rehab.
When you think of a celebrity who lives in a mansion with a pool and personal chef and trainer, who perhaps makes millions a picture, it’s hard to imagine why they would ever have to use.
That’s the thing with addiction and mental illness. Anyone can be affected. Anyone can suffer anxiety or depression or have a traumatic past event. Anyone could have grown up with parents who drank and kept the liquor cabinet unlocked.Or been peer pressured to try something at a party. There are endless types of people who struggle with addiction:
- A male, 55, who owns a business.Is a father to two. While juggling work, wife and kids he takes the edge off with a beer after work and doesn’t stop until lights out.
- A female, 23, just graduated college. She faces a mountain of student loan debt and can’t find a good job. Xanax calms her nerves, but that sometime stress reliever has turned into a steady habit.
- A veteran with PTSD. He has trouble opening up about the things he’s seen in the Middle East and suffers with some chronic pain. He self-medicates; the opioids dull both the physical and psychological pain.
- A lawyer, new at a high-pressure firm, has resorted to snorting meth to stay up late and keep up with the demands of the job.
- A mother of one feels fear and shame stemming from her husband’s verbal and physical abuse. Rather than asking for help she smokes heroin to forget.
- A man feels anxious and depressed. He feels something is wrong, but thinks it’s some kind of character defect. Instead of mentioning it to his doctor or seeking therapy, he finds vodka keeps him pleasantly numb.
- A twentysomething gay male, new to the big city, feels energized in the club scene. Too much so, in fact, as he begins to use meth and cocaine to keep up and because he’s heard sex and slamming crystal are an unbeatable combo.
Many people have reasons for use. Abuse. Trauma. Depression. Anxiety. Schizophrenia. Job pressures. Money woes. War wounds.
Pain is universal. Mental illness can affect anyone. But anyone can get help, too.
- history.com – Golden Age Hollywood Had a Dirty Little Secret: Drugs
- gizmodo.com – This is the Drug in The Rolling Stones’ Song “Mother’s Little Helper”
- history.com -War on Drugs
- vox.com – The War on Drugs, Explained
- nimh.nih.gov – Substance Use and Mental Health
- usatoday.com – Surgeon General: 1 in 7 in USA Will Face Substance Addiction
- surgeongeneral.gov – Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health
- healthline.com– Risk Factors for Addiction
- ncbi.nlm.nih.gov – Understanding Stigma of Mental and Substance Use Disorders
- healthline.com – 10 Celebrities with Heroin Addictions
- latimes.com – A Troubled Actors’ Rude Awakening
- People.com – ‘There Was a Lot of Pain’: 23 Stars on Their Experiences with Addiction
- tweaker.org– Slamming
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