The Urge: Our History of Addiction | Research by Carl Fisher
Dr. Carl Erik Fisher is an addiction physician who teaches and studies at Columbia University in the fields of ethics, psychiatry, and neuroscience.
He is also in the process of regaining his sobriety.
From Carl’s latest book, “The Urge: Addiction’s History,” here are five crucial takeaways.
The term “addiction” should no longer be used to describe it.
I have been educated in both medical school and treatment that addiction was a “disease.”
Distinct from the rest of the population, it was devastated.
This is a faulty belief that stems from our history, and it does more harm than good.
A rise in hostility and despair toward people with mental health issues can be traced back to biological factors.
In 1784, Dr. Benjamin Rush enjoyed a rare vacation in Pennsylvania’s backcountry in the summer after the Revolutionary War had ended.
Postwar poverty and societal upheaval affected him.
Rum and whiskey were common, as was binge drinking.
It wasn’t uncommon for Americans to start their day with an alcoholic beverage rather than a cup of coffee, and they would drink it throughout the day, as well as at mealtimes because the water was viewed as unhealthy.
When Rush returned to Pennsylvania, he labeled chronic intoxication as a disease of the brain.
Rush, on the other hand, argued that medicine could only partially solve the problem since he also understood the importance of social and economic policy.
The alcoholism movement in the 1940s and 1950s used the term “illness” as a rallying cry to get hospitals to open their doors to those with alcoholism.
As a result of the medical community’s near-total retreat from addiction therapy during this period, they attempted to gain traction by using disease as a lingua franca.
This idea of sickness has evolved over half a century.
Medical science’s best framework for comprehending addiction is too easily slipped into disease jargon.
It is implied by biologically reductionistic explanations of “brain sickness” that people cannot make their own decisions or exert control over their behavior.
This tactic is designed to elicit empathy, but it fails miserably.
According to research, mental illness is stigmatized more by biological explanations than by other
Not only does this idea imply a sense of doom, but it also restricts our perception of a multi-level situation, such as the one Benjamin Rush saw more than 250 years ago when he advocated for more community assistance and less individualism.
A “multi-level problem” is one that “requires multiple levels of analysis.”
For example, less of a personalized perspective and greater attention to communal support, according to this concept.
Part 4: The Good vs. Bad Drug Myth
In the 1980s, crack cocaine surged across the United States, seemingly out of nowhere.
New reports of an unimaginably potent new drug and racist stories about the dangers of black and brown users infecting white America fueled the public’s moral panic.
Physicians and experts referred to crack as a “superdrug,” “the most addictive drug known to man,” and “nearly immediate addiction.”
It wasn’t long before dopamine, a neurotransmitter that had previously been underappreciated became the focus of attention.
For many years, scientists believed that dopamine was in charge of regulating the brain’s “pleasure center,” which is where all of the pleasurable emotions associated with food, sex, and drugs are generated.
During the crack epidemic, this theory became a popular one.
For many years, neuroimaging and its associated theories about dopamine’s role in addiction perpetuated a myth that drugs work by interfering with the brain’s natural reward system.
It’s typical to hear people say things like this about addiction, but it’s untrue.
Some of the most prominent academics in the field still fail to grasp this.
When it comes to dopamine, it’s not about liking; it’s about desire and longing.
The brain is bombarded with dopamine by crack, but other drugs (such as cannabis and opiates) don’t release it in the same way.
Dopamine hijacking, however, was a great expression of widespread social problems and gave support for law-and-order crackdowns in the war on drugs.
Purdue Pharma developed OxyContin, and federal regulators and the medical community ignored the hazards of a glut of opioids flooding the market.
Anxiety over allegedly harmful substances distorts our perception of addiction.
The anti-alcohol preachers of the 19th century made up stories about “pleasurable and unpleasant vibrations” in the stomach nerves when they preached against alcohol.
Because the good-bad drug dichotomy is so prevalent, many people are oblivious to good substances.
In the postwar opioid pandemic, experts got so concerned about opioid withdrawal that they overlooked the hazards of a developing amphetamine epidemic (obscured by marketing from powerful pharmaceutical companies).
When it comes to harmful drugs, the tail wags the dog; our incorrect assumptions about addiction lead us to overlook the complete picture.
“Misconceptions about the dangers of risky substances lead us to overlook the full range of possible advantages and harms.”
part-5: There is no cure for addiction
Addiction is an illness that can’t be cured; it’s a part of who we are.
We can’t, however, assume that there isn’t anything we can do.
Bringing addiction treatment into the mainstream is one of the most important aspects of this effort.
A young man with alcoholism who drank four to five beers a night came into my psychiatry residency for an intake interview.
Even though his issues were far less severe than mine, my boss insisted that we deny him access to our clinic.
Also, my mentor was a kind and caring doctor.
As a result of rules and practices that limit access to healing, the problem is structural stigma.
There are countless ways we might help lessen the effects of addiction without resorting to violence.
Safe consumption facilities, syringe service programs, and other services that limit drug harm and allow individuals to connect are among the essential services we need to expand.
It is imperative that we encourage all forms of rehabilitation and that we recognize that healing is a lifelong process.
Addiction is a part of all of our efforts, and we need to accept that.
We need to think about addiction in a different way than we do now.
Addiction has many facets, both personal and social, which must be taken into consideration as we search for ways to reduce urges and help people get well.
It’s important to remember that dealing with one’s addictions is a normal part of being a human.
Read More on our website: A Stunning Documentary on Recovery from Addiction Featuring Portland, Maine
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