Mural on the Berlin Wall at the East Side Gallery (Spring 2002). Photo by Peter Rima
The worldwide misery caused by addiction is immense, striking millions of people. Not only the ‘addict’ but those close to them are devestated. In addition, there are huge economic costs to society and billion pounds costs from crime.
Also, beyond the identification of the most extreme forms of addiction, millions more are affected by less intense effects (including those on a ‘slippery slope’). For example, there is a tremendous toll on those who drink too much without being recognised as ‘addicts’. One unlucky bet from a regular gambler could result in financial ruin and its implications.
For those who seek recovery there are many sources of help (and it is worth remembering that many recover without intervention). Some succeed, some succeed partially, some die. In the wider social and political, medical and support spheres, ‘addiction’ continues to be a central focus of debate and research.
It is generally recognised that more needs to be done. There are insufficient facilities that provide recovery options. Mental health services often relegate ‘addiction’ to being of less than primary concern. In society at large, while things like smoking addiction are accepted as important, the many other killers are less thought about, or thought about very differently. Often, for instance, heroin addiction is thought by many to be associated with moral and character defects. A key right-wing philosophy puts all the emphasis on ‘individual responsibility’. It is, sadly, very common to hear people say things like, ‘It’s their own fault. Nobody made them drink, take drugs, gamble etc.’
Anybody who has made the barest inspection of addiction studies knows that the end result of addiction is the product of many factors. Some of these include:
- Individual susceptibility via genetics, peer group behaviour, mental health, poverty, cultural capital, education.
- Availability of harmful products.
- Multiple and complex needs including the first group above, housing, unemployment, prison and crime, lack of family support.
- Normalisation by industry and culture as a whole of harmful behaviours.
- Lack of support services and lack of effective strategies for many people.
- Stigmatisation. This hangs like a dark cloud over all discussion. Even recovered addicts themselves, usually unaware of how fortunate they are not to have faced any of the difficulties mentioned above, have been known to ‘blame the addict’ (while promoting their own self-satisfied moral strength).
- Education has been recognised as an important factor in ameliorating future harms. Alcohol and gambling industries present themselves as concerned about that high percentage of people who are addicts (and from whom most of their profits come), supporting charities and research. They stress that their products are to be enjoyed as ‘fun’ (‘When the fun stops, stop’ is the gambling industry’s slogan). In educational institutions, there have been initiatives in recent years but these tend to be very patchy and under-evaluated: some amount to little more than a few lessons, or a lecture.
- Advertising, especially for football gambling, has come in for criticism and many argue that it should go the way of tobacco advertising. Promotion by famous paid sports personalities has also been criticised especially for its effect on young people.
- While the psychology of addiction is extremely complex, it is fairly simple to understand why so many people turn to drugs (and, remember, alcohol is a hard drug) to alleviate misery, to numb the pain. While it’s not surprising that this connection is found strongly in people who have the least going for them, it’s very important to remember that there are many varieties of psychic suffering, and addiction curses many high up on the social pecking order.
- There is an increasing worry that something in culture and society is causing a stark rise in unhappiness and mental health disorders. Such conditions are breeding grounds for addiction. Many people are ‘self-medicating’ to escape misery, depression and anxiety.
I’ve purposely included in the above some value judgments because these are, like stigma, very common within any discussion of addiction. If you believe that the scourge of addiction and its devestating effects on millions of people can best be addressed by emphasising the responsibility of individuals to change their ways, I’d only disagree 90%. There is, and should be, a role for personal responsibilty, powerless people have to be given that power. But along with that, and along with intense attention to recovery, we need to address as well as possible the factors which encourage addiction in the first place. It’s not one or the other, that would be silly. Neither is it rocket science. If society regulates our food and medicines, the air we breathe, health and safety, then we can ask whether the regulatory frameworks in place for alcohol and gambling are adequate.
It’s not a question of banning or being anti-industry or anti-anything. Regulation is not a very exciting word but it’s crucial. There is a growing movement, for instance, including police officers and politicians, to legalise and regulate street drugs. Such a policy has been found to lessen drugs harm in countries like Portugal. But that’s a different story, and mentioned here only to throw in an other factor to what should be an ongoing debate.
(This post was originally published to The Machine Zone, 2 September 2018)