I am reposting this from my friend James Campbell, whom I consider a supreme authority on substance abuse and addiction. James is the Executive Director at the Family Excellence Institute and does trainings across the Southeast for Counselors and Therapists who work with Substance Abuse and Recovery. You can find him and his excellent poetry on Facebook.
Over the years I have rarely heard this question or variations of it asked. I believe the reason for this is that most people assume they already know the answer. If I were to go ask most people in my community to describe a person with addiction to me, I would get some pretty consistent answers. I know this, because I have asked. I don’t mean here people in the recovery community or in treatment centers. I have asked people who I know at local retail stores, schools, the grocery store, and even at family functions. Here are some of the common answers I hear.
People with addictions are: Lying. Weak-willed. Dirty. Homeless. Crazy. Skinny. Covered in sores. Criminal. Toothless. Depressed. Have a yellow tint to their eyes. Have bloodshot eyes. Have bad hygiene. Have track marks.
These are just a few of the things that I usually hear, but they are recurrent and prevalent. There is a lot of consensus among the general public that these are traits of what most would just call “an addict”. The problem is, of course, that this is an inaccurate list. These traits are a stereotype of a person with addiction, but they are only present in a miniscule minority of people with a substance use disorder.
When we diagnose someone’s drug use clinically there are certain symptoms of substance use disorders we look for.
Taking the substance in greater amounts or for longer times than intended
Unsuccessful attempt to quit or cut down use
Craving the substance
Not carrying out roles well because of use
Spending a lot of time obtaining the substance
Using despite social or interpersonal problems being caused or made worse
Stopping or reducing activities that were important to the person
Using the same amount without the same effect or using more to get that effect
Use despite knowing it’s causing or exacerbating physical or psychological problems
Using recurrently in a dangerous situation
Having just two of the above symptoms is enough to diagnose someone with a mild substance use disorder. Having six or more symptoms on this list is enough to diagnose someone with a severe substance use disorder. Most importantly, however, is the symptoms themselves.
Most of the traits of the stereotype of a person with an addiction are fairly easy to spot in another person. Bad teeth. Being dirty. Having sores. Having poor hygiene.
Most of the actual symptoms of a person with a substance use disorder, however, are not easily observed. Unless you are very close to a person the odds of spotting things like tolerance, craving, and reducing important activities are incredibly small.
Now for the important question, perhaps the most important one. So what? What difference does it make whether the stereotype is correct or lines up with the actual symptoms of a substance use disorder? The answer is the reason I am writing this and sharing it and the reason that I am asking you to do the same.
The stereotype of what a person with an addiction looks like keeps people who need to seek help from doing so. Many people who have symptoms of a substance use disorder actually believe they do not because of the stereotype. They may think things like, “I may drink a little more than I used to, but I still go to work every day” or “My spouse and I may fight about my using, but I just need to unwind on the weekends”. They often believe that if they don’t meet the stereotype that they can’t have a problem, but the stereotype represents only a tinypercentage of those with a substance use disorder or an addiction. The stereotype keeps about 90% of those who need help from ever seeking it out or getting it. The stereotype results in people dying-good people, people with families, people who are loved, people who have great worth and deserve to live-and that is unacceptable to me. People are dying because of ignorance about what a substance use disorder really is and how to identify it.
So, what does “an addict” look like? They look just like you, me, and those we love.
Please share this list and this post. Help tear down the stereotypes and spread the truth that you can almost never spot a person with a substance use disorder unless you are close enough to really know them and see their behavior consistently. Help those in your life who may need some help and support to know the truth about what a substance use disorder is and isn’t. Recovery is absolutely possible for those with a substance use disorder and for those who love them.
Copyright James Campbell
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