The basic fallacy of the World Health Organization’s new terminology is its reductionism-that is, its assumption that the biochemical properties of a drug determine the behavioural reality in relation to that drug.
By Sanjoo Thangjam
I do not consider addiction or alcoholism to be diseases, mental illnesses or mental disorders, etc. therefore, nothing I say anywhere on this article should be considered by anyone to be a form of “treatment” for addiction/alcoholism.
It is a presentation of my opinions and the information on which I base those opinions. It is not treatment, I am not a doctor, and if you think you need medical treatment, then this is not the place to get it nor is it a replacement for it.
In the early 1960s, the World Health Organization, in an effort to devise a new terminology that would apply to the “abuse” of all drugs, not just addicting drugs, adopted the term “drug dependence.”
According to WHO “drug dependence” is a state of psychic dependence or physical dependence, or both, on a drug, arising in a person following administration of that drug on a periodic or continued basis. The characteristics of such a state will vary with the agent involved, and these characteristics must always be made clear by designating the particular type of drug dependence in each specific case. All of these drugs have one effect in common: they are capable of creating, in certain individuals, a particular state of mind that is termed “psychic dependence.” in this situation, there is a feeling of satisfaction and psychic drive that require periodic or continuous administration of the drug to produce pleasure or to avoid discomfort (Eddy et al. 1965, p. 723).
The basic fallacy of the World Health Organization’s new terminology is its reductionism-that is, its assumption that the biochemical properties of a drug determine the behavioural reality in relation to that drug.
If the old definition of addiction is understood as a strictly biochemical description, then it contains some validity, although with serious flaws. But the new terminology is completely invalid, because it is trying to deal with the social dimension by absorbing, distorting, and underplaying what is in fact the central feature of drug taking.
In the World Drug Report 2015 of the United Nations on Drugs and Crime (UNODC) prepared by the Research and Trend Analysis Branch, Division for Policy Analysis and Public Affairs, under the supervision of JeanLuc Lemahieu, Director of the Policy Analysis and Public Affairs, and Angela Me, Chief of the Trend Analysis Branch, stated that there is still some scientific and legal ambiguity about the distinction between *“DRUG USE”, “DRUG MISUSE” AND “ DRUG ABUSE”,* therefore the neutral term *“DRUG USE” AND “DRUG CONSUMPTION”* are used in the report.
In view of the above facts as per the authority’s remarks – that is, the UNODC’s, many from People Who Use Drugs (PUDs) community, researchers, experts and likeminded are audaciously affirming that there are no such stupid and injudicious terms as Junkies, Drug Addicts, Substance Abusers or Alcoholics.
*a) JUNKIES & DRUG ADDICTS:*
The word “junky” conjures such graphic images these days, some of which seem to be diametrically opposed; on the one hand, our society shuns the junky, labels her/him dysfunctional, socially inept, lazy, weak willed, a danger to society everything that’s wrong with this world.
Most people would shudder to think there is a junky living next store. At the very least they buy a beefed up security system to protect their precious belongs from us. Worse, they would call the police and have their junky neighbour arrested just as soon as they can conjure up a reason.
On the other hand, society also glamorizes the junky; the lone wolf, living on the fringe of society, dabbling with the dark and forbidden. An artist. A poet. A musician. We make exceptions for the musician junky for some reason. We want a voyeuristic peek into their lives – the taboo underworld where most people dare not venture.
Just the word junky brings powerful imagery to mind. Whether you think of the dirty street dweller, passed out in or near a dumpster with a tie still on his bloody arm and dirty needles scattered around, polluting the streets and making them unsafe for your children, or the dark and mysterious artist, quietly brooding as he lays next to a gorgeous blond in bed half naked, quietly searching for that vein, until a plume of blood fills the chamber and he’s finally able to achieve the solace, the ultimate escape the he longs for, hopefulness lost in the clutches of addiction.
Yet, for all the negative or taboo connotations, the word junky is still thrown around as *“hip.”* Heroin Chic is alive and kickin’ in the fashion industry. People jump at the chance to label themselves a food junkie or a film junkie, or whatever they want to call themselves. But not a *drug junky*. And *CERTAINLY* not a *Heroin junky.*
But let’s look at the topic more subjectively.
What some of the more common or reputable dictionaries had to say on the matter. Here are a couple of the samplings:
*Dictionary.com on the word Junky:*
Of the nature of junk; trashy
1. Drug addict, junkie, addict, freak, nut
*On the word Junkie (slightly different):*
1. A drug addict, especially one addicted to heroin.
2. A person with an insatiable craving for something: a chocolate junkie
3. An enthusiastic follower; fan; devotee: a baseball junkie
*From the Oxford English Dictionary:*
1. A person with a compulsive habit or obsessive dependency on something: power junkies, a drug addict.
The good ‘old’ OED. Like the English, its diplomacy reigns supreme. But sadly this definitive source of the English language will no sooner change anyone’s personal beliefs on what a junky is than it will start injecting heroin on its own.
*The Urban Dictionary.*
This is where you go when you want to find the real State of the Union, since it’s written For the People, By the People. What does the critical mass consider a junky?
1. A heroin addict, one that is, was and will always be. Before the crack heads and the way before the dexheads and the E-tards wasting his life away, for pure bliss and contentment.
2. Someone who dabbles with illicit drugs.
It is when someone consumes alcohol or drugs. The very first time that he/she took a sip of alcohol, he/she was using. Substance use does not always lead to addiction; many people occasionally use alcohol or certain drugs without being addicted.
*b) SUBSTANCE ABUSERS:*
There is clear evidence that the phrases “substance abuse” and “substance abuser” harm, as well as disparage people with the habit of drug use. It’s time to ditch these terms.
*“ABUSE”* is an ugly word. “Child abuse,” “Sexual abuse,” “Physical abuse,” “Emotional abuse,” “Domestic abuse.” And then, of course, there’s “SUBSTANCE ABUSE.”
But one of those things is not like the others: In all of the other types of abuse, there is a perpetrator who is harming a victim. In substance abuse, however, it makes no sense to argue that the victim is the poor innocent line of methamphetamine or a glass of Chardonnay. The damage done – both by the problem and the term – is focused primarily on substance users themselves. The label is far from ordinary.
Debates over language often seem absurd or trivial. However, they make a difference in how issues are framed and therefore what solutions are proposed.
Frame addiction as *“substance abuse”* and it is easy to see why it should be a crime, but call it *“substance use disorder”* and it sounds like something to be treated medically. If we want to make progress in ending stigma, we should think hard about the words we use.
*c) ALCOHOLICS:*
One of the biggest stumbling blocks for people wanting to stop or cut down on their drinking is the belief that doing so makes them an *“alcoholic.”* It’s a similar stumbling block for their family members, who are experiencing second-hand drinking (the impacts on their emotional and physical health caused by coping with their loved one’s drinking behaviors) but are afraid to take a stand against those behaviors because it could be construed they believe their loved one is an alcoholic.
The 1980s *“Just Say No”* effort used these sorts of images, which contributed to the shame of calling oneself an alcoholic (or drug addict) and stigmatized people who did. For it’s the label, “alcoholic,”* of which a person is often most fearful – a label that much of society views as someone who is white knuckling his/her way through life, one sip away from a relapse, with permanent brain damage (think of the 1980s message, “Your Brain on Drugs”). It’s a label much of society has surrounded in stigma and shame because of society’s mistaken understanding. It’s a matter of willpower and not the brain disease it is now understood to be.
But there’s good news. There is NO NEED to call oneself an alcoholic to get sober. In fact, millions of people who drink too much are NOT alcohol dependent – meaning they’re not alcoholics – the term that’s long been assigned, but only recently understood.
One way is to ask ourselves if our drinking pattern is causing second-hand drinking. In other words, are you having arguments or intense discussions with our loved ones or friends about how we behave when drinking? Have I got awaken in bed with someone I’d not planned to sleep with? Does my family member or friend tells me about mean things I said or did the night before, things I know in my heart-of-hearts I’d never have done had I not been drinking?
If so, my drinking is a problem but it does not, however, necessarily mean I am an alcoholic.
So let’s keep it simple and let’s not worry about the label, “alcoholic.” Let’s simply celebrate a person’s decision to stop the drinking that causes the behaviors that result when they drink more than their liver can process – the behaviors that have made their lives and the lives of their loved ones unmanageable.
*JUSTIFICATION*
Three Most Relevant Reasons Addiction Is Not A Disease. So to sum up, there are three significant reasons why the current brain disease theory of addiction is false.
1. A disease involves physiological malfunction, the “proof” of brain changes shows no malfunction of the brain. These changes are indeed a normal part of how the brain works – not only in substance use, but in anything that we practice doing or thinking intensively. Brain changes occur as a matter of everyday life; the brain can be changed by the choice to think or behave differently; and the type of changes we’re talking about are not permanent.
2. The very evidence used to demonstrate that users’ behavior is caused by brain changes also demonstrates that they change their behavior while their brain is changed without a real medical intervention such as medication targeting the brain or surgical intervention in the brain and that their brain changes back to normal AFTER they VOLITIONALLY change their behavior for a prolonged period of time.
3. Drug use is not compulsive. If it was truly compulsive then offering a drug user tickets to the movies would not make a difference in whether they use or not because this is an offer of a choice.
Research shows that the offer of this choice leads to cessation of substance abuse. Furthermore, to clarify the point, if you offered a cancer patient movie tickets as a reward for ceasing to have a tumor, it would make no difference and would not also change his probability of recovery.
*“Even If The Authorities Say Addiction Is Definitely A Disease”- BUT IT IS NOT AT ALL ?*
The National Institute on Drug Abuse and Addiction (NIDA), Substance Abuse and Mental Health Services Administration (ASAM), the American Medical Association (AMA), Nora Volkow MD, Dr Phil, Dr Drew, and many others say that addiction is a disease.
Just as I hope people don’t uncritically take my word on the issue, I hope you don’t uncritically take their word on it as well. Please think critically, and judge the evidence for yourself. I have looked at the evidence and arguments presented for the disease model of addiction and I can’t find anything that holds up to scrutiny.
If authority is all that people care about, then let me say this – I can list plenty of authoritative sources who have also concluded that addiction is not a disease:
• Gene Heyman PhD of Harvard;
• Sally Satel MD of Yale;
• Stanton Peele PhD of NYU and The New School for Social Research;
• Peter Cohen PhD of the Centre For Drug Research in Amsterdam;
• Thomas Szasz; Professer David Hanson PhD;
• Professor Jeffrey Schaler;
• Dr Tom Horvath and
• the many other PhDs behind SMART Recovery.
There are more to be listed, in fact there have been several polls over the years asking doctors if they believe addiction or alcoholism is a disease, and majorities have said they don’t believe it is a disease.
Let me repeat the words of an experienced researcher, PhD, and a lecturer/professor from Boston College and Harvard who, in addition to publishing scores of papers in peer reviewed medical journals has also had an entire book debunking the disease model of addiction by Harvard University press.
(I say all of this about the credentials so that I can hopefully STOP getting commenters who say *“but you’re not a doctor, and what are your credentials blah blah blah,…”* here’s a “credentialed” expert who essentially agrees with most of what I’ve written in this article so save your fallacious ad hominems and appeals to authority for another day), Gene Heyman PhD said this, as of 2013.
(The writer is a Human Rights Activist of People Who Use Drugs (PUDs) and a columnist based in Imphal)