Understanding Addiction

Addiction is nothing new, as we can see from the above quotation, in which the biblical writer paints a hauntingly accurate picture of the devastation caused by alcohol addiction. Alcoholism, drug addiction, and addictive behaviors affect every group at every level in our society. In the United States, one out of four people has a parent, child, or sibling who is addicted. In 1995 the National Institutes of Health estimated the economic cost of alcohol and drug abuse at over $240 billion.

Lost productivity, illness, premature death, and health care expenditures are all part of this picture, as are costs associated with motor vehicle accidents and with crime and incarceration. The emotional and social damage is immeasurable. Abuse of alcohol and drugs disrupts personal development, relationships, and families, corrupting the very fabric of society. Addiction to nicotine is a problem of massive proportions, and the difficulty of shaking that habit is familiar to millions. Behavioral addictions include pathological gambling and sex and compulsive overeating.

Most of us are affected, directly or indirectly, by addiction or its consequences on others.

We are familiar with the image of the skid row wino and the strung-out junkie, but addicts don't usually look or behave like that; they are more likely to resemble your nextdoor neighbor. They are often accomplished people, and many have achieved fame. In recent years, public figures have become more open about their problems with addiction.

Betty Ford, the wife of former president Gerald Ford, struggled with alcoholism, then dedicated her life to establishing an addiction treatment center. Golfer John Daly also talked of his problems with alcoholism, as did the baseball hall of famer Mickey Mantle before his death from the physical consequences of addiction.

Our knowledge of the biology of addiction has grown tremendously in recent years. We have learned that the addicted brain does not function normally and that it is impossible to separate the brain's biological function from a person's psychology and will. Clinicians who treat addiction know that there is no one perspective or approach that is correct. Recovery for addicted people and their families involves physical healing, behavioral changes, relational reconciliation, and psychological and spiritual growth. This section brings those various aspects together to provide the reader with a useful working understanding of the problem of addiction and a basis for continued learning.

As a practicing psychiatrist and addiction specialist, I believe that arming the patient and family with information about an illness is essential for success in treatment. It is wise to know your enemy. In this section, I will attempt to provide a comprehensive overview of the problem of addiction from several perspectives, including that of the addict, the addict's family, and the treating clinician. As you learn about addiction, you will find that there are no simple answers and no routine cases.