Addiction is a bio-psycho-social disease, meaning genetic predisposition interacts with certain social and psychological factors to manifest the disease, which could otherwise have remained dormant for the rest of someone’s life. Addiction is a chronic condition (like Hypertension, Diabetes) characterised by relapse and remission. Proper maintenance is the key to success.
Addiction is often called a “family disease” and an addict is known as the index patient, while the family is the background patient. Family dysfunction, abuse, trauma, and mental illnesses are closely linked to addiction. Children growing up in dysfunctional homes start using substances (alcohol, drugs, prescription medicine etc.) or addictive behaviours (sex, gambling, extreme religious righteousness, video games etc.) to cope with difficult emotions that their brain fails to process. They get stuck in repetitive behaviour, even though it brings negative outcomes.
Addiction is a pathological learning process and creates a vicious cycle between thoughts, feelings and behaviour. We can only observe the behaviour, which is ultimately self-destructive and impacts everyone around them negatively. It is painful to witness this downward spiral of a person who is suffering from this overpowering, cunning, baffling disease. Friends and family try to help addicts, but it is not easy to help them if they they don’t understand this disease. Friends and family tend to fall into the role of an enabler or become co-dependent, which makes the situation worse.
Enabling behaviour includes trying to exercise control by giving threats or bribing them. Sometimes, family members try to keep it a secret and take responsibility for the addict’s actions. Some families become emotionally enmeshed with the addict, which adds an added layer of dysfunction to recover from. The co-dependent family member vicariously lives the life of an addict without using any substance; the addict becomes their addiction! None of these situations are helpful in the work of recovery.
Special programs (e.g couple counselling, family counselling, co-dependency programs etc.) and self-help groups (e.g. Al-Anon, Al-teen etc.) for family members, to guide them properly on how to be supportive, is quite useful. Shaming an addict is never helpful. Chronic addiction is the manifestation of toxic shame. Healing from shame and guilt is a perquisite for sustained recovery from addiction.
Family can be the main source of strength or weakness for a recovering addict. Sometimes, they must choose and create family in recovery community to get the support they need. The chosen family proves to be more helpful than the given family in many cases. On the other hand, it is sometimes essential for biological families to cut ties with the addict and create some breathing room for themselves to survive and become healthier.
Untreated addiction and mental illness can be dangerous to live with. Concurrent disorders (addiction and mental illness) are also sometimes complicated by co-occurring intellectual disability. This group of people are overrepresented in hospital emergency rooms, legal system and amongst the homeless population. Not getting diagnosed, not getting proper treatment and support will have a detrimental effect on the social system.
When people who have the most in society are greedy to have even more, the neediest people in the society become the reflection of that shamelessness on the two extremes. History tells us about “Opium war” between British and China in the17th and 18th century. History gives us the record of drugs being used in international politics. Bangladesh is the easy passage used by drug traffickers. Drugs, arms and criminality go hand in hand for many reasons. Politicising all important social institutions and destroying the justice system can go only in favour of social evils. Bangladeshis are now challenged as a nation in their overall intellectual capacity to handle this situation.
Addiction and mental illnesses are costly diseases that can’t be treated without public funding. This is not a lucrative field for medical business owners. Isn’t it yet time to ask the questions — what is the national budget for dealing with addiction and mental health? What is the government’s plan and how is it going to be executed?