What is an Addict?

18:03 What is an Addict? 0 Comments

I am fond of the definition of addiction which goes, “someone who does something over and over again expecting different results.” The alcoholic goes on a bender entirely convinced that this time will be different. He’ll be able to control his drinking, he won’t get into bar fights, he won’t drive drunk, he won’t cheat on his wife, he won’t do whatever insanely stupid thing he always does when he ingests alcohol. Left untreated, addiction is a progressive disease. If the drunk thinks that whatever trouble he got himself into last time won’t happen the next time he drinks, he’s actually right in the sense that not only will he do the same insanely stupid shit that he did last time but he will do stuff that is even more destructive to himself and the people he loves. Drunks and drug addicts don’t end up unemployed and homeless because they were born that way. It’s the addiction that did it to them. Once addiction is in full swing, nothing—and I mean nothing, not a job, a house, a car, a wife, kids, parents, friends—nothing is as important than getting a fix. That’s where the dishonesty comes in. Addicts lie because all they really want is the booze or the crack or the sex. They will sell their mother to get it. There’s a great scene in The Fighter where Dicky Eckland (played by Christian Bale) is in a crack house and his mother comes looking for him. He jumps out a second story window in a drug induced haze to try to keep his mother from seeing the truth. He lands in a huge pile of trash and he can’t avoid coming face to face with his Ma. But even that doesn’t get him sober. The final definition for addiction is when the thing you are addicted to is ruining your life. Some people can drink tons of booze or even take lots of coke and their life is honestly unaffected. It doesn’t send them into a downward spiral caused by the phenomenon of craving which blots out anything good in their life. A guy jumping out a window to avoid his mom is most likely an addict. But the addict’s mind tells the addict that they are not an addict no matter how complete the breakdown of normal life. That’s why most addicts end up in jail, dead or, despite all odds, getting the help they need to get and stay sober. There’s not a lot of gray in the trajectory of continued use. ♦◊♦ Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., is the standard by which mental illness is diagnosed and heath care is provided in the United States.  Health Insurance, including Medicare and Medicaid, look to the D.S.M. to define standards of care and to establish medical reimbursement.  The New York Times reports that the newest D.S.M. will have a much broader definition of addiction than in prior versions. In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation’s arbiter of mental illness have agreed to revise the definition of addiction, which could result in millions more people being diagnosed as addicts and pose huge consequences for health insurers and taxpayers. Under the new definition the addictive use of drugs and alcohol will be broadened and the number of activities that can be considered addiction will also be broadened to include such things as gambling for the first time. Currently only 2 million of 22 million addicts, defined under the old D.S.M., get treatment at least in part because they don’t have health insurance. The new definition may increase the number classified as addicts by as much as an additional 20 million. Insurance companies, and many clinicians, are criticizing the expansion of the definition of addiction as costing hundreds of millions of dollars.