Why do we as a society hate medication assisted treatment so much? Why are we so sure that punishment and pain will change things for people who are addicted to drugs?
I have spent the last 10 years fighting for change in the substance use field, fighting to end the drug war, working to change policies which further harm people struggling with addiction and battling with people who do not understand that addiction is not about a bunch of people partying till we drop, with not a care in the world, lying through our teeth, gunning to get anything we can out of everybody and anybody. We are portrayed as conscious-less liars who are selfish and irresponsible .
The thing is, I know why people think this. I understand how it could seem this way, and the saddest part, is that we, the people who struggle with the addiction/ chaotic substance use, often confirm to onlookers this very view. We reaffirm it in our stories, in our recovery tails, over and over again.
You see when we quit using, or go to treatment, we are usually pretty empty. We are then doused with loads of information. We are told over and over that we were selfish, did this to ourselves, did not care about anything but drugs. We are told this until we repeat it, and we are seen as non compliant until we do repeat it. We are taught the one acceptable narrative a person who struggles with addiction or chaotic use is allowed to tell. We are all but forced to recite this narrative ….it is sort of a precondition for re admittance….. (partial re admittance) back into society.
We reinforce the negative views that many people have of people who are struggling with substance use disorders by regurgitating the bullshit we are fed in these treatment programs and recovery centers. People who once struggled with chaotic use get on TV, make speeches in public and say time and time again for the world to hear self condemning things like: “thank god for prison, I would never have gotten my life together without it,” or we say, I loved drugs more than my family, more than my children, I only cared about drugs.”
We are fed this narrative during times in our lives we are in vulnerable and weakened states and we are taught it, made to say it if we have any hope of recovering and finally we say it, over and over and begin to believe it. The problem is this is just not true. Prison does not help anyone. Maybe someones life improved after prison, but I would argue that there are far more effective programs that could have truly helped a person. Prison is dehumanizing and horrific. I have never met a person who truly believes that prison has been a great thing for them once you really sit down and talk to them. Love and drug use do not have anything to do with one another. You would not look at a person who had a heart attack from eating too much red meat and say….”If you loved your children you would not have had that heart attack”. Love does not cure addiction and it does not sustain behavior change.
I believe myself to be strong willed, and self honest. I do not live in denial about my life and my reality, and feel resolute about my beliefs, but that is me at age 42, after two experiences of losing myself completely to a way of thinking, that is not my own. Now, this occurred after being exposed to over 32 treatment interventions before the age of 18, all of which pushed and pushed at my belief systems and my understanding of my life and reality. When people are in the midst of tragedy it is far easier to destabilize a persons understanding of their own experience. Traditional treatment models discourage critical thinking, they encourage that you remove old friends from your life and mind, and there is an inappropriate amount of power bestowed on members within the recovery group who have been in recovery for multiple years. In recovery time abstinent from drugs is equal to power (this has proven to be a recipe for disaster, a real mess. Men regularly take advantage of new young women who admire their “power”. It makes sense because in chaotic drug use power is essential for survival so money, things don’t matter as much as power in social groups.
We repeat over and over what we are told to repeat, that we are addicts, people who care about nothing but getting and using and finding ways and means to get more. We say this until we believe it, even though I think, most of us know deep down that this is not the truth. The real truth is that I feel horrible about things that I do that are against my values. I have never been okay with stealing. In fact, I remember vividly stealing my buddies wallet when I was about 16. I don’t know why I did it, I guess I needed money, but after I did it, I could not bear it. It was a little hippie zip up change purse. I remember this purse, just like it was yesterday.
I believe that one of the reasons that people like to punish people that use drugs, is because they believe we are having a great time. They honestly believe we are just fine with lying and stealing. They think we are just partying away with not a care in the world. People are made to believe that we are not haunted by our conscious like most human beings. Yes, I have had some good times, using drugs but, most of my life has been very painful. Everyday is painful for me. Life was always too much for me, that’s why I used drugs to begin with. I truly believe that if I had not found drugs, I would have killed myself. Drugs, made life more tolerable…..
Now let me get to the point. I think that one of the reasons that people hate medicated assisted treatment, and one of the reasons people like to inflict pain on people with substance use disorders is that they think we need to suffer. We have not suffered enough and if we suffered, then we would change. Well, not true. The people I help are all suffering. They can’t take not one more minute. They feel they can’t stand one more hurdle or difficulty to overcome. They have all but given up. Pain does not create change for people suffering in chaotic substance use. It is connection, passion and love that get us back up and active in life again. Connection to life, connection to family, connection to work.
I have heard about 5 deaths in the past two weeks of people overdosed. Each participant had been thrown out of medication assisted treatment or relapsed and they were too ashamed to tell anyone they were using. We don’t need to punish people who use drugs, they have already been punished enough. They need love, connection, real treatment that actually works (medication assisted treatment) and support. Medication assisted treatment (MAT) is the gold standard for opioid use. It works, it saved my life and countless others. I don’t think it is perfect, but it is not the sham that so many people believe. It is not the easy way out. It is not just substituting one drug for another. You don’t get high from MAT and it is not just a quick fix. There is still much work to be done after a person stabilizes on MAT. We must open ourselves up to MAT….if we don’t people will continue to die. I feel so unhappy that there are answers available, yet stigma and misinformation stand in the way of true recovery.
statistics about MAT:
Dr. Nora Volkow:
“Studies have shown that outcomes are much better when you are on medication-assisted therapy. For one, it decreases risk of relapse — significantly. Second, MAT has also been shown to be effective in preventing infectious diseases like HIV. Third, medication-assisted therapy has been shown to be effective in preventing overdoses,”