The face of addiction: Differentiating between abuse and dependence.

 

 

 

 
Most people know the textbook example of addiction as the vicious, consuming black hole that can ultimately destroy one’s family, career, mental and physical health, and severely compromise the quality of life. Indeed, many of us have struggled with addiction or have encountered someone who has. Because of all the attention this disorder generates, it is easy to make sound judgment, to assume that a heavy drinker is an alcoholic or a cocaine user is a drug addict. Yet, as we will see, the criteria for diagnosing true substance dependence (addiction) is complex. 
addicthelp.org
 
First of all, not everyone who indulges in their vices, whether it be smoking, drinking, drugs, gambling, shopping, etc. is considered dependent. People who repeatedly continue their self-destructing behavior, despite recognizing how the habit is negatively affecting their quality of life, are engaging in substance abuse. They may face serious ramifications, such as legal trouble, financial struggles, problems at home, etc. However, unlike those with substance dependence, they do not exhibit substance tolerance or withdrawal symptoms.
 
Substance abuse however can transcend into substance dependence. The theories about this spiral into addiction are both controversial and plentiful: neurological disruptions regarding levels of serotonin and dopamine, genetics, environmental cues, etc. Still, it should be noted that abuse does not always lead to dependence. Many people go through an “experimental stage,” especially during their teenage and young adulthood years, and they do not suffer from addiction later on.
 
For people with substance dependence, however, the user acquires tolerance to the substance, therefore requiring a dosage increase to achieve the same intoxication or altered state. Likewise, the individual is deemed unsuccessful in reducing or quitting from the substance, despite his or her willpower or desire to do so. Withdrawal symptoms, such as hangovers, headaches, tremors, nausea, and shakes, occur during periods of abstinence. When the individual engages in the substance, he or she often often intakes more than intended and a “loss of control” feeling is common. Individuals may go to extreme measures (theft, lying, spending inordinate amounts of money or time) to find the substance when experiencing strong cravings for it.
 
 
It is critical to understand that the two mental illnesses are not interchangeable. In other words, a person cannot have both diagnoses at the same time. For users to be considered substance dependent, they must have already surpassed the stage of substance abuse. Furthermore, the necessary course of treatment action is different. Treatment plans for substance abuse often promote learning the appropriate strategies and techniques to reduce environmental and social triggers for cutting back intake. Some, but certainly not all, individuals choose a path of sobriety at this point. While people may seek professional help at this point, others are able to quit or cut back and improve their quality of life on their own. However, for people who are substance dependent, the treatment tends to be more aggressive. Recovery programs, such as the popular Twelve Steps and rehabilitation centers, usually advocate full sobriety. Most individuals must seek professional help in order to achieve this.
 
It should also be noted that the amount and frequency of abuse does not necessarily determine dependence. In fact, the face of addiction is difficult to detect, simply because some people engage in their substances secretly or do not fit the “addict” stereotype. Others may go through stages of heavy use followed by stages of abstinence or steady use. For instance, a college student who goes out to the bars and staggers home drunk every night for one week cannot automatically be deemed an alcoholic. For one, dependence patterns must have been evident for at least twelve months. This rules out most situational factors and variables that can lead to substance abuse. Also, we must consider the context. Is this drinking binge an isolated event? Did an emotional event, whether happy or sad, just happen?  Let’s examine an elderly woman who drinks a glass of wine a night to calm her nerves. A few months, noticing she is feeling more stressed, she starts drinking two glasses. Sometimes, on particularly bad nights, she finishes the bottle. Is she substance dependent? If she finds that she cannot curtail her habit, despite a longing to quit and the withdrawals provoke a sense of anxiety and relentlessness, she may be developing a problem.
 
To conclude, we are quick to throw around the terms like addiction and addict, but automatic labeling can be harsh, false, and detrimental to a person who is not actually suffering from dependence. While there is a plethora of research discussing the proposed models of addiction, it is important to continue studying why most people engage in substance abuse at some point and why only some of them transcend into substance dependence. This knowledge can help prevent and raise awareness about the addiction epidemic.
 
References:
All information can be retrieved from the DSM-IV-TR or behavenet.com; substance abuse and substance dependence.

 

 

 

Lance Armstrong, doping, and how the average person responds.

 

 

 

As of now, the verdict behind the allegations of Lance Armstrong using performance enhancing drugs during his pro-cycling career, is still unclear, but the assumptions are rampant. If charged guilty,  Armstrong will be not only banned from competing in this sport, but the U.S Anti-Doping Agency will strip him of his record-breaking, seven Tour De France titles.

The full article about this controversy can be found here: http://www.nytimes.com/2012/08/24/sports/cycling/lance-armstrong-ends-fight-against-doping-charges-losing-his-7-tour-de-france-titles.html?pagewanted=all

Armstrong is not refuting these charges, and, in fact, in response to all the doping allegations, he stated, “There comes a point in every man’s life when he has to say, enough is enough. For me, that time is now.

In the name of cycling, Armstrong’s name is synonymous with success and fame, just as Tiger Woods was with golfing (before his cheating scandal), Kobe Bryant is with basketball, and Serena Williams is with tennis. These names carry a certain degree of fame, because people recognize them, even if they do not follow that particular sport. 

In line with the makeup of most court cases, Armstrong’s high-profile situation can conceivably go in four directions: 

1. Armstrong is considered guilty, although he is actually innocent.

In statistics, we call this Type 1 Error. In law enforcement, this refers to the belief of “guilty until proven innocent.” In sports and media cases, however, this is usually uncommon, because we take extreme measures to avoid accusing an individual (especially celebrities) of a crime he or she did not admit.  As of now, Armstrong represents a strong, moral character in both professional athletics and cancer advocacy. A guilty charge will likely result in a dramatic loss of supporters, sponsors, and overall disapproval. HOWEVER, if, in fact, he is found innocent and this is discovered much later on, the public will respond with overwhelming rage towards the “injustice” of the legal team and court power behind the case.

2. Armstrong is considered innocent, and he is actually innocent.

This an ideal situation within the political spectrum. However, just like any other court outcome, it has its share of flaws. For instance, it is far easier to prove innocence over guilt, since guilt demands a certain criteria of evidence. In Armstrong’s case, guilt is hard to prove, since this case refers to past allegations, and Armstrong cannot actually be tested for using performance enhancing drugs. The U.S Anti-Doping Agency will have to dig much deeper to find substantial evidence to convict him of committing the alleged crimes, including looking back at former test results and hearing the eyewitness testimonies of several close teammates. Upon the completion of this battery of tasks, if Armstrong is convicted innocent, some will respond with relief and restoration in an iconic American figure. Others will once again be disappointed in the way law enforcement favors celebrities.

3. Armstrong is considered guilty, and he is actually guilty.

This, too, is considered an ideal situation, because it removes the ambiguity and replaces it with the black-and-white. Above all, a guilty sentence with substantial evidence provides reassurance, in the sense that justice is served. We seek this in high-profile criminal cases, such as murder or rape, when we feel certain that the alleged perpetrator was indeed guilty. If this happens to Armstrong, his prestigious reputation will suffer, and consequently, he will lose many privileges and support he generates as a professional cyclist. However, not everyone will be disappointed. Some supporters will stand by his side and point out that, “most everyone else was doping, too.” In all levels of athletics, cheating is a rampant trend; few, however, actually get caught and in trouble for their crimes. Cycling is not immune to the doping scandal, and Armstrong is hardly a unique case in regards to the Tour De France. A guilty sentence may simply reinforce and bring attention to this epidemic in professional sports, which can help strengthen future laws and disciplinary action. 

4. Armstrong is considered innocent, although he is actually guilty.

This is a realistic representative of the “err on the side of caution” case, and in the legal sense, because we do not convict someone “until proven guilty.” People tend to perceive this as either the best thing we have in judicial court, or the worst, due to its subjective nature. Celebrities have the luxury to afford the best attorneys and public relations teams. The criminal justice system appears to favor individuals with status and affluence, which can explain why famous people often receive lesser sentences or jail time for their crimes than would average citizens. With regards to Armstrong, if this situation occurred, he would essentially “beat the system.” The public response tends to divide when this happens. Avid supporters will likely respond in a smug, “I told you so” manner, whereas those who oppose Armstrong or believe in the doping accusations may refuse to take an innocent charge at face-value and argue that “he’s guilty, but just got lucky, because he’s famous.” This type of behavior was famously displayed with the drawn-out O.J Simpson trial.

In conclusion, Lance Armstrong’s reputation has already shifted from world-class professional cyclist and famous cancer advocate to “the cyclist who may have been doping.” In the next few weeks, that title will change again to “the cheater who doped” or “the cyclist who was accused of dope,” depending on the court outcome. Nevertheless, his sentence will stir even more controversy, because an innocent verdict does not mean everyone will necessarily believe it, just as not everyone will believe he is guilty if given a guilty verdict. And, finally, there will always people who argue that we spend far too much attention on high-profile celebrities, and that this is an irrelevant issue anyway.