Madam, – I was taken aback by Lara Marlowe’s column (“How US obsession with addiction has spawned a rehab industry”, June 18th).
While I agree with her observation that it has become an everyday occurrence for celebrities caught drink-driving, “in flagrante” or with drugs, to just “put their hands up” and side-step the issue by saying they are “going into rehab” in some vain attempt to save face, I totally disagree with her premise that addiction, in all its guises, essentially comes down to choice.
This unfortunately common misperception only serves to make it even more difficult for those in addiction to ask for help – as if the stigma in this country of mental health problems and addiction wasn’t enough.
Perpetuating this view also encourages many people close to those in addiction to mistakenly ask: why don’t they just pull themselves together and sort their lives out – like everybody else? The fact is that they may want to sort their lives out, but can’t, and need professional help. In the article, Steven Slate is quoted saying “. . .the best way to overcome addiction is to find other things that make you happy.” I rest my case.
What wasn’t mentioned in the article is that prevailing medical opinion here and internationally, including the opinion of the two largest and most well-funded governmental research bodies internationally on addiction – the (US) National Institute on Drug Addiction (www.nida.nih.gov) and the World Health Organisation (www.who.int) – is that addiction and substance dependence is a disease. However, even the disease model doesn’t fully capture the complexity of the problem. Addiction is an issue that is exceptionally difficult to address, its causes are multifactorial and include genetics, past trauma, mental health issues, family and the social environment.
Ms Marlowe states that rehabilitation centres are “one of the most unregulated industries in the US”. What she fails to acknowledge is that there are several national and international accrediting bodies for treatment centres in Ireland, the UK and in the US: JCI (www.jointcommissioninternational.org/), HQAA (www.hqaa.org) and CARF (www.carf.org) among them. An addiction counsellor goes through the same accreditation process as a psychologist or any other medical professional and is required to belong to an accrediting body such as the NAADC and ACA in the US and the IAAAC or IACP in Ireland.
The most disturbing perspectives in her article, however, are the first and last assertions – that redemption is only for Americans and lastly that addiction is a choice.
Let’s be clear: addiction is an epidemic in Ireland. According to the 2004 World Health Organisations Report on Substance Abuse, 47 per cent of Irish males are categorised as problem drinkers and in the 2010 report illustrated that “Ireland, along with Eastern Europe, has one of the highest baseline addiction and abusive drinking rates in the world”.
Despite this, Ireland is hugely under-serviced for the effective treatment of addiction. As someone who hails from California, yet works daily in addiction in Ireland, I believe it would benefit us all if even a fraction of the “rehab culture” that exists in the United States existed here – so that addicts who are in desperate need of help can get it and so they and their families can be treated openly, compassionately and effectively. To me, that’s a far better solution than telling them to go off, cheer up and “find other things that make them happy”.
For a more accurate and informed source of information on what addiction is, how it impacts individuals and society, see the 2010 World Health Organisation’s Report on Substance Abuse at www.who.int/substance_abuse/ publications/Media/en/ – Yours, etc,