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The $36 Billion Dollar Question

Updated: Apr 3, 2019

I loosely follow this woman on youtube who got off of suboxone a little before I did. I loved her updates and the fact that she was unabashedly herself. When I say loosely, I mean I probably only watched 5 of her many, many videos in the past two years. A couple of days ago I watched her most recent update, and she mentioned that she went back on a low dose of Suboxone. I looked back at the titles of all of her vlogs and noticed that in the past two years she has gotten off and on Suboxone three times. Why do some people get over their addictions and others do not? This is the $36 billion question*.

After reading a few of the comments on her vlog, I noticed a few people commenting about being addicts, and one person, in particular, wrote that, because she was an addict, anything that makes her feel good she does in excess. This is the type of mindset, the once an addict always an addict in all things, is one of the paradigms that need shifting. When we say things like, “I am an addict/alcoholic/etc.,” we make them so (I wrote about it two weeks ago). Sure, I was an addict, but, I am not an addict now.

The current medical model labels addiction as a disease. This contributes to the paradigm that addiction is something that cannot be cured—that your addict is always in the back of your psyche doing pushups, waiting for you to slip up. I don’t believe that addiction is a disease. Imma repeat that: I don’t believe there is enough scientific evidence to support the hypothesis that addiction is a disease and I definitely don't believe that my addict is doing pushups in some dark place in my mind. It is easy to jump on the addiction is a disease wagon because the insurance companies will pay for the treatment. I also think that it slowly forces us, as a society, to stop seeing addiction as something morally wrong.

The Desire of Biology by Marc Lewis, Ph.D. looks at the neuroscience behind addiction. He challenges the main argument for addiction being a disease: that addiction changes the structure of the brain; therefore it is a disease. Our brains were born to change. Not only does Lewis do a thorough job of describing how the brain changes during addiction, but he also talks about the normalcy of the brain changing, something known as plasticity. The brain is meant to change, that is what it does. It is for this reason babies can learn to talk and walk and so forth. Meditation also changes the structure of the brain, but it would be absurd to call it a disease.

One powerful takeaway from Biology of Desire is that the reduction of grey matter in specific regions of the prefrontal cortex of the brain (impulse control) were returned to baseline levels within six months to a year of abstinence. However, that was not the end of it; grey matter levels continued to grow beyond the baseline levels recorded for people who have never been addicted. Lewis hypothesizes that this might mean that people who are no longer addicts regain their self-control, but also develop novel strategies for self-control (Lewis 2015). Though Lewis cautions that this is only one study and we should not be presumptuous, he notes that the results are interesting and worth further investigation.

This is exciting news. but how do people decide it is time to claw their way out of the well of addiction?.

Lewis speculates that for addicts, time is not linear but a circle that goes around and around. I think that anyone who has been addicted to a substance that has taken over their life can attest to this analogy. When I was using heroin, I was in a hellish cycle of getting dope, using the dope, figuring out how to get more and it went on and on and on. Lewis talks about the addicted person being able to have space to reflect on the past and present and imagine a better future. But how does someone in a deep dark well of addiction gain the gift of a shift in perspective?

For me, I knew that being a junkie was not who I was meant to be forever. I knew that I was a tourist in a foreign land, but it took my paycheck getting garnished for not paying my student loans to shock me out of my revery and back into my life. I struggled for a while teetering back and forth between abstinence and “recreational” use and eventually wound up on Suboxone. Almost 8 years later, once again, it took me seeing a future where Suboxone played no part to compel me to finally leave it behind. I have not looked back since.

After watching the woman’s vlog, I wonder, what is the difference between her and I? Why was I able to get off of Suboxone successfully and she was not? Was it because I was on it forever or was it because I had a super fucking strong future narrative? I guess that is the $36 billion question.

* $36,000,000,000 is the amount that I found when looking for the expenditure on rehab per year in the US. I am not even sure if it is real, but it had a nice ring to it.

Biology of Desire, by Marc Lewis PhD can be purchased at your local bookstore or at online bookstores as well.

Check out his blog here.

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