Counseling for Addiction: Disease, Choice or Something Much More Complex?

Everyone has their own views and opinions on the origins of addiction.  Some view it as a moral failure; others view it as an inherited disease over which they have no control.  Some view it as proof that someone just hasn’t yet matured.

I hope to one day live in a world where everyone sees it for what it really is: a biopsychosocial condition that can never be explained away with one simple cause.

Attributing addiction to one single factor completely misses the point.  There are biological factors, psychological factors and social factors that interplay off of one another and are completely different from one person to the next.

I write this not only as someone who has suffered from addiction, but also as someone who works with an addicted population on a daily basis.  My nine to five job is that of a mental health and addictions counselor for men in the correctional system who have issues with drugs, alcohol and mental illness.  Never once has a client entered my office and said ‘you know, I just woke up one day and decided to start mainlining heroin.  It just seemed like the sensible thing to do.’

In contrast, what I do hear on a daily basis are the myriad of reasons that someone can get involved with drugs in the first place.  Although there are many variables, the one near-constant is trauma.  I have yet to see someone in my office who has not survived at least one major trauma.  Most have four, five or even ten stemming from early childhood right up until the present day.

Sexual abuse has to be the most common form of trauma that I hear about.   It is actually much more shocking when I get a client who hasn’t been sexually victimized.  Among the homeless, severely addicted, crime-involved men that I work with, sexual abuse is all but guaranteed.  And not surprisingly, most of them have not dealt with it properly until they set foot in my office.

Renowned addiction expert Dr. Gabor Maté, who works in Vancouver’s downtown East Side stated ‘ask not why the addiction, but why the pain.’  And that is a question that addiction workers and the general public need to start asking more often.

I have also yet to meet a client who doesn’t suffer from some form of diagnosable mental illness.  Often, it is major depression or bipolar disorder.  Schizophrenia would come a close second with the anxiety disorders pulling up the rear.  They have used drugs and alcohol to cope with their mental illnesses, because it provided some relief.  Albeit temporary and ultimately harmful relief, but for those few seconds, it provided relief.

It’s easy to look down your nose at someone smoking crack or shooting heroin on the sidewalk.  It’s much more difficult to put yourself in their shoes, and walk a mile with their past dragging you down from the inside out.

Addiction is a complex entity that begs to be understood.  No one chooses to become an addict and no one enjoys spending all their time and money chasing that temporary relief.  But unfortunately, once you are in its grasp, it can be a difficult and life-threatening road to travel.

The war on drugs isn’t working.  We end up incarcerating people whose only crime is coping with terrible life circumstances in the only way they know how.  They were often taught from an early age, either through addicted parents or peers that drugs and alcohol are the only way to cope.  And until someone shows them something different, who are we to judge their decision?

People suffering from addiction need compassion and understanding and tools that they can use on a daily basis to deal with their difficult and complex emotions without resorting to drugs and alcohol.

What they don’t need, is more judgement, alienation and condemnation.

Chris Curry is a counselor, author, public speaker and musician who is dedicated to eradicating the stigma surrounding mental illness.

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Anthony Centore

Anthony Centore Ph.D. is Founder and CEO at Thriveworks--a counseling practice, focused on premium client care, with 240+ locations across the USA. He is Private Practice Consultant for the American Counseling Association, columnist for Counseling Today magazine, and Author of How to Thrive in Counseling Private Practice. Anthony is a multistate Licensed Professional Counselor and has been quoted in national media sources including The Boston Globe, Chicago Tribune, and CBS Sunday Morning.

Check out “Leaving Depression Behind: An Interactive, Choose Your Path Book” written by AJ Centore and Taylor Bennett."