Coming from an emotionally honest, loving and stable background, my 12 years of intravenous heroin addiction with over 6-years in 27 different prisons, confused everyone.

Visits from and interviews with Doctors, Psychiatrists, Social Workers, Probation Officers, Addiction Counsellors and even clergy, left me convinced that my state was not only hopeless because it was without definition, but that I was hopeless as an individual because it was me who was carrying this thing around.

As and when I said ‘I just don’t believe addiction is a disease’ I was quietly told that this was all a part and symptom of the addiction and its characteristic denial. My quiet conclusion was ‘well in that case, if it is a disease that tells its victim that it is not a disease, everyone suffers from it’!

I looked around me and all I could see was unemployment, broken marriages, single parents, criminal activity and a persistent niggle of discontent.

I attended between seven and nine meeting a week for four years at NA and/or AA, identifying myself with “I’m Colin and I’m an addict” or “I’m Colin and I’m an alcoholic” – simply because that  was the way things were expected to be done. To question ones diseased status was treated as being in ‘denial’ and in many instances, met with a could shoulder because you must surely be ready to relapse.

The Minnesota Model of addressing my addictions really brought life changing attitudes and beliefs into my view of the world and the role I had to play in life, and its proponents told me that my addiction was a disease – so it must be true, it had to be true, it must be a disease. But still, the niggle would not leave me that I was polluting a really healthy family line by just blending in and becoming like the people I mixed with – just like in my addiction, but I simply did not know that there could possibly be another ‘diagnosis’ to consider. Today I do.

The Socio-Cultural Influence

A very healthy idea within 12-Step recovery circles is one of each individual taking personal responsibility for the use, abuse and addiction to chemicals and for the corresponding consequences of that addiction. Bethesda Addictions Treatment Centre is a very strong advocate for this personal ownership concept and each member of our team strives to ensure that each client passing through our doors gets a clear view of the part they played in the chaos behind them. However, we have learned over the process of many years, working with street kids, down-n-outs and with the wealthier members of society, that addictions are not what we originally thought them to be and that each and every addicted individual person we came across has a wide variety of contributing factors outside of themselves which played a significant role in the problem at hand.

Within each individuals family and personal context we inevitably find attitudes and behaviours which have socially shaped the individual in our care. The nature of society itself plays a significant role in determining the manner in which the individual and his peer group relate to social conditions. The family, the circle of friends, and the environment around them are crucial in both starting and maintaining substance use and abuse. It is under the influence of these primary structures that each individual’s attitude to drugs is developed and at the beginning of the road to ruin of chemical dependency, the chemical supply comes almost invariably from within the immediate social circle.

Compulsive destructive drug use is much more common in poor and underpriviliged communities. These are the people with very little if any prospect of adequate education or material advance, whose families are broken and splintered and who are frequently exposed to criminal behaviour. They have very little to look forward to, very few social skills and inter-personal relationships have very few if any points of inspiratrion and they see no reason to admire or aspire to the values of the affluent whom they see on televison or in the big car driving by.

Bethesda Addictions Treatment Centre has an approach orientated towards The Socio-cultural belief, in full agreement with Peele’s comment in his ‘Social Disease’ theory; ‘addiction in its various forms is an adaptive mechanism widely resorted to by normal individuals in society – by all of us, perhaps. It constitutes a search for something external and secure to give reassurance in the absence of a deeply felt connection with life’ (The Experience of Addiction).

Having now worked in some of the world’s harshest prisons, with the homeless and within the private clinic environment with addicted individuals from the affluent sector of society for many years, I have found the similarities are striking. During the process of exploring the dynamics of addictions across the social spectrum, relevant to each personal context, a state of anomie has inevitably proved prevalent where individuals ‘pursue their own goals with little concern for the common good’. The chemicals used may have varied from the extremely cheap home-made booze to the very expensive crack-cocaine and ecstasy, but the social conditioning of the contrasting cultures produced the same results, treatment for chemical dependency, and the need for the 12-step recovery programme.