Blog Post 2 Continued

Blog Post 3

The most significant learning that I have engaged with so far at Drug Policy Australia (DPA) began while I was drafting a newsletter email to be sent to the broader membership of DPA. Once I had finished the segments of the email dedicated to recent global policy changes in the drug policy space, Greg asked me to write a short segment relating to the nature, cause and definition of ‘addiction.’ Addiction is conceived of in many different ways, and I have even heard the appropriateness of the word itself be called into question. So, to help me look up a Canadian physician called Gabor Mate, who has worked in, and written extensively about addiction recovery services. After watching this video, I was quite inspired and went down a rabbit whole watching and reading Mate’s thoughts on addiction, its origins and how this relates to broader patterns of social integration as well as medical and public health practices. Mate builds on his work in the field of addiction to make broader claims about the relationships between the surrounding social environment, addiction, self-actualisation, biological health, and essentially human characteristics.

Mate defines addiction as a pattern of behaviour which is pleasurable or temporarily relieves pain, but also has negative consequences in the long run and despite these consequences, the individual will return to the activity time and time again. Importantly, substances do not feature in this definition. Historically – and these ideas are embedded in the policy framework which prohibits drug consumption – addiction has been conceived of as a choice which is indicative of a moral failing of the addict. Contemporarily, the conventional wisdom in relation to addiction is that it is a disease of the brain inherited through family lineage and passed on through the genes. This problematises the drugs themselves, through their interactions with physiological predispositions of specific individuals, as being at the heart of the addiction. However, this cannot explain why people are addicted to activities like shopping, gambling, sex, work, or smart phones. If an addiction is conceived of in purely biological terms, a disease of the brain, this frames and limits the scope of activities we can undertake to address the harms associated with addiction.

In his work in communities where addictions to illicit substances was prolific, Mate observed a thread that was common to addicted people. Trauma and dysfunctional early childhoods were experienced by the most addicted people. It follows then, that to understand addiction in its entirety, we have to observe the complex interplay between human biology, psychology, and the surrounding environment. The disease model of addiction understands addiction in genetic terms. Individuals a pre-disposed to addictive behaviours because they have a genetic predisposition which is hereditary and passed on through family lineage. However, the physiology of the brain is not static. It is elastic, and is innately susceptible to change, particularly during early childhood. Where a child has unmet emotional needs at a young age, the likelihood for addiction – among other biological and psychological health problems – is significantly higher. The bio-psycho-social model of addiction offers not just a more wholistic way to understand the causes of, and appropriate treatments of addiction, but applied more generally, can reveal a deeper truth about the nature and causes of illness in society.

The bio-psycho-social model implies that the mind, body and social world are in a constant interplay whereby each entity is in a process of mutual [re]constitution. The distinction between the mind and body is broken down, revealing a diffuse network of actors and forces which are complicit in creating the cognitive, biological and social structures which govern our lives. If the environment impacts the psyche, which impacts the physiological structure of the brain, then it is possible to draw a deeper connection between the social environment we live in and our physical biological health. Traumatic events happen as a result of actions conducted in our social environment. The manifestation of these traumatic events is trauma. It results from something that happens to us, that then becomes embedded, subconsciously, within ourselves and guides our relationship with the outside world. Trauma, at its core, is a restriction on our authentic expression when we respond to certain stimuli. It becomes clear, that emotions are inseparable from not just our emotional well-being, but also our physiological health, and in turn our biological health. This is not to ignore the fact that some illness is purely manifest our biology – genetics. However, an increasingly powerful body of evidence indicates that the hidden root cause of otherwise causally undetermined illnesses such as cancer, heart disease, multiple sclerosis, arthritis as well as many other neurodegenerative diseases lies in emotional stresses, onset in early childhood and perpetuated throughout our adult lives, resulting from our surrounding social environment. People will often pass off hand remarks about social forces, actors or entities describing them as a cancer on our society. For instance, a revolutionary Marxist might pass comment that ‘capitalism is a cancer on society.’ Such ruthless and blindly aggressive accusations may be closer to a direct comparison, as opposed to an analogy. In other words, to understand disease in its entirety, we need to understand the person in their entirety. This includes understanding our social world and its impact on our minds.