Dependence and Addiction

by Duncan Vere


read : Dependence and Addiction (Part 1)



Characteristics of dependence
A person who has become dependent in a drug may:

  • Show a progressive craving for a drug
  • Develop a lifestyle that increasingly focuses on their ‘need’ for the drug
  • Become involved in crime to get money
  • physically abuse family members
  • have withdrawal symptoms when they stop taking the drug
  • say ‘I want to stop’, but in fact continue
  • develop a stereotypical pattern of behaviour
  • develop tolerance to the drug
  • return rapidly to dependence behaviour after a period of abstinence

Chief Social Issues

Drugs radically affect the way that people behave towards each other. Consequently there are a number of areas of current debate:

Descriminalisation

One issue is whether we should allow people to have free choice, or whether we should regulate, restrict or ban the sale of addictive drugs.

Some people argue that it is hypocritical to allow the sale of alcohol and tobacco, both of which cause massive damage to people’s health, but ban other potentially safer drugs. They point to the fact that the total number of deaths caused by misuse of alcohol greatly exceeds the number caused by misuse of drugs15, and around 0.9 per cent of smokers die each year of smoking-related disease, compared to only 0.0002 per cent of Ecstasy users.16

Opponents of this view say that if people started to try to market alcohol and tobacco now they would never be allowed. They are only on the market because of the extent to which they are now a part of the fabric of our society and banning them would be impossible. But that does not stop them being dangerous. Decriminalising drugs would simply place another set of damaging products onto the market.

Would this encourage more people to try them and get addicted?

Licensing Laws

Social policy in the UK restrict the sale of many products including tobacco and alcohol. This is done to protect the user and others who choose not to use them.

Is it possible to balance liberties and restraint?

Manufacturers’ profits

Many drugs come originally from parts of the world that are experiencing severe economic hardships. Sales of drugs are a vital component of their economy.

How could people be encouraged to stop producing drugs?

Advertising

New laws are restricting the advertising of alcohol and tobacco.

Wowever, while it is not strictly conventional advertising, tobacco, alcohol and other drugs are frequently used in popular films.

Can this lead to a dangerously relaxed attitude to these products?


Biblical issues
The Bible is comfortable with the idea of using chemicals for both pleasure and medicine (Ps 104:15; 1 Tim 5:23; Titus 2:3). However anything that could cause physical damage is prohibited (1 Cor 6:19-20; Proverbs 23:29-35).

The problem with becoming dependent on drugs is that they cause a loss of self-control. People should not be brought under the control of anything except their own reason and God’s Spirit (Eph 5:18; 1 Cor 6:10-12). Dependence is a form of mental slavery.

It is good to care for ourselves and for others. This is part of the stewardship of people’s lives. It includes avoiding mental and social wounding and involves building one another up in love (Rom 14:19-20; 1 Thess 5:11)

Certain aspects of behaviour that often accompany drug dependence damage spiritual growth. These include drunkenness, promiscuity, harmful relationships and crime.

Within in the Bible, the family is a central focus of personal and community life (Ps 68:6; Jer 31:10). However, family cohesion is severely disrupted by drug dependence3. Where families break down society breaks down (Deut 29:18-29). Drug dependence is so destructive because it can tear families apart.



Kicking an Addictive Habit
To kick any addiction a person may need many things including:

  • a willingness/desire to change
  • an admission that he or she is an addict
  • psychological help to overcome hurts
  • a displacing power of a stronger affection – this could be the fear of the consequences of addiction, a new personal relationship, religious faith, a hobby or even a pet
  • short-term pharmacological help

Self harm

Taking drugs involves risk and young people enjoy taking risks. This is fuelled partly by their tendency to believe that they are in some way immortal, that they personally will avoid addiction even if other people might succumb.

Along with dependence on the compound, drug taking can lead to mental and physical injury such as liver damage, bronchitis and diseases such as liver damage, bronchitis and disease such as HIV-AIDS.

Should people have the freedom to damage themselves if they choose?

Education

Saying ‘no’ to something is never as good as offering a positive alternative.

How can people be encouraged to seek alternatives?

Social cost

Addiction leads to illness, accidents, unemployment, family breakdown, child neglect and violence.

Can the cost be quantified?

Searching for Freedom

Our age is one in which personal choice is held in high esteem. We don’t like to be told what we can or cannot do. Telling people not to take drugs is often seen as authoritarian.

However, the Christian view is that it is damaging to become a slave to anything, and addiction to drugs is a form of slavery. Intriguingly, it is today’s demand for freedom of choice that can lead to addiction.

People are designed to have a relationship with their creator God. We are intended to depend on him and relate to him. Christians testify that in contrast to the restrictions imposed by addiction to drugs, dependence on God is the route to real freedom.

Helping people regain their freedom by breaking addictive habits is never easy and treatment programmes are expensive.
There is plenty of evidence that long-term treatment and rehabilitation offers the best hope. For every £1 spent on treatment there is a £3 saving associated with reduced crime.17

While some people find that they can control their addictive habits, many more find that total abstinence is the only way to rebuild their lives.

We need to provide help that matches individual needs, and that develops as the person makes progress along the path leading away from addiction Any help offered should aim to increase the person’s ability to make decisions, restore his or her ability to work and to reinstate personal and family relationships.

References

      14. True WE(1999) Archives of General Psychiatry 56: 655-661
      15. Population Trends (1994) 76: 7
      16. Gossop M (1998) Living with drugs, 111-112
      17. Drug Driven Crime (1999) A report by the National Association for the Care and Resettlement of Offenders

Christian Medical Fellowship (CMF) Files No. 08, 1999


Duncan Vere is a hospital general physician (retired) with a special interest in drugs and treatments. He is Professor (Emeritus) of Therapeudics in the University of London and a Fellow of the Royal College of Physicians and the Faculty of Pharmaceutical Medicine.