For more than 20 years, I have worked with countless clients struggling with addiction, but one story of transformation has stayed with me. Despite a lifelong battle with drugs and alcohol, Michael, as I’ll call him to protect his privacy, remained dedicated to breaking their grip on his life. During his time at a treatment facility, I observed his hard work to change his thinking and behavior, and I will never forget what he shared during a graduation celebration: When he was 8 years old, his parents gave him an Easter basket filled with a six-pack of beer.
That story has always moved me, both as a licensed chemical dependency counselor and as a woman of strong Christian faith for whom Easter has such personal meaning. That story points to the complexities of addiction, treatment and recovery. September marks National Recovery Month, which raises public awareness for mental health, addiction and recovery, and it provides an opportunity to think about the true face of addiction in the United States — and how we can help reverse a terrible trend.
It is far too easy for people to believe that addiction is a flaw in someone’s character, the ultimate result of poor choices in life. But for the 46.3 million Americans — an astounding 16.5% of our population — who are believed to have a substance abuse disorder, according to the most recent data available, that is far from the whole truth.
Even my understanding of how addiction affects the brain shifted dramatically as I pursued a master’s degree in mental health and addiction counseling. My education affirmed what I had observed earlier in the field: Individuals in the throes of active addiction have lost the choice to not use because addiction is a chronic brain disease.
As an organ, the brain has two primary jobs — keep the body alive and think. If addiction is a brain disease, and the brain’s job is thinking, not only is it logical to conclude the addict’s thinking is impaired, but the addict’s behavior also affirms this conclusion.
Addiction affects the addict and all those who love the addict. Remember Michael? He grew up modeling behavior seen in his family. When a child continually sees a parent use mood-altering substances, including alcohol, to get through their day, the lesson and the behavior leave a deep imprint.
Unfortunately, statistics reveal substance abuse is worsening. The number of drug overdoses in the United States resulting in death has been rising for the past two decades. Based on the most recent data available from the National Center for Health Statistics, published in December 2022, the COVID-19 pandemic exacerbated this disturbing trend. For example, the age-adjusted rate for drug overdose deaths jumped more than 14% from 2020 to 2021, and adults aged 65 and over had the largest percentage increase during that time.
And then there’s fentanyl, which is 50 to 100 times more potent than morphine. Its increasing availability has made it responsible for more deaths of Americans under the age of 50 than heart disease, cancer, homicide, suicide or accidents. According to the Centers for Disease Control and Prevention, in the 12-month period ending in January 2022, 67% of overdose deaths involved synthetic opioids like fentanyl. Given the prevalence and dangers of fentanyl, anyone who uses drugs now runs the risk of an overdose.
Those national statistics are reflective of what we are seeing in North Texas. More than 1,100 North Texans have died since 2021 from fentanyl, according to state health department data. At the Salvation Army, which operates treatment and rehabilitation programs, we have seen those trends mirror those of the community at large.
But what is so often overlooked — and a story like Michael’s confirms — is the degree to which so many of our clients are struggling with childhood trauma and co-existing conditions related to mental health. While the larger problems facing the addict we see on TV or on the street corners are visible, untreated trauma and mental health needs are the invisible issues that keep individuals trapped. Compassion looks beyond the surface, scary as it might be, and recognizes the hurting person and reaches out to offer help.
If I could change one thing about our understanding of addiction in this country, it would be for us to see the humanity of those who are struggling. No child says that they want to be an addict when they grow up; no teenager says they want to live on the street because of drugs and alcohol.
A profound series of events brings each person to the depths of addiction before they are able to ask for help, and unfortunately, that typically happens only in moments of deep crisis. But compassion and access to treatment can help turn the tide. Michael shared this when giving his testimony during graduation from a six-month rehabilitation program where he was able to learn new ways of thinking, practice new healthy behaviors, and find hope in the world of recovery. Now filled with hope, Michael found a new life and a new future. That’s the outcome I want for anyone struggling with addiction.
Dawn McFarland is a licensed chemical dependency counselor. She serves as the area commander for the Salvation Army of North Texas and is a member of the board of governors of the Hazelden Betty Ford Graduate School of Addiction Studies. She wrote this column for The Dallas Morning News.