We can start by thinking about addiction as an "adaptation" to trauma, rather than a disorder.
The opioid epidemic has become familiar territory in the news. For most Americans, it’s become familiar territory in our everyday lives as well — almost all of us know someone who’s been snared by opioids (synthetic prescription drugs like hydrocodone, oxycodone, and fentanyl, or the cheaper and more pervasive heroin). Opioid overdoses now kill more Americans than car crashes and gun homicides combined, and are so ubiquitous that public librarians are being trained to reverse overdoses.
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But our government and medical professionals have yet to offer a unified response to this still-growing public health crisis, in part because there is no clear answer to the fundamental question: why?
There are a myriad of causes that created this perfect storm of drug addiction, of course, from economic stagnation to pharmaceutical greed. But the “why” of addiction itself is still the the focus of intense debate and disagreement, leading to a schizophrenic response from lawmakers.
However, Dr. Daniel Sumrok says he’s found the cause of addiction — and that it’s a normal, predictable response to childhood adversity.
Ritualized compulsive comfort-seeking (what traditionalists call addiction) is a normal response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed. … The solution to changing the illegal or unhealthy ritualized compulsive comfort-seeking behavior of opioid addiction is to address a person’s adverse childhood experiences (ACEs) individually and in group therapy; treat people with respect; provide medication assistance in the form of buprenorphine, an opioid used to treat opioid addiction; and help them find a ritualized compulsive comfort-seeking behavior that won’t kill them or put them in jail.
Dr. Sumrok is the director of the Center for Addiction Sciences at the University of Tennessee Health Science Center’s College of Medicine, and is one of the first 106 physicians to become board-certified in addiction medicine. He began studying addiction in Vietnam vets suffering from PTSD, but he didn’t realize the importance of ACEs until he began working in an eating disorders clinic and learned that 90 percent of patients had experienced childhood sexual abuse.
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Dr. Sumrok explains that addiction of any kind is a normal response to trauma, and not a disorder. It is, in fact, a brain adaptation — human brains are plastic, and they react and change in response to extreme stress and trauma. The amygdala can’t cope with toxic stress overload, so the brain desperately seeks a coping mechanism. These children are not taught to cope with stress in healthy and normal ways, but are left to fend for themselves … so their brains protect themselves in whatever way they can.
But brain plasticity works both ways, and the growing field of resilience research is yielding promising results. People can learn healthy coping mechanisms to help them come to terms with and overcome their childhood trauma. For Dr. Sumrok, the first step in helping patients go down that road is to treat them with respect, instead of blame and shame.
Although I can’t say childhood trauma played a role in my own struggles with addiction, this rings true to me. People who haven’t experienced addiction often don’t believe us when we say that addicts hate their drug of choice, and dream of getting clean with the same kind of longing a prisoner must feel for open roads. Often, it isn’t economic barriers that keep addicts away from recovery — it’s the shame tied up with addiction. When a person is in intense physical and psychological pain, the emotional pain of being treated with contempt can be too much. This, along with the fear of being handed over to law enforcement, can keep addicts trapped in a hell of addiction.
Treating drug addicts with simple human dignity and compassion is essential if we want any chance of stemming the tide of the opioid crisis. Dr. Sumrok’s answer to the why of addiction could go a long way toward helping policymakers, doctors, and the general public see the victims of the opioid crisis as they are — victims of trauma, responding in the only way they know how.