If you follow social media at all, you may have noticed some spirited back and forth surrounding the recent application by TLC Maryville for a certificate of need to open a Medication Assisted Treatment program in downtown Maryville.
There’s an opinion piece in today’s edition that’s an answer to an opinion piece last week by CEO Steve McGrew of Cornerstone of Recovery (full disclosure: my full-time employer), which was itself a response to a front-page story a week ago by my old colleague Bob Norris about the venture.
Long-story short: It’s a lot of back-and-forth about specific wording of what does and does not constitute an “Opioid Treatment Program,” and for a county with such a drug problem, such quibbling about semantics overshadows a larger point: We’re really fortunate that addicts and alcoholics have the options that they do for help. Because consider: While overdose deaths in Blount County dropped from 54 deaths in 2017 to 45 deaths in 2018, according to Tennessee Department of Health statistics, other numbers weren’t as positive. Opioid overdose rates remained largely unchanged (27.2 to 27.1 people per 100,000 residents from 2017 to 2018); opioid drug overdose deaths increased from 29 to 30; and heroin overdose deaths doubled, from 5 in 2017 to 10 in 2018. That drastic increase in heroin overdose deaths is largely due to tighter restrictions on prescription opioids driving users to switch to street opioids like heroin, which are increasingly cut with the powerful narcotic fentanyl. Clearly, there’s an overwhelming need for recovery, and whether it’s TLC Maryville or Cornerstone of Recovery or Celebrate Recovery or True Purpose Ministries or various 12 Step programs, I don’t think there’s any danger of the field becoming overcrowded or running out of people to help. It might seem rather counterintuitive to a business plan — because some of us are indeed businesses that require a transfer of cash for the services we provide to keep the doors open — to hope that eventually we go out of business, but for those of us in recovery as well as in the business of it, that’s absolutely true. Speaking solely for myself — but knowing others in recovery the way I do, I feel safe in saying that Zac Talbott probably feels the same — I would love to live long enough to see a day when addiction is nonexistent and we all have to shut our doors … but barring alien visitors showing up with a cure to all of mankind’s woes, that’s not likely to happen.
What can, however, make our jobs easier and our services more successful is the continued change in the public mindset of what addiction and alcoholism truly are. Because time and time again, whenever it’s bandied about on social media, there are inevitably those who chime in with opinions born often from a place of pain and fear instead of reality. In that regard, I’d like to address a few common claims we see on a regular basis.
• “Addiction is a choice, not a disease.” Slow your roll: The American Medical Association declared alcoholism as a disease in 1956 and classified addiction as such in 1987. These days, the National Institute on Drug Abuse, the American Psychiatric Association, the American Psychological Association, the American College of Physicians, the National Association of Social Workers, the American Hospital Association, the American Public Health Association and the World Health Organization all classify addiction and alcoholism as legitimate medical conditions. I get it; because it doesn’t look or present as what we think of as a typical “disease,” it can be difficult to accept that concept. The American Society of Addiction Medicine defines it as well as anyone: “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations.” While I appreciate enthusiastic discourse on a number of social and political issues, you’ll pardon me if I choose to believe the designations about addiction and alcoholism of those in the fields of medicine and science over the behavioral health expertise of Uber drivers and massage therapists.
• “But nobody chooses to get other diseases. That doesn’t make sense.” Actually … what about lung cancer, caused by smoking? Diabetes and heart disease, caused by poor diet? Inevitably, those insistent on debate will counter with examples of those particular diseases having other causes, and they do. But what about sexually transmitted diseases? You can’t contract those unless you make a choice to engage in sexual activity, but are they any less legitimate illnesses because of that choice?
• “Saying it’s a disease is just an excuse.” Again … I get it. Addicts and alcoholics cause a great deal of harm, hurt those who care about us and can be financial and legal burdens on society. But those who feel that saying addiction and alcoholism are diseases is tantamount to a “get out of jail free” card need to learn more about the recovery process. Every single recovery program advocates and teaches personality responsibility … acceptance … changing behavior … and making amends, even if that means serving jail time. I have a friend who’s currently four months into a three-year sentence for her actions during her addiction, and while she of course didn’t want to report to prison, she accepted that serving time is something she has to do to pay her debt to society. Are there addicts and alcoholics who may use it as an excuse? Of course, but that goes for anyone with any other illness and a “poor, pitiful me” mindset.
At the risk of sounding repetitive, I get it. Addiction is a touchy subject, and those afflicted often sicken everyone else around them — with fear, with anger, with depression, with resentment. So many comments I see on social media are from individuals who have been hurt, but whether you’re one of those individuals or just want to learn more about these afflictions, please don’t hesitate to reach out to one of the resources Blount County has to learn more.
Whether it’s Zac and his team at TLC Maryville or mine at Cornerstone of Recovery or all the rest of us fighting to save lives, we want to educate the public as much as we want to rehabilitate those who suffer. Because by doing the former, we broaden the safety net supporting the latter, and the entire community benefits.