A few years ago, in a hole-in-the-wall tavern in Waikiki, I met a fellow I admired as a Navy veteran and son of a successful Hilo business family. He obviously had great intelligence and was well-read on current affairs.
But he was an alcoholic, and also addicted to marijuana use. That had left him jobless and homeless. He was fired from some jobs. Gave up on others he considered beneath him. He entered a homeless shelter.
Then the Veterans Administration stepped in and assigned him a studio apartment. The VA paid part and he paid the balance from his Social Security disability money. Much of what he had left went for alcohol and to street marijuana sellers.
He’s one of many — some among the homeless we see along Beretania Street between Long’s and the India Store, adjacent to the unused baseball field and a public restroom they’ve commandeered.
Can they be “cured” or at least made functional?
The National Institutes of Health (NIH) says researchers have found that much of addiction’s power lies in its ability to hijack and even destroy key brain regions that are meant to help us survive.
So for the deeply addicted, probably not.
“Brain imaging studies of people addicted to drugs or alcohol show decreased activity in the frontal cortex,” says Dr. Nora Volkow, director of NIH’s Institute on Drug Abuse. “When the frontal cortex isn’t working properly, people can’t make the decision to stop taking the drug even if they realize the price of taking that drug may be extremely high, and they might end up in jail. Nonetheless, they take it.”
The Treatment Research Institute concludes: “There is no ‘cure’ for addiction. But the disease can be managed and recovery is possible. The most successful treatments are modeled after treatments for other chronic, non-curable, relapsing diseases such as diabetes, hypertension or asthma. Helping patients comply with medications which reduce symptoms and adopting new health behaviors.”
Relapse rates for all the substance use disorders are about the same as those for other chronic illnesses, but there are about 20 million individuals who are in stable, long-term (a year or more) recovery. And here’s the breakdown of the gender of addicts under treatment in Hawaii:
But the fellow I know has a “to hell with it” attitude. He knows he’s an addict. He knows about his money problems and the damage to his health. But he doesn’t care. He loves his drink and his weed.
I think that’s a wide-spread attitude and why I’ve tended to give up on our homeless programs for addicts and think the outreach and sweeps programs will just continue to have customers costing us money, with a handful put in marginal housing but certainly not cured.
The abusers generally feel there’s no way out, and so do I.
I’ll get heat for this from the do-good population, but the statistics give me confidence.
A person has to want to be “cured.”
Most addicted persons do not.