Expert: In dealing with addiction, brain is really just another organ


emily's and cody's opioids-SET Jackson

In an arsenal of tricks developed solely to keep using drugs, shame proved to be the most effective weapon.

For 16 years, Shayna Wheeler had been mired in addiction, developing a dependence on everything from alcohol to pain pills to meth and heroin. She was ashamed of her behavior, which led her back to the drugs to escape those feelings.

But she also knew that those who loved her felt uncomfortable with her addiction. They didn’t want to confront her, no matter how out-of-control her actions became.

That was how the addiction survived.

“Addiction works when it gets to hide. It works when it gets to be quiet, when parents and grandparents and loved ones are meant to feel uncomfortable, so they don’t bring attention to it,” Wheeler said.

For people who have been addicted themselves, their family and loved ones or people who work to treat dependency, the stigma of addiction is one of the greatest barriers to treatment and recovery. Addiction, classified as a chronic disease, carries with it a shame that other diseases do not have.

No one would be made to feel immoral or evil for receiving treatment for other conditions such as diabetes, heart disease or learning they had cancer. But addiction is treated differently, and that’s an issue driving the opioid crisis every day, said Justin Phillips, founder of Overdose Lifeline, an Indianapolis-based nonprofit dedicated to preventing opioid deaths.

“We judge people with addiction all the time,” Phillips said. “There are still plenty of people in the state of Indiana and throughout the country who feel that people who overdose should die and that we should not be saving them.”

The shame surrounding addiction is part of a larger stigma attached to mental illnesses and the brain in general.

Only in 2011 did the American Society of Addiction Medicine define and classify addiction as a chronic disorder, a disease that affects important parts of the brain. That changed previous definitions that classified it as a behavioral or emotional condition.

Acceptance of that definition — by doctors, by legislators who make decisions about funding for research and treatment, by the public — has not been universal, said Dr. Ruben Baler, a neuroscientist and health science administrator for the National Institute on Drug Abuse.

The problem stems from the tradition of thinking that the brain is somehow different from the pancreas or the liver or other organs; instead, people tend to think of the brain as something special.

“We tend to believe that’s where the ‘me’ resides, the person, the soul, the spirit,” Baler said. “That brings about all sorts of concepts that are really strange and don’t belong in biology and medicine, but have really hampered our understanding of mental illness. They’ve made us blind to the fact that the brain is really just another organ.”

Because of the shame surrounding addiction, many people are afraid to ask for help, said Dr. Joseph Niezer, a psychiatrist for Franciscan Health Network Psychiatric Specialists in Indianapolis.

Niezer joined Franciscan Health in August, after completing the psychiatry and neurology program at Indiana University School of Medicine. In addition to being chief resident with the psychiatry program, he worked one or two nights a week for the Kolbe Center, an addiction clinic in Broad Ripple.

Every day, he dealt with people who were begging for treatment for their addictions, more often than not to opioid drugs.

“There was no shortage of demand. The owner of the clinic had people calling him constantly asking for help, and we just didn’t have the capacity,” Niezer said.

From his training, he has learned that people dealing with addictions become pretty good at hiding their behavior from the people close to them, and that hiding is driven by a sense of shame.

“This is a brain disease, and people shouldn’t feel ashamed to get treatment for it,” he said.

Phillips has struggled with her own addiction to alcohol before starting recovery more than 20 years ago. She never was addicted to opioids personally, but her son, Kevin Sims, died from a heroin overdose in 2013.

Shortly after his death, she founded Overdose Lifeline in part to help open discussions about opioid addiction, particularly among parents and loved ones.

But removing that stigma is hard, Phillips said.

Part of the difficulty for many people to be open about addiction is that the behavior of people who are addicted is so illogical, Phillips said.

“That they love you but they’d still steal from you, that they know they can overdose and die but can still use, that’s very illogical,” she said. “We have equated self-will and morality with alcohol and drug abuse since the beginning of time.”

The fear of being judged leads someone in addiction to hide their behavior and sneak around. Even if they realize that there’s a problem with their drug use, they can’t go to anyone to ask for support because they are ashamed.

“It’s already hard to ask for help, let alone when you think someone will judge you,” Phillips said.

Parents of children using opioids also have a fear of being judged. Their child’s drug use reflects on them, and often people think that they did something wrong to lead their kids to become addicted.

“How could I have not saved my kid or done better? But the truth of the matter is, with the truth of the disease of addiction, we could get that individual the best care in the world, but if they don’t want it, they won’t get better,” Phillips said. “That’s hard too. At the end of the day, it’s on them.”

Processing those feelings, and being open about addiction in the family, can be the hardest aspect for parents.

But that’s what you have to do to help your child get over addiction, Wheeler said. In her own experience, she is adamant that silence, hiding the problem, is the worst possible approach.

“You have to be open, and you can’t allow someone who has an addiction keep running the show. It’s not the person who is running it, it’s the addiction. So you have to separate your child from the addiction,” she said.

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